The Center for Health Affairs

April 2006

The Focus on Quality A Closer Look at a National Trend

Issue Brief available at: www.chanet.org

The Evolving Field of Quality Improvement in Healthcare

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Institute of Medicine (IOM) report To Err Is Human heightened public discussion Emphasis on:

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data collection

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measurement of treatment outcomes

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implementation of clinical pathways Trend to begin tying reimbursement to progress on quality measures

National Quality Initiatives Take Shape

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Accrediting body

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Joint Commission on the Accreditation of Healthcare Organizations (JCAHO)

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Core Measures National Patient Safety Goals Payers

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Centers for Medicare & Medicaid Services (CMS)

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Reporting Hospital Quality Data for Annual Payment Update (RHQDAPU)

National Quality Initiatives Take Shape (cont’d)

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Payers

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CMS (cont’d)

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Hospital Quality Alliance – Improving Care Through Information Initiative

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In collaboration w/ the American Hospital Association and others

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Premier Hospital Quality Incentive Demonstration

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In collaboration w/ Premier, Inc.

National Quality Initiatives Take Shape (cont’d)

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Business groups

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The Leapfrog Group

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Hospital Quality and Safety Survey

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The Institute for Healthcare Improvement

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100,000 Lives Campaign

Rating Systems and Report Cards Evolve to Inform Consumers

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U.S. News & World Report

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America’s Best Hospitals

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Solucient

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100 Top Hospitals HealthGrades

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HealthGrades ratings

Evaluating Quality Initiatives and Rating Systems / Report Cards

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Importance of risk adjustment

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Statistical process to identify and adjust for variation in patient outcomes stemming from differences in patient characteristics

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Credibility dependent on measures used

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Surveys of providers’ reputations vs. compliance with clinical pathways

What our Hospital Is Doing