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Hospital Quality Initiative:

Hospital Quality Initiative:. Preparing for Public Reporting. Presenters. Evan Stults Executive Director, QIO Support Center for Communications Qualis Health. Cassie Sauer Director, Advocacy & Public Relations Washington State Hospital Association. Earl Kurashige, RN Project Manager

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Hospital Quality Initiative:

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  1. Hospital Quality Initiative: Preparing for Public Reporting

  2. Presenters Evan Stults Executive Director, QIOSupport Center forCommunications Qualis Health Cassie Sauer Director, Advocacy & Public Relations Washington State Hospital Association Earl Kurashige, RN Project Manager Qualis Health

  3. Guests • Rick McNaney, Government Task Leader, QIO Communications, CMS Central Office • Diana Migchelbrink, Project Officer, CMS Seattle Regional Office

  4. Webcast Outline • Background on the quality initiative • State and national launch activities for public reporting of quality data • How to leverage public reporting for your hospital’s benefit • Messages and positioning your hospital’s quality improvement efforts • The future of the Hospital Quality Initiative

  5. Background on the Hospital Quality Initiative

  6. Quality Improvement Organization (QIO) • In Washington State: Qualis Health • Contracts with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services (DHHS) • Works with health care providers to improve the quality of care

  7. The Hospital Quality Initiative • Voluntary program for measuring hospital quality • Provides information to improve hospital quality and to help consumers make more informed decisions

  8. The Hospital Quality Initiative(cont.) • Supported by AHA, AMA, Federation of American Hospitals, Association of American Medical Colleges, JCAHO; also consumer, union, and business groups • Measures quality in three standardized areas: heart attack, heart failure, pneumonia

  9. Timeline • Spring / Summer 2004: Hospitals voluntarily enroll • August 2004: Hospitals submit 1st quarter data • November 2004: Hospitals submit 2nd quarter data • December 2004: 1st quarter 2004 data posted at www.cms.hhs.gov • Mid-February to mid-March 2005: Hospitals can preview 1st and 2nd quarter data • March / April 2005: Public reporting begins at www.medicare.gov

  10. Components of the Quality Initiative • Community-based quality improvement support • Consumer information for informed decision-making • Collaboration and partnership to leverage knowledge and resources • Regulation activities by state survey agencies and CMS • Incentive for hospitals to voluntarily report quality measures

  11. Benefits of the Quality Initiative – Hospitals’ View • Create one uniform set of quality measurements • Eliminate duplication and confusion with different money-making quality programs • Engage hospitals in choosing measurements that make sense • Receive higher Medicare payments

  12. Three Components of the Initiative • Hospital Quality Alliance (HQA), formerly the National Voluntary Hospital Reporting Initiative (NVHRI) • Medicare Modernization Act of 2003, providing an annual payment update incentive for reporting hospital quality data • Hospital Patient Perspectives on Care Survey (HCAHPS)

  13. MMA Payment Issues • Fiscal years 2005 - 2007 • Participation allows hospitals to get full market basket update • Non-participation: market basket minus 0.4%

  14. Market Basket versus Market Basket Minus 0.4% • Total value for Washington: $5 million annually • Examples of individual hospital benefit (annual figures): • Mason General Hospital: $21,000 • Yakima Valley Memorial: $86,000 • Sacred Heart: $386,000 • Swedish: $492,000

  15. Critical Access Hospitals • Washington has many (37) • No payment benefit • Some difficulty collecting data • Over 400 signed up nationwide • CMS to address appropriate quality measures of care • Encouraged to sign up, even if not ready to submit data

  16. The Data in Hospital Compare

  17. The Measures

  18. The Measures Heart attack • Aspirin at arrival • Aspirin at discharge • Beta-blocker at arrival • Beta-blocker at discharge • ACE inhibitor for left ventricular systolic dysfunction (LVSD) Optional: • Adult smoking cessation advice/counseling • Thrombolytic agent received within 30 minutes of hospital arrival • PTCA received within 90 minutes of hospital arrival

  19. The Measures (cont.) Congestive heart failure • Left ventricular function (LVF) assessment • ACE inhibitor for left ventricular systolic dysfunction (LVSD) Optional: • Discharge instructions • Adult smoking cessation advice/counseling

  20. The Measures (cont.) Pneumonia • Mean time to first antibiotic dose • Pneumococcal screening and/or vaccination • Oxygen assessment Optional: • Blood cultures performed before first antibiotic received in hospital • Adult smoking cessation advice/counseling

  21. Preview Your Data • First, know your data • Preview period is now - closes March 10 • Make sure you have reviewed your data • Serious problems: contact Earl Kurashige • Consider sharing your data with others in your media market so you are all prepared

  22. How to See Your Data • QualityNet Exchange webpage www.qnetexchange.org • Accessible to hospital’s QNet Administrators • My QNet Home/HQA Preview Reports

  23. Understand Your Data • Review your performance data • Compare with national averages • Think about how to interpret the data • Consider how will the public or referral sources will interpret the data and what you can tell them • Research whether you have seen improvement since you started gathering data

  24. Share Information • Know the staff who compiled the data for the quality initiative • Inform your administrator, staff, physicians, and referral sources about Hospital Compare • Involve your governing board • Prepare for questions • Be proactive – educate your patients and the public, promote your hospital’s quality efforts

  25. Washington’s Data • Washington hospitals are about average on most measures • Below average on pneumococcal vaccinations

  26. The Public Launch of Hospital Compare

  27. National Activities • March / April 2005: Web launch of Hospital Compare • CMS’s launch activities for previous quality initiatives (nursing home, home health) included: • Press conferences in Washington, D.C. • Other earned and paid media • National media outreach

  28. Local Activities • Media release for earned media • Profiles of providers’ quality improvement successes • Press conference, possibly at Harborview • Hospitals in other areas can work together to do a joint press conference • Outreach materials for consumers

  29. Purchased Advertising • Qualis Health providing funds to purchase advertising with WSHA • Qualis Health and WSHA logos • Message will feature collaboration and partnership • Ads will refer patients to web site

  30. WSHA Position WSHA Board Resolution: May 2003 • Encourages hospitals to participate • Affirms intention not to use any information generated for competitive marketing purposes • Supports advancing best practices in health care and improving health care

  31. Promote Hospital Participation • Public reporting offers: • More information to help consumers make informed decisions about hospital care • More resources to help hospitals improve care • The opportunity for collaboration between hospitals, Qualis Health and WSHA • Communicate your hospital’s enthusiasm for the Hospital Quality Initiative

  32. If Your Data Are Good • We are pleased with our performance. • Explain why you think your measures are good. • These findings reflect our dedication to the care and comfort of our patients. • These data represent a snapshot in time; quality is a priority that must constantly be monitored.

  33. If Your Data Are Mixed • We are pleased with our positive performance. • We will examine those areas where there are opportunities for improvement. • We have already seen improvement in xxxx. • Describe what you are doing to improve. • If you have new data, share it.

  34. If Your Data Are Poor • We are dedicated to the care and comfort of our patients and these data help us focus our efforts on areas to improve. • We are taking all necessary action to ensure quality of care at our facility. • We have already seen improvement in xxxx. • Describe what you are doing to improve. • If you have new data, share it.

  35. Data Limitations • We are just at the beginning of providing data on hospital quality • Data are for just six months’ worth of patients on a relatively small set of measures • Data should not be over-interpreted

  36. Positive Positioning • Develop key messages and talking points that highlight your hospital’s efforts to improve quality • In what QI efforts has your hospital participated? • What other QI activities are under way? • How have these efforts benefited your patients? • What projects have you done with Qualis Health? • Frame your quality improvement efforts so that patients will relate to them

  37. Positive Positioning • Create a hospital quality profile • Number of patients, number of staff, awards, certification, special programs • Include performance data in a success story about your hospital’s quality improvements • Patient stories and interviews can bring the data to life • Find patients who can testify to your excellent care

  38. Success Stories • MultiCare Health System • Community Acquired Pneumonia order set • Central Washington Hospital • Pre-printed Community Acquired Pneumonia Physician Orders • Swedish Health Services • Five-fold improvement from early 2003

  39. Media • Become familiar with Hospital Compare • Review performance data during preview period and on morning of national launch • Anticipate questions that may be uncomfortable • Meet with local media in advance • Give them background • Share your scores • Do this with competitors!

  40. What Not To Do • CMS has discouraged marketing messages such as “rated #1 by Medicare” • WSHA members agree not to use data for competitive marketing • Be careful about promoting scores • New data every quarter • Data can shift significantly

  41. The Future of Hospital Compareand Further Resources

  42. Expansions of the Initiative • New voluntarily reported measures for the three initial conditions (heart attack, heart failure, and pneumonia) in early 2005 • First-time voluntarily reported measures on prevention of surgical infections may be posted publicly in mid to late 2005 • Information about patients’ perspectives on their care may be added in late 2005

  43. Learn More • Centers for Medicare & Medicaid Services • www.cms.hhs.gov/quality/hospital/ • Qualis Health • www.qualishealth.org • Washington State Hospital Association • www.wsha.org

  44. Preview Hospital Compare • CMS web conference March 10 from 10-11:30 a.m. (PST)  • Details on plans for the national rollout of the site • Live question and answer session • www.cms.hhs.gov/quality/hospital/HQIDescription.pdf

  45. Comments from CMS • Rick McNaney, Government Task Leader, QIO Communications, CMS Central Office

  46. For More Information Evan Stults, Qualis Health 1-800-949-7536, ext. 2401 evans@qualishealth.org Earl Kurashige, Qualis Health 1-800-949-7536, ext. 2342 earlk@qualishealth.org Cassie Sauer, WSHA 206/216-2538 cassies@wsha.org

  47. Questions?Comments?

  48. Thank you for participating! Please fill out the evaluation.

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