IHI, as part of a campaign to improve health across the United States (“Protecting
5 Million Lives from Harm) stated, “Based on data collected over several years from
multiple partner institutions, IHI estimates that nearly 15 million instances of
medical harm occur in the US each year – a rate of over 40,000 per day.” The Agency
for Healthcare Research and Quality (AHRQ) says in their Patient Fact Sheet “20
Tips to Help Prevent Medical Errors” that more people in the United States die from
medical errors than from motor vehicle accidents, breast cancer, or AIDS! These
tips help patients know how they can participate in their health care plan and help
prevent medical errors. Patients are encouraged to share information with their
healthcare provider about their health, family history, medications, and any allergies
or adverse reactions. Patients are also encouraged to do research and choose a healthcare
provider or hospital carefully. A number of private groups and agencies now publish
information that the public can use to compare hospitals and providers.
Ratings for most healthcare organizations within Washington State are available
to the public. This includes ratings for skilled nursing facilities, as well as
ratings for quality of care and patient safety in Washington State hospitals for
those patients with heart attack, heart failure, pneumonia, hospital infection,
children with asthma, and patient satisfaction with their hospital care. The
Puget Sound Health Alliance Community Checkup provides reports in which
any consumer or healthcare professional can sort and compare by clinic, medical
group, hospital, or health plan for asthma, prevention, low back pain, use of antibiotics,
depression, generic drugs, diabetes, and heart disease.
As part of the national effort to improve patient safety, The Leapfrog Group’s Hospital
Survey is a voluntary program for hospitals and their performance is measured against
national standards of quality, safety, and efficiency. Hospitals are compared on
the basis of general patient safety and the safety of specific procedures The Centers
for Medicare & Medicaid also compares the quality of care and patient safety in
hospitals for those Medicare or Medicaid patients with heart attack, heart failure,
pneumonia, or surgery and publishes the data on their website. The Medicare website
explains their rating system for nursing homes and compares care for nursing home
patients on a number of measures.
Condition Specific Transparency – Quality Metrics
From California
Healthcare Foundation’s Quality Initiative
One of the ways to measure quality and patient safety is to select specific conditions
and apply evidence based guidelines. The conditions may be selected because
they are common, because they are costly, or because they have a high risk of mortality.
Metrics may include the following:
- Clinical significance—prevalence of condition; impact on
quality and length of life
- Impact of quality of care on measured performance—conditions
whose outcomes are not heavily influenced by factors other than quality (e.g. many
co-morbidities)
- Magnitude of variation in quality—those conditions with greater
variation in quality have the potential to have the most impact if accurate measures
can be reported
- Practicality of measuring quality—important for reducing
the reporting burden
- Contribution to the scope of provider performance assessment—whether
the information will be relevant to a large number of consumers
