Sounding the Alarm on Hospital Quality

Submitted by on Friday, September 12, 2014 - 09:52

Fourteen years ago, in response to the IOM's report on the Quality of Health Care in the U.S., employers banded together to demand greater transparency in the quality of health care – as we reported last year, the state of transparency in physician quality is very poor, with just a few pockets of bright lights spread out throughout the country. We didn't really expect much and weren't surprised by the results. So we set out to focus on making hospital quality data more accessible to consumers. After all, beyond the continued work by the Leapfrog Group to establish the Hospital Patient Safety Score, there had been close-to-mandatory reporting of hospital quality to CMS for over a decade. As we've mentioned quite a few times before, the Commonwealth Fund has assembled a significant database of all available hospital quality measures being reported. It stood to reason that many of these measures could be converted into composite measures, similar to the Patient Safety Score, and provide consumers with good insights on the quality of care for injuries and procedures that are commonly treated in hospitals. Yet, as we've often discovered in this industry, what stands to reason everywhere else simply doesn't seem to apply.

What this means to you – We're still working through some of the results, but the reality is, to say the least, disappointing and alarming. As reported recently in JAMA, the NSQP measures spotlighted on the government's Hospital Compare website are, in fact, ineffective at comparing hospital performance. Unfortunately, the same is true for almost all the other measures on Hospital Compare and most of the publicly reported hospital measures in the U.S. The few areas where measures are meaningful are in "consumer sensitive" conditions like strokes and heart attacks during which consumers are usually rushing to their smartphones to figure out which hospital to go to (that's a bad joke of course). The upshot is that in the one area where we actually thought there had been significant progress in transparency, there is none. American consumers who are looking for information on the quality of care for routine procedures simply cannot find it. What's available is, for all intents and purposes, useless. In the fourteen years since the Leapfrog Group was formed and started demanding the reporting of hospital safety metrics, very little else has been accomplished. We're sounding the alarm because, unfortunately, it appears as if we've been asleep at the switch, lulled into believing that progress was being made, that the industry was taking the reporting of quality measures seriously, and that consumable information was making its way to ordinary citizens. We've been had, but watch out, because we're now wide awake.