Improving Quality of Care for Hospitalized Children and Adults

Mar 18, 2013Download as PPTX, PDF0 likes189 views

Philip R. Lee Institute for Health Policy Studies

The document discusses two policy issues related to improving quality of care for hospitalized children and adults. The first is developing quality measures for pediatric inpatient stays, including readmission measures, to help identify high and low performing hospitals. The second is exploring how timely and actionable patient feedback during hospitalization could improve outcomes by capturing patient observations about variations in care. A study found higher scores on online hospital reviews correlated with lower mortality and readmission rates for conditions like heart attack and pneumonia.

Improving Quality of Care for Hospitalized
Children and Adults
Naomi S. Bardach, Renée Asteria-Peñaloza, Michael D. Cabana, and R. Adams Dudley

Policy Issue: Capturing and Improving Quality
in Pediatrics
 PRL-IHPS develops quality measures for hospitalized pediatric
patients, to help identify high and low performing hospitals

 There are few pediatric quality measures for inpatient stays,
which account for 1 out of 6 hospital stays nationally

 There is a national call for pediatric quality measures, with a
priority placed on readmissions measures

 We are developing pediatric readmissions measures, using
them to measure quality for hospitals in a multi-state database,
and will conduct interviews with high and low performers to
explore potential reasons for variations in quality

Policy Issue: Activating Patients and Amplifying the Patient
Voice to Improve Outcomes
 PRL-IHPS is exploring how timely and actionable patient feedback regarding
their care may improve outcomes

 There is a correlation between patient experience scores and hospitals
mortality and readmissions.

 It is possible that patients are observing variations in care that have a
meaningful impact on their health

Capturing those observations and sharing them with others might lead to
better outcomes

Higher Patient Scores from Online Reviews Correlate with
Lower Hospital Mortality and Readmissions
Outcome Correlation with p-value Correlation with p-value
Percent High Yelp Percent High Ratings
Score on HCAHPS

Mortality rate, Heart Attack -0.19 0.005 -0.13 0.052

Mortality rate, Pneumonia -0.14 0.03 -0.18 0.004

Readmissions, Heart Attack -0.17 0.01 -0.39 <0.001

Readmissions, Heart Failure -0.31 <0.001 -0.39 <0.001

Readmissions, Pneumonia -0.18 0.005 -0.27 <0.001

Hospitals with >5 Yelp ratings (N=270) were analyzed. Weighted Pearson’s product moment correlation coefficients, using weights
inversely proportional to the number of Yelp raters.
Data for 30-day mortality and readmission rates come from the Center for Medicaid and Medicare Services public reporting website,
HospitalCompare.hhs.gov.
Bardach et al. “The Relationship between Commercial Website Ratings and Traditional Hospital Performance Measures in the US” (BMJ Quality and
Safety, November 2012).

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This document describes a new model for policy change through academic, civic, and community partnerships in San Francisco. The model brings together community groups, civic organizations, and academic experts from UCSF to improve health and reduce health disparities. Key partners include community coalitions, organizations, residents, UCSF institutes and programs, and city departments. The goal is to use academic research and expertise to help community and civic partners design scalable interventions that make a measurable impact on community health. Initial focus areas chosen are alcohol policy, children's oral health, hepatitis B quality improvement, and physical activity and nutrition.

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Improving Quality of Care for Hospitalized Children and Adults

1. Improving Quality of Care for Hospitalized Children and Adults Naomi S. Bardach, Renée Asteria-Peñaloza, Michael D. Cabana, and R. Adams Dudley Policy Issue: Capturing and Improving Quality in Pediatrics  PRL-IHPS develops quality measures for hospitalized pediatric patients, to help identify high and low performing hospitals  There are few pediatric quality measures for inpatient stays, which account for 1 out of 6 hospital stays nationally  There is a national call for pediatric quality measures, with a priority placed on readmissions measures  We are developing pediatric readmissions measures, using them to measure quality for hospitals in a multi-state database, and will conduct interviews with high and low performers to explore potential reasons for variations in quality Policy Issue: Activating Patients and Amplifying the Patient Voice to Improve Outcomes  PRL-IHPS is exploring how timely and actionable patient feedback regarding their care may improve outcomes  There is a correlation between patient experience scores and hospitals mortality and readmissions.  It is possible that patients are observing variations in care that have a meaningful impact on their health Capturing those observations and sharing them with others might lead to better outcomes Higher Patient Scores from Online Reviews Correlate with Lower Hospital Mortality and Readmissions Outcome Correlation with p-value Correlation with p-value Percent High Yelp Percent High Ratings Score on HCAHPS Mortality rate, Heart Attack -0.19 0.005 -0.13 0.052 Mortality rate, Pneumonia -0.14 0.03 -0.18 0.004 Readmissions, Heart Attack -0.17 0.01 -0.39 <0.001 Readmissions, Heart Failure -0.31 <0.001 -0.39 <0.001 Readmissions, Pneumonia -0.18 0.005 -0.27 <0.001 Hospitals with >5 Yelp ratings (N=270) were analyzed. Weighted Pearson’s product moment correlation coefficients, using weights inversely proportional to the number of Yelp raters. Data for 30-day mortality and readmission rates come from the Center for Medicaid and Medicare Services public reporting website, HospitalCompare.hhs.gov. Bardach et al. “The Relationship between Commercial Website Ratings and Traditional Hospital Performance Measures in the US” (BMJ Quality and Safety, November 2012).

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Improving Quality of Care for Hospitalized Children and Adults

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