The Joint Commission (an accrediting body formerly called JCAHO) has adopted patient safety goals for 2018. Goals apply to Ambulatory Care and Office-Based Surgery, Behavioral Health Care, Hospitals (including Critical Access Hospitals), Home Care, Laboratories, and Nursing Care Centers (Long Term Care). The simplified versions are quick for consumers to read and understand
AHRQ is one of 11 principal operating divisions within the Department of Health and Human Services. It is the lead Federal agency charged with improving the safety and quality of America’s health care system. Its mission is to make health care safer, higher quality, more accessible, equitable, and affordable. It also works to help people understand that evidence and put it into practice. FY17 budget was $416 million, down 3% from the prior year
Survey results from 447,584 hospital staff members (55% avg. response rate) in 680 participating hospitals in 2016 provide a baseline on the patient safety culture in US hospitals. While teamwork within units, and supervisors promoting safety received relatively high marks, handoffs and transitions, as well as nonpunitive response to errors were identified as weak areas. Less than half of respondents indicated staff felt free to question the decisions or actions of those with more authority. Similar results for shift changes, hospital units coordinating with each other, or transferring patients from one unit to another. Concerns about working in crisis mode too often. See especially Charts 5-1 and 5-2 and Tables 6-3, 6-4
Compare the United States with Canada, Australia, France, Germany, Netherlands, New Zealand, Sweden, UK and many other countries on longevity, key healthcare performance measures, and non-medical determinants such as smoking and obesity. Interactive database shows relative actual scores from OECD’s international 2015-2016 results. A few ready-made reports are available. However, in general, the database is complex due to its detail. Many people will have difficulty finding the higher level comparisons they wish.
The latest NHQR report focuses on about 250 measures of the quality of healthcare in the US. Across all measures of health care quality, most improved. Pace varies by area. Access improved for the rate of uninsured, but not for other access measures. On Affordability, about 70% of care affordability measures did not change. Disparities persist, especially for poor and uninsured populations in all priority areas. Pub. Oct. 2017
National Committee for Quality Assurance (NCQA) – the premier accrediting body for health insurance plans – annual State of Health Care Quality Report, 2017. Reports performance for over 1000 managed care HMO & PPO plans on measures of effectiveness (HEDIS) during 2016, in more than 40 health topics such as cancer screening, diabetes care, osteoporosis management, heart care, immunization rates, asthma care, COPD, diabetes, appropriate medications, maternity care, mental health follow-up and readmissions. Also reports averages for member satisfaction and experience with getting the kind of care they expect (CAHPS). Aggregate data only
This article, by Stein, Day, et al, published in the American Journal of Medical Quality, April 2014, concludes patient experience is generally correlated with the quality of care provided. Study based on a study of 4605 hospitals in 2011. Full article link
The mission of the QIO program is to improve the effectiveness, efficiency, economy, and quality of services delivered to Medicare beneficiaries. It has been modified to incorporate Quality Innovation Networks and complaints on behalf of patients and beneficiaries. Find a Quality Improvement Organization here, organized by region and area
Hospital readmissions are an important measure for assessing performance of the health care system. One strategy for improving health care quality and lowering costs is to reduce rates of preventable readmissions. Statistical Brief #230 presents data on hospital readmissions within 30 days following an initial hospitalization. In 2014, the readmission rate for all payers combined was about 14.0 per 100 admissions. High rates of readmission for schizophrenia and other psychotic disorders (22.9%), and Congestive heart failure (23.2%). High numbers of return to hospital for septicemia, complications of devices, implants, or surgical procedures; diabetes, and COPD. Pub. Oct. 2017
ACHE annual survey asked CEOs to identify their top three issues. The overwhelming number one choice continues to be financial challenges with top concern about Medicaid reimbursement and increasing costs of staff and supplies. Second choice was Government mandates. Third top issue was Personnel shortages (esp. RNs and primary care doctors). Patient Safety and Quality came in 4th. Population health management was #9. Response rate 29%, by the American College of Healthcare Executives. Released February 2018
The Patient Safety chartbook is part of the National Healthcare Quality and Disparities Report. It shows the progress made on lowering hospital-acquired conditions (HACs) such as pressure ulcers, adverse drug events, catheter-associated urinary tract infections, other infections. Rates shown to 2014 or 2015. Overall rate in 2015 was 115 HACs per 1000 adult discharges, down 21% from 2010. Published July 2017 by AHRQ.