Quality Reporting Brandy Rex G30263404 The George Washington University
Quality Reporting • Medical Errors cause 98,000 deaths per year (Pham et al., 2012). • Preventable adverse drug events cost $3.5 billion annually (Pham et al., 2012). • The problem is that the quality of medical care is subpar to that of scientific or technological innovation.
Motivating factors • Increase consumer loyalty. • Increase the number of new patients into the network. • Reduce waste and increase efficiency. • Reduce variation. • Reduce hospital acquired infections such as urinary tract infections, surgical site infections, pneumonia, and infections of the bloodstream (Pham et al., 2012). • Reduce overuse, underuse, and misuse of services (Ransom, Joshi, Nash, & Ransom, 2008; Wynia & Kurlander, 2007).
Organizational Impact • Improved patient outcomes. • Improved patient safety. • Reduced spending on overuse and misuse of services. • Increased services to our customers for services that have been underused. • Increased incentives for meeting and exceeding Centers for Medicare and Medicaid Services’ (CMS) quality measures (Hany’s Quality Institute, 2007). • Improve hospital’s reputation (Hany’s Quality Institute, 2007).
Departmental Consequences • Improved patient safety. • Improved patient centeredness of care. • Reduction in health care disparities. • Increased legal compliance with regulations. • Improved ethical behavior.
Patient Safety • Improved communication and teamwork. • Improved procedural processes as a result of standardization of care and reduction of variation. • Improved reporting system to learn from “near misses” and adverse medical events.
Patient Centeredness • Reduction in health care disparities as a direct result of increasing patient centeredness. • Improved patient outcomes and compliance with treatment regiments (Agency for Healthcare Research and Quality (AHRQ), 2011).
Disparities • Quality reporting arms the organization with the knowledge of where disparities exist. • Acute care for illness and injury has risen 77 percent while many other areas of preventative care and chronic disease management remain lacking (AHRQ, 2011). • Programs can be instituted to increase chronic care disease management.
Legal • CMS has been authorized to pay hospitals higher annual incentives when they successfully report designated quality measures (Eills, Harlow, Petersen, Schwarts, & Trostorff, 2011). • CMS is also allowed to terminate hospitals from the Shared Savings Program if they do not report their quality measures (CMS.gov, n.d.). • Value Based Purchasing is the way that CMS pays institutions based on their quality performance (Eills et al., 2011).
Ethical Considerations • Both physicians and nurses have devoted their livelihoods to ethical and quality health care. • Quality reporting is an extension of what these two groups already do on a daily basis.
References • Agency for Healthcare Quality and Research (AHQR). (2011). National healthcare disparities report, 2011. Retrieved from http://www.ahrq.gov/research/findings/nhqrdr/nhdr11/nhdr11.pdf • CMS.gov. (n.d.). Shared Saving Program (SSP). Retrieve from http://www.cms.gov/Medicare/Medicare-Fee-for-Service- Payment/sharedsavingsprogram/index.html?redirect=/sharedsavingsprogram/ • Eillis, A. B., Harlow, D. C., Petersen, C., Schwartz, R. H., & Trostorff, D. (2011). Quality and other reporting requirements. Retrieved from https://marketcenter.bakerdonelson.com/files/Uploads/Documents/QualityOth erReportingMB%20%282%29.pdf • Hany’sQuality Institute. (2007). Understanding publicly reported hospital quality measures. Retrieved from http://www.hanys.org/publications/upload/hanys_quality_report_card. pdf
Pham, J. C., Aswani, M. S., Rosen, M., Lee, H-W., Huddle, M., Weeks, K., & Pronovost, P. J. (2012). Reducing Medical errors and adverse events. Annual Review of Medicine, 63, 447-463. doi: 10.1146/annurev-med- 061410-121352 • Ransom, E. R., Joshi, M. S., Nash, D. B., & Ransom, S. B. (2nd Ed.). (2008). The healthcare quality book. Chicago: Health Administration Press. Washington, D. C.: AUPHA Press. • Wynia, M. K., & Kurlander, J. E. (2007). Physician ethics and participation in quality improvement: Renewing a professional obligation. In Jennings, B., Baily, M. A., Bottrell, M., & Lynn, J. (2007). Health care quality improvement: Ethical and regulatory issues. (pp. 7-22). New York: The Hastings Center.