Consumers across the U.S. will be able to see more about how well their local hospitals are performing with new information now available at the Hospital Compare website (also at www.medicare.gov). The consumer-oriented website will now report on steps that hospitals take to prevent surgical infections and will reflect up to four quarters of data from 2004. The website has been updated and improved by the Centers for Medicare & Medicaid Services and the Hospital Quality Alliance (HQA).
“We are continuing to work together to make progress in helping consumers and health care professionals get better information at Hospital Compare, and to use this information to improve care,” said CMS Administrator Mark B. McClellan, M.D., Ph.D. “As we enhance the information on hospital quality, patients can get more help in making important decisions about their care, and health professionals can take further steps to improve care.”
The two new surgical infection prevention measures and a new pneumonia measure bring the total number of measures on www.hospitalcompare.hhs.gov to 20, including the 10 clinical measures that short-term acute care hospitals must agree to report publicly in order to receive the incentive payments as created by the Medicare Modernization Act. The two new surgical infection prevention measures are the first of a larger set of patient safety measures that will be collected as part of the Surgical Care Improvement Project (SCIP). The SCIP is designed to improve patient safety and reduce the incidence of postoperative complications by 25 percent by 2010 in U.S. hospitals. The HQA is actively considering how to incorporate these and other patient safety measures into the measures available at www.hospitalcompare.hhs.gov.
There has been significant growth in the number of hospitals reporting more than the ten “starter measures.” In addition, CMS and the HQA are seeing an increase in the information that hospitals are now providing:
- More than 90 percent of the 4048 participating U.S. hospitals are reporting at least the 10 “starter” measures,
- Over 70 percent (2903) are reporting all 17 of the quality measures first introduced in April 2005, an almost three-fold increase in active participation (967 hospitals).
- Just over 80 percent (3291) of all reporting hospitals publicly reported the new pneumonia measure,
- More than 20 percent (777) of facilities took the lead in reporting on patient safety using the two surgical infection prevention measures, and.
- More than 450 critical access hospitals, a category of small rural hospital established in Medicare law that are not eligible for the incentive payment, are submitting data, and 11 percent increase in reporting.
Hospitals are required to accurately abstract and report their data. For 2006, approximately 96 percent of the hospitals that submitted the data will meet the criteria and are eligible to receive the incentive payments. Those not receiving the full update did not meet the validation requirement, did not submit the 10 starter measures (where applicable) continuously each quarter, or chose not to participate.
“While it is too early to determine any major trends in hospital performance on the measures, the latest information makes it even clearer that there are important opportunities for quality improvement,” said Dr. McClellan. “Certain processes appear to be well ingrained in U.S. hospitals – rates for aspirin at arrival and discharge and beta blocker at discharge for heart attack patients and assessment of blood oxygen levels for pneumonia patients remain high – but the rates for other measures indicate a continuing need for improvement efforts at the national level.”
There is also improvement in counseling smokers to stop smoking, particularly among heart failure and pneumonia patients. Among the “starter set” measures, only pneumoccocal vaccination showed notable, although albeit small, improvements in a rate that remains below 50 percent.
“We’re pleased that hospitals are submitting information about the quality of care they provide, and that the information is increasingly being used to help patients get better care,” said Dr. McClellan. “But the information clearly shows some important areas where care can be improved, to improve lives and avoid costly complications. We intend to continue to build on these steps together, to get higher quality care to patients.”
The Hospital Quality Alliance is a public-private collaboration of government agencies, hospitals, quality experts, purchasers, consumer groups and other health care organizations that are working together to implement a national strategy for hospital quality measurement and advancing quality of care.
In addition to the new hospital quality measures, beginning today, Spanish users of www.medicare.gov will find information about the quality of care provided by the nation’s home health agencies in Spanish. The Spanish Home Health Compare joins Spanish language translations of Nursing Home Compare, Medicare Health Plan Compare and the Prescription Drug and Other Assistance Programs sites.
CMS’ Quality Initiative uses a multi-prong approach to drive systems, support and provide incentives to facilities – and the clinicians and professionals working in those settings – in their efforts to achieve superior care through:
- Ongoing regulation and enforcement conducted by state survey agencies and CMS;
- New professional and consumer hospital quality information on our websites, www.cms.hhs.gov and www.medicare.gov and at 1-800-MEDICARE;
- The testing of rewards for superior performance on certain measures of quality;
- Continual, community-based quality improvement programs through our Quality Improvement Organizations (QIOs); and,
- Collaboration and partnership to leverage knowledge and resources.
A quality measure is a formula that converts medical information from patient records into a rate or percentage that shows how well a hospital cares for its patients.
The twenty measures now available at www.hospitalcompare.hhs.gov are:
Heart Attack (Acute Myocardial Infarction or AMI)
- Aspirin at arrival
- Aspirin at discharge
- ACE Inhibitor for Left Ventricular Systolic Dysfunction
- Beta Blocker at arrival
- Beta Blocker at discharge
- Thrombolytic agent received within 30 minutes of hospital arrival
- Percutaneous Coronary Intervention (PCI) received within 120 minutes of hospital arrival
- Adult smoking cessation advice/counseling
- Assessment of Left Ventricular Function
- ACE Inhibitor for Left Ventricular Systolic Dysfunction
- Discharge Instructions
- Adult smoking cessation advice/counseling
- Oxygenation Assessment
- Initial Antibiotic Timing
- Pneumococcal Vaccination Status
- Blood culture performed prior to first antibiotic received in hospital
- Adult smoking cessation advice/counseling
- Appropriate Initial Antibiotic Selection*
Surgical Infection Prevention
- Prophylactic Antibiotic Received Within 1 Hour Prior to Surgical Incision*
- Prophylactic Antibiotics Discontinued Within 24 Hours After Surgery End Time*
Note: * denotes measure displayed for the first time in September 2005