Key Topic Guide Series - Quality Measurement / Outcomes
Report Cards | Massachusetts Initiatives |
Other Regional Initiatives | Articles | Journals |
Government | Organizations | Pay for Performance (P4P)
American Nurses Association, Magnet Recognition Program
http://nursingworld.org/ancc/magnet.html
The Magnet Recognition Program was developed by the American Nurses
Credentialing Center, a subsidiary of the American Nurses Association,
to recognize health care organizations that provide excellence
in nursing care and uphold the tradition within nursing of professional
nursing practice. The Magnet Recognition Program is based on quality
indicators and standards of nursing practice as defined in the
American Nurses Association's Scope and Standards for Nurse
Administrators (1996). Magnet designation is an indicator
to the public that a particular hospital provides superior nursing
care and can also help recognized hospitals to attract and retain
quality employees. Winchester
Hospital (Consortium CIO Forum member) recently attained this designation -
one of only 92 in the country, and only 2 in Massachusetts, the
other being Massachusetts General Hospital.
Home Health Compare
www.medicare.gov/HHCompare/Home.asp
Like Nursing Home Compare (see below), these report cards are released
by The Department of Health and Human Services through the Centers
for Medicare and Medicaid Services (CMS). Consumers can search
by state, county, city, zip code and agency name. The quality measures
available include four measures related to improvement in getting
around, four measures related to meeting the patient's activities
of daily living, two measures related to patient medical emergencies,
and one measure related to improvement in mental health.
Hospital Quality Initiative
http://cms.hhs.gov/quality/hospital/hqii.asp
The American Hospital Association (AHA), the Federation of American
Hospitals (FAH), the Association of American Medical Colleges (AAMC)
launched a national voluntary initiative to collect and report
hospital quality performance information. A number of state hospital
association, including the Massachusetts Hospital Association,
have agreed to support this project. This effort is intended to
make critical information about hospital performance accessible
to the public and to inform and invigorate efforts to improve quality.
The new Medicare reform law requires participation in this Initiative
for full reimbursement. Centers for Medicare and Medicaid
Services (CMS) has updated its National
Voluntary Hospital Reporting Initiative web site and so
far in MA, 54 acute care hospitals (83 percent) have enrolled in
the program. Data for 20 MA hospitals were posted in the
recent update. The next update is due in May 2004.
Leapfrog Group
www.leapfroggroup.org
The Leapfrog Group was organized by the Business Roundtable and
numerous large Fortune 500 companies to establish criteria for
improving patient safety in hospitals. In 2001, the Group issued
its first web-based, voluntary survey to hospitals in six regions.
The Survey serves as a means for hospitals to communicate to their
communities their efforts to reduce preventable medical errors.
The survey focuses on three recommended safety practices: computerized
drug orders, intensivist physicians in the ICU, and minimum procedure
volumes by specific procedure. The MEDSTAT Group conducts the surveys
on behalf of the Leapfrog Group. Results of these surveys may be
viewed on the Leapfrog Group site.
The Medicare Quality Improvement Community (MedQIC, pronounced med-quick)
www.medqic.com
MedQIC is a national knowledge forum for healthcare and quality improvement professionals, providing access to quality improvement resources and a community of professionals sharing knowledge and experiences to accelerate healthcare quality improvement across the nation. It is sponsored by the Centers for Medicare and Medicaid Services
National Committee for Quality Assurance (NCQA)
www.ncqa.org
The NCQA collects information on health care quality from plans
which it accredits. The organization, which is a private, not-for-profit
organization, has launched an "interactive tool" on its
website to allow consumers to create their own report cards based
upon their personal preferences and situations. NCQA uses a "star" rating
system, based upon the following categories: access and service,
qualified providers (physician and nurses credentialling and rating),
staying healthy, getting better, and living with illness.
View the NCQA's State
of Health Care Quality Report which reveals the national
health care system is "riddled" with quality gaps
at high cost to the country in terms of sick days and lost
productivity.
Nursing Home Compare
www.medicare.gov/NHCompare/home.asp
The Department of Health and Human Services, through the Centers
for Medicare and Medicaid Services (CMS), completed its first evaluation
of the quality of care in the nation's nursing homes in the fall
of 2002. Ten criteria are reported for each nursing home, including
those relating to incidence of pressure sores, experience of pain,
rates of infection, limitations in daily activities, use of restraints,
delirium, and ability to walk. CMS plans to update these ratings
on a standard schedule.
Patientfirst
www.patientsfirstma.org/staffing/index.cfm
Launched in January 2006, this page maintained by the Massachusetts
Hospital Association details nurse staffing levels and patterns
for specific departments within most Massachusetts acute care hospitals.
Tufts Health Plan
www.tufts-health.com
Tufts Health Plan, one of the larger managed care organizations
in New England, announced in Fall 2001 that it had introduced a "Report
Card" program to evaluate large physician group practices
on six quality measures. The Plan began by reporting on three patient
satisfaction ratings and three practice evaluations (diabetic eye
exams, breast cancer screening, cervical cancer screening). More
measures will be added in 2002. The first Report Cards are available
in a written report and also on the Tufts Health Plan web site.
HealthShare
www.healthshare.com
HealthShare produces an online hospital comparison tool called Select
Quality CareT which is based on performance data derived
from national and state government agencies: mortality and length-of-stay
data, complication rates, and patient volumes for specific procedures. The
Select Quality CareT tool now incorporates new Agency for Healthcare
Research and Quality (AHRQ) Quality Indicators (QIs) including
include 54 Patient Safety Indicators, 16 Prevention Quality Indicators,
and 22 Inpatient Quality Indicators. HealthShare partners
with health plans, insurers and employers.
Subimo
www.subimo.com/who/partners.html
Subimo aggregates data from The Health Forum (an American Hospital
Association company), Ingenix, National Research Corporation (NRC),
Solucient, Adam.com, The Leapfrog Group, and Thomson to create
platforms that combine condition-specific information with hospital
data (frequency of procedure, etc.) to aid in selecting hospitals
and physicians. Subimo's platforms are available to health
plans, insurers and employers via license arrrangement.
AHRQ Patient Safety Indicators (PSIs)
www.qualityindicators.ahrq.gov/psi_download.html
The AHRQ Quality Indicators Windows Application is a tool to assist
quality improvement efforts in acute care hospital settings. Using
hospital discharge data from your organization, the application
facilitates the review of individual cases flagged by the AHRQ
Quality Indicators and calculates basic rates for comparison with
peers. The single application includes all of the AHRQ QI modules: Prevention
Quality Indicators, Patient
Safety Indicators, and Inpatient
Quality Indicators.
Massachusetts Department of Health Care Finance and Policy
Health
Care Quality and Cost Information
Includes data on volumes by physician and surgeon for knee and
hip replacements, esophageal resection, gastric bypass, pancreatic
resection, and other procedures.
STATE'S
HEALTHCARE WEBSITE UNVEILS THIRD UPDATE AND EXPANSION, July 25, 2006
Massachusetts Health Care Task Force, Quality Working Group
www.state.ma.us/healthcare
Massachusetts Health Care Task Force, Quality Working Group has
adopted four policy goals for the Commonwealth: adopt the concept
of "patient centered quality" in regulatory and policy
matters, devote an increasing proportion of medical care to evidence
based best practice guidelines, change financial incentives to
encourage patient centered quality, and expand quality and error
reporting at the provider level. Read their April 2001 final draft
report at www.state.ma.us/healthcare/pages/tf_22.htm#anchor990368.
Massachusetts Health Quality Partners (MHQP)
www.mhqp.org
This coalition of health care organizations in Massachusetts is
working to advance a number of initiatives through broad-based
collaboration. They have administered a survey of patient satisfaction
in the state using consistent, comparable reporting measures. The
Massachusetts Acute Care Hospital Statewide Patient Survey Project
covers 58 different hospitals (80% of the state's adult medical
and surgical discharges & 90% of maternity patients) surveyed
on seven dimensions of care including Information & Education,
Coordination of Care and Integration of Services. These findings
represent over 12,500 responses from patients. Additionally, MHQP
has released comparative quality information about the care offered
by primary care physicians in nine large physician networks in
Massachusetts. Care is benchmarked against 16 accepted preventive
and chronic care measures.
Massachusetts Healthcare Purchasers Group
MHPG produces a guide to quality ratings for Massachusetts health plans. The Group is a coalition of companies and public agencies
that work together to ensure that high quality health care is available
at a reasonable price.
MassCHIP
http://masschip.state.ma.us/
MassCHIP offers free, online access to an extensive array of public
health and sociodemographic data to any citizen of the Commonwealth. Developed
by the Massachusetts Department of Public Health, MassCHIP has
a strong commitment to fostering an increased capacity for
local decision-making. It contains 36 major data sets which
users may query. MassCHIP returns counts of events and a
wide variety of statistical measures, including percentages, age-specific
and age-adjusted rates, and standardized incidence ratios. The
system also offers 40 topic-specific reports, for which users
can choose geographic areas of interest. Additionally, MassCHIP
is more than a data repository. Significant efforts have
been made to relate the data to issues of national policy, specifically
with respect to Healthy People 2010 objectives.
MassPRO
www.masspro.org
MassPRO, the Massachusetts Peer Review Organization, Inc., a Quality
Improvement Organization (QIO), is pursuing several quality improvement
initiatives. Its Health Care Quality Improvement Program (HCQIP)
works with partner organizations in Massachusetts to focus on key
conditions and disease prevention areas and to develop measurement
and tracking tools for improved outcomes. The "Get With The
Guidelines" program for implementing the American Heart Association's
secondary prevention guidelines provides participating hospitals
with web-based questionnaires. The Payment Error Prevention Program
(PEPP) focuses attention on common billing errors to help coding
professionals improve reimbursement rates. The Study of Clinically
Relevant Indicators for Pharmacological Therapy (SCRIPT) field
tested performance measurement assessments for three medication
areas; atrial fibrillation, congestive heart failure, and coronary
artery disease. MassPRO's Medicare Annual Report describes these
and other initiatives.
Metro West Health Data Book
www.mchcf.org
The Metro
West Health Data Book from the Metrowest Community Health Care
Foundation presents an analysis of "leading indicators" of
health for 25 Metrowest (Boston) communities. The report
includes demographic and economic status data to provide context
to the health care benchmarking data gathered at the community
level. The Foundation has analyzed data on risk behaviors
(domestic violence, child neglect, alcohol and tobacco abuse),
access to medical care, immunizations, screening, early care treatment,
quality of life, morbidity and mortality, and health disparities.
CheckPoint: Wisconsin Hospitals Accountable for Quality
www.wicheckpoint.org/
Wisconsin Hospital Association's voluntary quality monitoring initiative. Reports
on five error prevention goals and 14 interventions that medical
experts agree should be taken to treat heart attacks, heart failure
and pneumonia.
Delmarva Foundation
www.delmarvafoundation.org
Delmarva Foundation is a national, not-for-profit organization working to improving healthcare quality in over 30 states. It is the Medicare Quality Improvement Organization (QIO) for Maryland and the District of Columbia. Their quality improvement efforts include frontline interventions, training, informed choices for consumers, performance review, data analysis, and quality assurance.
Pennsylvania Cost Containment Council
http://www.phc4.org/
The Pennsylvania Cost Containment Council reports on the quality performance of Pennsylvania's hospitals, as well as their financial strength. Most recently, the independent state agency has published statistics on the rate and cost of hospital-acquired infections in the Commonwealth's hospitals.
QualityCounts: Consumer Information for Better Health Care
http://www.qualitycounts.org/index.htm
Report cards provide information on Wisconsin hospitals, comparing
how often mistakes, complications and deaths happen, with how often
they can be expected to occur, given how sick patients were.
Rhode Island Department of Health
www.health.ri.gov/
The Rhode Island Department of Health website tracks diseases and
other health-related topics for consumers and health professionals. The
site provides health data and statistics such as the cancer registry
statistics, hospital discharge data, and youth substance abuse
statistics for the state of Rhode Island.
Texas Health Care Information Council
www.thcic.state.tx.us/
The Texas Health Care Information Council has released Indicators
of Inpatient Care in Texas Hospitals, 1999-2001 which is a report
on performance by Texas hospitals on twenty-five measures of quality. The
report can be viewed, searched, and downloaded through their website.
The following are a selection of recent aticles addressing one
or more aspects of quality measurement. These articles have been
gathered into the Quality Measurement and Outcomes Assessment subject
files in the Consortium's Resource Center. For more information
contact us at via e-mail or (781) 419-7800.
(Available online by subscription only. Consortium members please
contact us at via e-mail,
for username and password.)
- Krumholz, Harlan M., MD, Saif S. Rathore, MPH, Jersey Chen,
MD, MPH, Yongfei Wang, MS, and Martha J. Radford, MD, "Evaluation
of a Consumer-Oriented Internet Health Care Report Card: The
Risk of Quality Ratings Based on Mortality Data." New
England Journal of Medicine (Vol. 287, No. 10, March 13, 2002),
pp. 1277-1287
Journal
of Clinical Outcomes (JCOM) - Free full-text articles
of this peer-reviewed journal are available online. Titles
include "Physician Profiling in Managed Care" and "Approaching
Dyspepsia in the Primary Care Setting." Readers can
e-mail their comments about the articles.
Centers for Medicare and Medicaid Services (CMS)
http://www.cms.hhs.gov
In addition to offering hospital and nursing home report cards (see under Report Cards above), CMS began reporting charge and payment information on 61 procedures performed in ambulatory surgery centers. CMS is also working collaboratively with other HHS agencies to develop quality measures specific to hospital outpatient care. Hospitals will be required to report these measures in order to receive payments beginning in FY2009.
Agency for Healthcare Research and Quality
(formerly Agency for Healthcare Policy and Research)
www.ahrq.gov/clinic
The Agency's Clinical Information Index Page contains evidence
reports and summaries, including "Diagnosis of Sleep Apnea," "Traumatic
Brain Injury," and "Advanced Prostrate Cancer." Medical
effectiveness treatment and outcomes research is available on topics
such as "Low Birthweight in Minority and High Risk Women."
TalkingQuality website
www.TalkingQuality.gov
Created by the The Agency for Healthcare Research and Quality (AHRQ),
the Centers for Medicare & Medicaid Services (CMS) and the
U.S. Office of Personnel Management (OPM), this site provides tools
and guidance to help "benefit managers,consumer advocates,
and state officials" communicate about issues of health care
quality with their constituencies. Tools on the site include: step-by-step
instructions for implementing quality measurement and reporting
projects (ex: health plan report cards), collecting and analyzing
data, presenting and disseminating information, and evaluating
the sucess of initiatives. One special feature is a Planning Workbook
which can be downloaded from the site.
National Quality Measures Clearinghouse (NQMC)
www.qualitymeasures.ahrq.gov
The National Quality Measures Clearinghouse™ (NQMC), sponsored
by the Agency for Healthcare Research and Quality (AHRQ), U.S.
Department of Health and Human Services, is a database and Web
site for information on specific evidence-based health care quality
measures and measure sets. NQMC is sponsored by AHRQ to promote
widespread access to quality measures by the health care community
and other interested individuals.
Centers for Disease Control and Prevention (CDC)
www.cdc.gov
A search on the words clinical outcomes yielded over 150 articles,
practice research reports, guidelines, tables and figures, white
papers and conference presentations. Research includes "An
Approach to the Validation of Markers for Use in AIDS Clinical
Trials" and "The Impact of Laboratory Practice on Patient
Outcomes."
National Center for Quality Assurance (NCQA)
www.ncqa.org
The NCQA collects information on health care quality from plans
which it accredits. The organization, which is a private, not-for-profit
organization, has launched an "interactive tool" on its
website to allow consumers to create their own report cards based
upon their personal preferences and situations. NCQA uses a "star" rating
system, based upon the following categories: access and service,
qualified providers (physician and nurses credentialling and rating),
staying healthy, getting better, and living with illness.
National Report on Health Care Quality
www.ahcpr.gov/news/press/pr2000/natreppr.htm
The President's Quality Commission has requested an annual national "report
card" on the quality of health care in America. The first
report is due in 2003 and will highlight areas where improvement
in health care delivery is needed.
Rhode Island Department of Health
www.health.ri.gov
The Rhode Island Department of Health website tracks diseases and
other health-related topics for consumers and health professionals. The
site provides health data and statistics such as the cancer registry
statistics, hospital discharge data, and youth substance abuse
statistics for the state of Rhode Island.
Texas Health Care Information Council
www.thcic.state.tx.us
The Texas Health Care Information Council has released Indicators
of Inpatient Care in Texas Hospitals, 1999-2001 which is a report
on performance by Texas hospitals on twenty-five measures of quality. The
report can be viewed, searched, and downloaded through their website.
AQA Alliance
( formerly the Ambulatory Care Quality Alliance)
http://www.aqaalliance.org/
Founded in 2004 with support from both AHRQ and CMS, the AQA Alliance is formulating a model which examines "episodes of care" - not just inpatient procedures but all the associated care before and after, including complications - so that cost, quality and value inferences may be made.
RAND Health, Quality Monitoring System for Children and Adults
www.rand.org/health/tools/qualist.html
Covers general medical conditions, oncology and HIV, cardiopulmonary
conditions, children and adolescent health care, women's health.
Each QA Tools indicator is based on a focused review of the scientific
literature and on the ratings of a panel of experts in the field.
The Commonwealth Fund
www.cmwf.org
The Commonwealth Fund is a private foundation whose "broad
charge" is "to enhance the common good." As such,
the organization supports independent research on health and social
issues. The Fund operates two national programs, one of which is
dedicated to improving the quality of health care services.
HealthGrades
www.healthgrades.com
Free public access searching for quality of care data for hospitals
on cardiac, orthopedics, neuroscience, pulmonary and vascular procedures
and diagnosis. Users can search by procedures, diagnosis, hospital
or city. Report cards show number of Medicare cases and ranking
on in-hospital deaths/mortality ranking from best (5 stars ) to
poor (1 star). Data are obtained from the Health Care Financing
Administration (HCFA) MEDPAR (Medicare Provider Analysis and Review)
file and risk adjusted for three years.
Henry Ford Center for Health Services Research
www.hfhs.cce.org
This site contains neurosurgery and orthopedic outcomes information,
a data center for the Spinal Surgery Consortium Project, and articles
on clinical outcomes, such as "Clinical Effectiveness in Obstetrics
and Gynecology."
Joint Commission on Accreditation of Healthcare Organizations
www.jcaho.org/
The Joint Commission evaluates and accredits more than 16,000 health
care organizations and programs in the United States. An independent,
not-for-profit organization, JCAHO is the nation's predominant
standards-setting and accrediting body in health care. The
JCAHO website provides a comprehensive guide to help individuals
learn more about the safety and quality of JCAHO accredited health
care organizations and programs throughout the United States. Quality
Check®, located at www.qualitycheck.org,
includes each accredited organization's name, address, telephone
number, accreditation decision, accreditation date, current accreditation
status and effective date, and its most recent performance report.
The performance report provides detailed information about an organization's
performance and how it compares to similar organizations.
Medical Outcomes Trust
www.outcomes-trust.org
Information on outcomes instruments and publications, such as the
Sickness Impact Profile, the Quality of Well-being Scale and condition-specific
measures such as the Adult Asthma Quality of Life Questionnaire,
is supplied. Medical Outcomes Trust Members have access to a registry
of health outcomes projects.
National Quality Forum
www.qualityforum.org
The National Quality Forum's web site reveals their current activities
and their consensus reports. The Forum makes available their
organizational news, which are updated regularly. Members
can also take advantage of their members only page.
Office of Health Policy and Clinical Outcomes, Thomas Jefferson University
http://jeffline.tju.edu/CWIS/OHP/ohp.html
The Office's online Health Policy Newsletter, available since 1994,
contains articles such as "The Minimal Data Set for Post-Acute
Care: A HCFA Initiative in Post-Acute Care Assessment," and "A
Cancer Education Service (ACES) Program of Research with Minority
and Underserved Populations."
Office of Health Services Research, University of Pennsylvania Health System
http://health.upenn.edu/hsr/index.html
Information from the Office's Integrated Clinical and Administrative
Research Database is available. Users may click on "Diagnoses" to
see the top 50 diagnoses recorded and on "Demographics" to
learn about the gender, age and ethnic mix of the population. Online
interactive surveys, such the Short Form 12 (SF-12), are provided
on this site.
Quality Indicator Project
Maryland Hospital Association
www.qiproject.org
The Quality Indicator Project® began in 1985 as a voluntary
pilot project of seven Maryland acute care hospitals that wanted
to test a handful of clinical performance measures for data collectability
and usefulness in quality improvement activities. Today, the Project
has more than 1,200 participants across four different indicator
sets: acute care, psychiatric care, long-term care and home care.
Hibbard, Judith H., Jean Sotckard, and Martin Tusler, "Does
Publicizing Hospital Performance Stimulate Quality Improvement
Efforts? Results from a study in Wisconsin suggest that
that making performance information public stimulates quality
improvement." Health Affairs (Vol. 22, Number
2, March / April 2003), p. 84-94
(Available online by subscription only. Consortium members
please contact us at via e-mail,
for username and password.)
This page last updated December 4, 2006
For more information on the Resource Center & Library, please
contact us at via e-mail or (781) 419-7800. We welcome your further questions & look
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