Obama initiatives include VA hospital report cards
Filed under: Government, Health journalism, Hospitals, Public records
Saying that “commitment to open government goes beyond the making of government-wide policy for the future,” the White House announced a number of “open government” initiatives on Tuesday.
The initiatives come with an “Open Government Directive” (PDF) from Peter Orszag, director of the White House’s Office of Management and Budget, that sets out steps toward creating a more open government and establishes deadlines for action:
- Publish Government Information Online - Includes a requirement that each agency create an Open Government Web page within 60 days.
- Improve the Quality of Government Information - Within 45 days each agency must designate an official to be accountable for the quality and objectivity of federal spending information
- Create and Institutionalize a Culture of Open Government - Within 120 days, each agency will publish on its Open Government Web page an a plan about how it will improve transparency and public participation.
- Create an Enabling Policy Framework for Open Government - Officials will review OMB policies to find impediments to open government and propose changes to increase openness.
Photo by Ed Dame via Flickr
The specific initiatives just announced come from all departments of the cabinet. One of the most notable is a hospital report card that will include raw data for veterans administration hospitals:
To empower Veterans and the public at large to track quality, safety, and access to Veterans Health Administration (VHA) facilities, the Department of Veterans Affairs is publishing hospital “report cards,” including raw data on care provided in outpatient and hospital settings, quality of care within given patient populations, and patient satisfaction and outcomes.
Other health-related initiatives include:
Department of Health and Human Services, Department of Agriculture, Department of Commerce, Department of Energy & the National Aeronautics and Space Administration: National Assets for High-Tech Economic Growth
Fledgling businesses need easier ways to identify and assess entrepreneurial opportunities that will create jobs and strengthen economic growth. Towards that goal, the National Institutes of Health (NIH) and Food and Drug Administration (FDA) in the Department of Health and Human Services (HHS), the Agricultural Research Service in the U.S. Department of Agriculture, the National Institute of Standards and Technology (NIST) in the Department of Commerce, the Department of Energy, and the National Aeronautics and Space Administration are increasing access to information on 1) new technologies available for commercial licensing, 2) Cooperative Research and Development (CRADA) awards and opportunities, 3) Small Business Innovation Research (SBIR) awards and opportunities, 4) Small Business Technology Transfer (STTR) awards and opportunities, and 5) projects sponsored through grants and contracts.
Department of Veterans Affairs: Geographic Distribution of Expenditures
The National Center for Veterans Analysis and Statistics will release three years of raw data on estimated annual VA spending in each county and congressional district. The data represent payments to Veterans and dependents, services provided to Veterans, and general operating expenses. These data will be used by state and local Veteran agencies, Veteran advocacy groups, and the public to compare to and plan for local Veteran needs. Making the raw data available will enable its combination with local-population and veteran-related data, fostering new knowledge and improved services for Veterans.
Department of Agriculture: Promoting a Healthier America
To unleash innovative approaches to improving the health of America’s children, the Department of Agriculture is releasing nutrition data for over 1,000 commonly consumed foods and launching a national competition for creative, mobile and web-based games. The competition will challenge entrepreneurs, software developers, and students to leverage the newly released data to develop games to help children make healthy eating decisions.
Department of Labor: Keeping America’s Workers Out of Harm’s Way
For the first time, the Occupational Safety and Health Administration in the Department of Labor is systematically publishing employer-specific information about occupational fatalities online. Employers with reported fatalities will have an incentive to take steps to improve safety and prevent future accidents. In addition, responsible employers will be able to use the database to identify dangerous conditions and take proactive precautions.
Department of Veterans Affairs: Veteran Population Model
The Veteran Population Model - using combined data from the Department of Veterans Affairs (VA), Department of Defense (DoD), and Bureau of the Census - provides the official estimates and projections of the veteran population for each year from April 1, 2000, through September 30, 2036. Previously available only through predefined queries, access to the raw data will enable public and private-sector service organizations to incorporate VetPop data into their models to project future demand based on population and demographic estimates.
Q&A on achieving a more open government
Chief Technology Officer Aneesh Chopra and Chief Information Officer Vivek Kundra take questions on the directive and the move to a more transparent government.
When quality matters to boards, hospitals do better
In Health Affairs, Ashish K. Jha and Arnold M. Epstein have released a study in which they found a link between hospital boards that focused on quality of care and hospital quality ratings. They also found that quality isn’t a top priority for most hospital boards. The researchers hope their findings will help those who want to improve hospital quality by demonstrating just how much influence a hospital board can have.
Jha and Epstein surveyed 1,000 board chairs from a wide sample of not-for-profit acute-care hospitals in the United States. For quality ratings, they relied on the Hospital Quality Alliance.
Related
AHCJ President Charles Ornstein, whose hospital quality coverage has earned national recognition, recently updated his comprehensive “Road map for covering your local hospital’s quality” tip sheet.
AHCJ article: Making sense of hospital quality reports
Book: Covering the Quality of Health Care: A Resource Guide for Journalists
Slim guide: Covering Hospitals: Using Tools on the Web
Free online training
On the Beat: Covering Hospitals: An innovative simulation guides you through the sources and resources you need to tackle the beat. You’ll tap into the same tools that you’ll use on the job, and you’ll have a virtual mentor to walk you through the maze of reports, statistics and sources. One story line teaches you about reporting on hospital quality
Data
Investigating hospitals: Find stories with ready-to-use Hospital Compare data: AHCJ has made it easier for journalists to compare hospitals in their regions by generating spreadsheet files from the HHS database, allowing members to compare more than a few hospitals at a time, using spreadsheet or database software. AHCJ provides key documentation and explanatory material to help you understand the data possibilities and limits.
Tip sheets
- How to cover your local hospital - Overview of many organizations that offer hospital quality ratings
- Sorting out hospital rankings
- Intro to investigating health data using spreadsheets
- Computer-assisted reporting basics: Investigating health data using spreadsheets
Reports
- Study: Hospital quality comparisons are inconsistent
- Performance data may not affect patient decisions
- GAO report on reliability of hospital quality data reported to CMS
- 2007 state quality data available
- Hospital quality resources by state
Hot Health Headlines
- Rating Hospital Heart Care
- Government releases new hospital death rates
- Mortality data and its use in quality improvement efforts
- Surgery death rates going public in U.K.
- Ranking Hospitals on Bang for the Buck
AHRQ interviews Ornstein, talks medical errors
Filed under: Health data, Health journalism, Hospitals, Public records
Robert Wachter, M.D., (bio), editor of AHRQ WebM&M (Morbidity and Mortality), interviewed AHCJ President Charles Ornstein, of ProPublica, for a recent issue (get the audio version here). Their conversation began as a general discussion of health journalism, then zeroed in on hospital errors and the Pulitzer Prize-winning series on King/Drew Medical Center in Los Angeles that Ornstein did with Tracy Weber when both were at the LA Times.
The whole thing is worth a read. In this excerpt Ornstein discusses how health journalists find stories:
Good reporters have a variety of sources of information. Reporters who routinely cover the hospitals in their communities should be constantly looking at state inspection reports, lawsuit data about payouts, their Joint Commission accreditation, and how they’re doing with their training program. All these types of things should be on the radar screen and monitored regularly. But nothing can replace talking to employees in the facilities and the patients that receive care there—trying to get an on-the-ground perspective.
In a companion piece, Wachter reflected on the role the media has played in shaking the medical profession out of a dangerous rut of complacency:
What do we need from reporters who cover the medical errors beat? … reporters need to know enough about error science that they appreciate the importance of searching for systems factors, without immediately zeroing in on more dramatic and obvious sharp-end errors. They need to get the facts right. And, while raising the appropriate concerns, they need to avoid sensationalism and place the error, or the topic, in broader context. When they do these things, they are providing a unique and critical service to patients and caregivers.
11 Calif. hospitals fined for preventable mistakes
Cheryl Clark writes for HealthLeaders Media that 11 California Hospitals were fined $25,000 each by the state for mistakes that put patients in immediate jeopardy or, in a few cases, even injured or killed them. Among the most egregious mistakes were a “man undergoing a leg amputation for cancer he never had,” a patient being set on fire during an eyelid-related procedure and a laundry list of equipment forgotten inside of patients.
This naming and shaming of errant hospitals has become a regular ritual in California, Clark reports:
Kathleen Billingsley, deputy director for the California Department of Public Health, said the 11 new fines bring the total of 115 monetary penalties against 80 hospitals to $2.87 million under a law that took effect Jan. 1, 2007. She has made public announcements about other batches of fines seven times previously, most recently Sept. 3.
According to the Web site’s “About Us” page, “HealthLeaders Media is a leading multi-platform media company dedicated to meeting the business information needs of healthcare executives and professionals.”
USA Today matches hospital quality data, tourism
Filed under: Health data, Health journalism, Hot Health Headline
USA Today’s Steve Sternberg and Jack Gillum put a new spin on federal Hospital Compare ratings and other hospital quality data, matching the ratings, as well as data on death rates, with popular travel destinations and the locations of state parks. The reporters make the case that travelers should keep hospital quality data in mind when planning vacations.
From the story, which also includes a list of poorly-rated hospitals in travel hotspots:
A USA Today analysis finds two dozen hospitals near popular travel destinations, as compiled by the National Travel Monitor, have death rates among the worst in the USA. A separate analysis shows that one of every four hospitals with high death rates for heart attack, heart failure or pneumonia — 94 of 402 — are near state parks.
Related
AHCJ Vice President Charles Ornstein, whose own hospital quality coverage has earned national recognition, recently updated his comprehensive “Road map for covering your local hospital’s quality” tip sheet with links to state-by-state resources and additional nationwide tools for journalists looking into hospital quality.
AHCJ article: Making sense of hospital quality reports
Book: Covering the Quality of Health Care: A Resource Guide for Journalists
Slim guide: Covering Hospitals: Using Tools on the Web
Free online training
On the Beat: Covering Hospitals: An innovative simulation guides you through the sources and resources you need to tackle the beat. You’ll tap into the same tools that you’ll use on the job, and you’ll have a virtual mentor to walk you through the maze of reports, statistics and sources. One story line teaches you about reporting on hospital quality
Data
Investigating hospitals: Find stories with ready-to-use Hospital Compare data: AHCJ has made it easier for journalists to compare hospitals in their regions by generating spreadsheet files from the HHS database, allowing members to compare more than a few hospitals at a time, using spreadsheet or database software. AHCJ provides key documentation and explanatory material to help you understand the data possibilities and limits.
Tip sheets
- How to cover your local hospital - Overview of many organizations that offer hospital quality ratings
- Sorting out hospital rankings
- Intro to investigating health data using spreadsheets
- Computer-assisted reporting basics: Investigating health data using spreadsheets
Reports
- Study: Hospital quality comparisons are inconsistent
- Performance data may not affect patient decisions
- GAO report on reliability of hospital quality data reported to CMS
- 2007 state quality data available
- Hospital quality resources by state
Hot Health Headlines
- Rating Hospital Heart Care
- Government releases new hospital death rates
- Mortality data and its use in quality improvement efforts
- Surgery death rates going public in U.K.
- Ranking Hospitals on Bang for the Buck
Poor, rural hospitals have higher death rates
Filed under: Health data, Health journalism, Hot Health Headline
USA Today’s Steve Sternberg and Jack Gillum expanded upon a Centers for Medicare and Medicaid Services report showing higher death rates at the nation’s worst hospitals, adding their own analysis showing that death rates are also higher at hospitals in low-income and low-population counties.
AHCJ publication
Covering Hospitals: Using Tools on the Web
Tip sheets
Tools for covering hospitals: Financial documents
‘A Hidden Shame:’ Tips for reporting on deaths in mental hospitals
Ripping the cover off hospital finances
Computer-assisted reporting basics: Investigating health data using spreadsheets
Sorting out hospital rankings
Finding patterns and trends in health data: Pivot tables in spreadsheets
AHCJ articles
Sunshine Week: Some hospital quality measures online but more could be done
Making sense of hospital quality reports
Deciphering cost reports helps paint picture of hospital’s financial health
Reporter digs up Seattle hospital salaries
John Ryan of KUOW News in Seattle used publicly available data and records requests to localize the national debate on nonprofit compensation with a piece on top earners at Seattle-area hospitals. Ryan details his information-gathering process here and shares his list of top local earners.
Tip sheet
Digging Into Hospital Finances:
Five key documents for reporters and recent trends
Previous coverage
Ryan used a mix of local and national sources, getting explanations from some of the top earners (and perspective from some of the bottom earners) and quotes from those who believe nonprofit workers should not be earning that much money. He also included the thoughts of those who believe nonprofit hospitals need to pay competitive salaries in order to bring competitive talent.
Another story looks at the role of charity care and how much of it is provided: “Only three of the nonprofit hospitals in central Puget Sound give away more than 2 percent of their care to the poor: Providence Regional in Everett, Saint Clare in Lakewood, and Saint Francis in Federal Way. The Washington Department of Health tracks those figures.”
Sunshine Week: Some hospital quality measures online
Felice Freyer, a medical writer at The Providence (R.I.) Journal and a member of AHCJ’s Right to Know Committee, writes in an article for AHCJ that “In recent years, state and federal agencies have begun yanking data out of filing cabinets and opening their folders to the daylight of cyberspace.”
As Freyer points out, “The Internet offers vast new opportunities to answer every patient’s most pressing question: Am I entrusting my health to people who will take good care of me?”
Web sites that offer hospital quality data not only inform consumers, they prod everyone in health care to do a better job. Much more can and should be done to give the public better access to what the regulators know.
Read more of Freyers article.
Additional Sunshine Week coverage: Online health data varies by state
N.J. law would publicize detailed hospital error info
In an Associated Press story, Eli Segall looked at proposed legislation in New Jersey that would require hospitals to publish error information and would prevent hospitals from billing patients or insurers for procedures during which mistakes were made.
While current New Jersey law calls for the publication of statewide statistics for preventable mistakes, the proposed legislation would take it a step farther and require data to be shared for individual hospitals. Reports for 2005 and 2006 have been published under the current law; 826 mistakes - 40 percent of which were patient falls - were reported statewide.
According to one of Segall’s sources, patients were only billed for mistaken procedures in isolated cases under existing laws and that in many cases hospitals don’t bill anybody when egregious mistakes have been made and insurers may refuse payment when mistakes have been made.
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Health Journalism 2010, AHCJ's annual conference, features a world-class program with story ideas, sources, stronger reporting skills, chances to meet newsmakers and network with other journalists.
- Health and education: Covering these intersecting beats
- Reporting on the business of health care
- Health reporting resources for journalists on state and local government beats
- Shortened Lives: How location, lifestyle affect health
- Covering a complex story for the long haul
- Aging in the 21st Century: Presentations and tip sheets
- AHCJ calls for better information from Joint Commission Web site
