Courtesy of NCH’s Straight Talk with Allen S. Weiss, MD, MBA, FACP, FACR, President & CEO, NCH Healthcare System
Objective measures for quality exist in all walks of life including healthcare. The National Quality Clearinghouse now lists more than 2,500 performance measures according to a recent New England Journal of Medicine Perspective. https://www.nejm.org/doi/full/10.1056/NEJMp1802595
The largest payer by far for healthcare in our nation is CMS (Center for Medicare and Medicaid Services). Along with payment for healthcare services for Veterans, Native Americans, and the Children’s Health Insurance Program (CHIP), our federal government pays for about two-thirds of all care. In spite of the facetious remark, “I’m from the government and I’m here to help you,” CMS has successfully encouraged patients to seek and care-givers to provide quality care utilizing transparent, objective, defined metrics.
CMS’s most recent healthcare system/hospitals star ratings are based on seven major measures (mortality, safety, readmission, patient experience, effectiveness of care, timeliness of care, and imaging) and 57 sub-categories. Fair, transparent, timely, and important measures easily understandable for patients, care-givers, and payers as well as all interested in value (defined as quality divided by cost) are necessary for our nation to improve. Scheduled every six months—January and July—CMS updates the scores for about 4,000 of the 5,000 hospitals in the country. Behavioral health, Rehabilitation, and Pediatric Hospitals are not included.
These objective understandable measurements, although not currently perfect, do provide helpful information and are now available at www.medicare.gov/hospitalcompare/search.html. Using this tool has a dual benefit: assisting patients in choosing healthcare options and accelerating performance improvement because all can share best practices to improve their delivery. Better performance also equates to fewer complications, decreased waste, and lower costs. All of these attributes contribute to a healthier America and the ability to transfer resources previously regarded as “waste” in healthcare to other worthwhile endeavors such as education, infrastructure, safety, and environmental protection.
NCH received a 3-star rating three years ago when the rating system started and became 4 stars in 2017. This January we were recognized as the first and only 5-star system in Southwest Florida and one of five in Florida; we were reaffirmed as 5 stars in July. As you can imagine, this confirmation is not only reassuring but also encouraging. We are sharing our “report card” both internally and externally because we feel obliged to those we serve to be transparent with both our successes and our opportunities for improvement.
Recognizing that we have opportunities to continuously improve with objectively defined goals for patient experience, documentation of pre-existing conditions, avoidance of urinary tract infections, and other clinical parameters to maintain our 5th star is motivating for all concerned.
Importantly, all of Southwest Florida has improved since CMS has publicized quality metrics. The overall goal for all in the noble profession of healthcare is to help everyone live a longer, happier, and healthier life.
P.S. DO YOU HAVE A COLLEAGUE OR FRIEND WHO WOULD BE INTERESTED IN UPDATES? Please enter their email address at nchmd.org/straighttalk, and we will add them to our complimentary mailing list.