Download VBP and RRP

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
– value-based purchasing
– readmission reduction program
• Update quarterly
* CMS is the Centers for Medicare & Medicaid Services; a federal agency
5 scores
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2.
3.
4.
5.
Outcomes
Ratings by patients
Clinical process
Efficiency
Readmissions
With component details available
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)
Outcomes
Death rate for heart attack patients
(CMS Hospital Compare. Medicare patients; risk-adjusted 30-day)
Ratings by patients
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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
Ratings by patients
Overall hospital rating
(CMS Hospital Compare. All inpatients; % rating 9 or 10 out of 10)
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.
Efficiency
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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
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
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.
Readmissions
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Heart Attack
Heart Failure
Pneumonia
Chronic Obstructive Pulmonary Disease
Total Hip and Total Knee Replacement
Readmissions
Readmission after hip or knee replacement
(CMS Hospital Compare. Medicare patients ; risk-adjusted 30-day)
5 scores
1.
2.
3.
4.
5.
Outcomes
Ratings by patients
Clinical process
Efficiency
Readmissions
With component details available