Patients like quality, satisfaction surveys
A on-line survey of 2,015 U.S. adults conducted by Harris Interactive for The Wall Street Journal Online showed that U.S. adults are gaining confidence in the fairness and reliability of healthcare quality assessments. The Wall Street Journal Online/Harris Interactive Health-Care Poll said most adults favor the use of patient satisfaction surveys to determine health care quality above all other quality measures. More than half of those surveyed said it is also fair to measure healthcare quality based on the use of electronic medical records.
The survey also said that 87% of the respondents were interested in using web-based consumer ratings tools, suggesting that an initiative to allow consumers to rate their doctors could be highly successful.
"These findings suggest that as quality measurement in health care becomes more readily available to consumers and they become more familiar with these measures that trust in the process will increase," Katherine Binns of Harris Interactive said in a prepared statement. "At the end of the day, however, it's feedback from their peers — other patients — that matters most to consumers."
Cigna stops paying for 'avoidable' conditions
Effective Oct. 1, 2008. Cigna HealthCare will no longer reimburse hospitals for certain "avoidable" conditions and surgical errors. Cigna said it will not reimburse for surgical procedures performed on the wrong person or site, and may not reimburse for certain "avoidable hospital conditions" when permitted under its hospital contracts. Included among the cited conditions are infections from urinary and central-vein catheters, use of the wrong blood type during transfusions, bed sores, and hospital-acquired injuries.
States participating in QI institute
Nine states — Colorado, Kansas, Massachusetts, Minnesota, New Mexico, Ohio, Oregon, Vermont and Washington — will develop and implement strategies to improve health care quality and efficiency under a new project called the State Quality Institute and sponsored by the Commonwealth Fund. Each state will convene a team of public officials, health care providers, insurers, employers, and others to identify challenges and policy options in areas such as value-based purchasing, data collection and transparency, and care coordination and disease prevention. The teams will receive help from experts and share their experiences and successful practices.
More hospitals offering palliative care
According to a new analysis by the Center to Advance Palliative Care (CAPC), U.S. hospitals continue to implement palliative care programs at a rapid pace. Based on data from the 2008 American Hospital Association's Annual Survey of Hospitals, the study found 1,299 hospitals provide palliative care programs, up from 632 in 2000. About 31% of the 4,136 hospitals appropriate for palliative care programs, which excludes psychiatric and rehab hospitals, have a program, CAPC said. The rate increases to 47% for hospitals with more than 50 beds and 77% for hospitals with more than 250 beds. "Palliative care represents a paradigm shift in how we treat serious illness in America," said CAPC Director Diane Meier. "Ten years ago there were almost no hospital palliative care programs in the U.S."
AHRQ resource features 100 innovations and tools
The Agency for Healthcare Research and Quality. (AHRQ) has launched a new web resource that allows users to learn, share, and adopt innovations in the delivery of health services. The resource, which is called the Health Care Innovations Exchange, is available at www.innovations.ahrq.gov.
AHRQ's Health Care Innovations Exchange is the federal government's repository for successful health care innovations. It also includes descriptions of attempts at innovation that failed. The web site is designed as a tool for health care leaders, physicians, nurses, and other health professionals who seek to reduce health care disparities and improve health care overall.
"Sharing information about important new developments in methods of delivering effective health care is typically a hit-or-miss process," said AHRQ Director Carolyn M. Clancy, MD. "Such information exchanges often occur only within organizations, through conferences, and by chance over the Internet. AHRQ's updated innovations exchange will encourage information sharing, reduce duplication and save time and money."
The web site will contain 100 examples of innovations in the delivery of health care services and attempts at innovation; that number will increase as the site is updated every two weeks. Profile examples include an intensive care unit's successful efforts to shorten patient stays by setting and adhering to daily care goals; an initiative by geriatricians, nurse practitioners, and social workers to help seniors avoid institutional care by visiting seniors at home; and a patient/physician e-mail communication system that overcomes the inconvenience of automated phone systems and accommodates the difficult schedules of both the physician and the patient.
Through learning and networking opportunities offered by the Health Care Innovations Exchange, users will be able to:
- Read articles and perspectives on the creation and adoption of innovation;
- Read expert-generated commentaries on specific innovations;
- Comment on specific innovations;
- Participate in topic-specific presentations (e.g., Webinars) and discussions;
- Join on-line forums that connect innovators with organizations that adopt them. Participants will identify new approaches to delivering care, develop effective strategies for implementation and evaluation, and share tips and information.
In addition to offering a venue for learning and networking, the AHRQ Health Care Innovations Exchange offers a new home for AHRQ's QualityTools — a collection of tools used in quality improvement efforts.
In other news from AHRQ, the agency reported that the number of hospital patients stricken by Clostridium difficile, or C. difficile-associated disease — an infection that can lead to diarrhea, blood poisoning, and even death — increased by 200% between 2000 and 2005. The sharp upturn follows a 74 percent% increase in the number of cases between 1993 and 2000.
AHRQ's analysis also found:
- There were more than 2 million cases of C. difficile in U.S. hospitals between 1993 and 2005;
- Two out of three infected hospital patients in 2005 were elderly;
- On average, patients with C. difficile were hospitalized almost three times longer than uninfected patients;
- The in-hospital death rate for patients with C. difficile was 9.5%, compared with 2.1%;
- The highest rate of C. difficile infection in hospital patients was in the Northeast (144 stays per 100,000 population) and the lowest (67 stays per 100,000 population) was in the West.
NCQA to expand quality program
The National Committee for Quality Assurance (NCQA) has released for public comment updated standards for Physician and Hospital Quality (PHQ), a program that evaluates how well health plans measure and report the quality and cost of physicians and hospitals. The proposed changes would make the program available to accredited and non-accredited health plans and add new requirements to respond to demand from employers and regulators across the country.
"Provider quality will only improve when measurement is based on trustworthy information," said NCQA President Margaret E. O'Kane. "Consumers and employers must be able to rely on the information that's published about their doctors and hospitals or used to design networks."
The updated standards are more explicit about how plans involve physicians and consumers in measurement programs. They require plans to use standardized measures such as those endorsed by the National Quality Forum, and they require plans to consider quality, and not just cost, when they act on measurement results.
Patients like quality, satisfaction surveys; Cigna stops paying for 'avoidable' conditions; States participating in QI institute; More hospitals offering palliative care; AHRQ resource features 100 innovations and tools; NCQA to expand quality programYou have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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