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Reporting hospital quality

Reporting hospital quality. Ben Yandell, PhD, CQE System Associate Vice President Clinical Information Analysis ( CIA ) Norton Healthcare. KHC Reporting Workgroup. Use existing, externally-defined indicators Hospital Compare website by CMS* Select indicators used in

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Reporting hospital quality

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  1. Reporting hospital quality Ben Yandell, PhD, CQE System Associate Vice President Clinical Information Analysis (CIA) Norton Healthcare

  2. KHC Reporting Workgroup • Use existing, externally-defined indicators • Hospital Compare website by CMS* • Select indicators used in • value-based purchasing • readmission reduction program • Update quarterly * CMS is the Centers for Medicare & Medicaid Services; a federal agency

  3. 5 scores • Outcomes • Ratings by patients • Clinical process • Efficiency • Readmissions With component details available

  4. Outcomes • 30-day survival after hospitalization - heart attack - heart failure - pneumonia • Hospital-acquired infections - bloodstream - urinary tract infection - surgical-site • Complications - Pressure Ulcer (“bed sore”) - Blood clot - Bloodstream infections - Pneumothorax (“collapsed lung”) - Sepsis (a severe reaction caused by infection) - Surgical incision problems - Unintended puncture or cut during surgery - Postoperative Hip Fracture (usually due to a fall)

  5. Outcomes Death rate for heart attack patients (CMS Hospital Compare. Medicare patients; risk-adjusted 30-day)

  6. Ratings by patients • Overall rating of hospital • Communication with nurses • Communication with doctors • Responsiveness of hospital staff • Pain management • Communication about medications • Cleanliness and quietness • Discharge information • “Consistency” – based on the lowest-scoring item

  7. Ratings by patients Overall hospital rating (CMS Hospital Compare. All inpatients; % rating 9 or 10 out of 10)

  8. Efficiency • Medicare expenses from 3 days before through 30 days after hospitalization. Average annual spending per Medicare beneficiary for all Medicare-reimbursed care: hospital, physician, rehabilitation, durable medical equipment, etc.

  9. Efficiency • 3% more efficient – Kentucky average • 2% more efficient – U.S. average; Baptist • As predicted – Jewish & St. Mary’s • 1% less efficient – Norton Hospitals, Floyd Memorial, Clark Memorial, Indiana average • 2% less efficient – U of L Hospital Compare 1/11/14; calendar year 2012 data

  10. Clinical process • Heart attack patients receiving medication to dissolve blood clots received it within 30 minutes of arrival • Pneumonia patients received recommended initial antibiotic • Surgical patients received recommended antibiotic • Antibiotic discontinued as recommended after surgery • Urinary catheter removed on postop day 1 or 2 • Beta-blocker continued postop • Surgical patients received recommended blood-clot prevention • Hospitalized patients received influenza immunization

  11. Clinical process Urinary catheter removed after surgery (CMS Hospital Compare. All inpatients; urinary catheter removed within day or two.) Footnote 2. Data based on sample.

  12. Readmissions • Heart Attack • Heart Failure • Pneumonia • Chronic Obstructive Pulmonary Disease • Total Hip and Total Knee Replacement

  13. Readmissions Readmission after hip or knee replacement (CMS Hospital Compare. Medicare patients ; risk-adjusted 30-day)

  14. 5 scores • Outcomes • Ratings by patients • Clinical process • Efficiency • Readmissions With component details available

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