Updated hospital data allows reporters to identify ongoing problems
Filed under: Health data, Hospitals, Public records
The release this month of federal data on hospital quality is a good reminder for reporters to give their local hospitals a checkup.
Now that CMS has been reporting information on mortality and readmissions for several years, it’s possible to use the data to identify hospitals that repeatedly excel and those that have ongoing problems. While some journalists may have a been-there-done-that reaction to yet another round of data, the latest release has important information for your readers, viewers and listeners. After several years, a surprising number of hospitals can’t seem to improve — and an elite group has been able to maintain its excellence.
AHCJ not only offers the data in easy-to-analyze formats; we also offer tip sheets on using spreadsheets to analyze health data. To give you a head start, Charles Ornstein, senior reporter at ProPublica and AHCJ’s president, has done some preliminary analysis and points out states in which hospitals fared well and the states where hospitals did poorly. He also identifies the best and worst in the country based on mortality rates for patients suffering heart attacks, heart failure and pneumonia.
Spotlight on health care quality, measures
Filed under: Health policy, Public health, Studies
The April issue of Health Affairs focuses on the quality of health care in the United States. Some highlights of the issue, which was sponsored by the Robert Wood Johnson Foundation:
- analysis and commentary on improving performance measures
- research that found the methods currently used to gauge patient safety actually missed 90 percent of the adverse events
- the cost of errors and adverse events
- research on measuring quality
- lessons to be learned from other countries
- how pay-for-performance has affected quality
- several case studies of how quality has improved in specific institutions
Those of you who attended Health Journalism 2010 might be particularly interested in an update from Peter J. Pronovost, M.D., who was the keynote speaker at last year’s conference. In this issue of Health Affairs, Pronovost writes about the advances in reducing central line-associated bloodstream infections – which he discussed at last year’s talk.
Remember, AHCJ members receive free access to Health Affairs. If you haven’t already signed up for access, be sure you take advantage of that benefit.
Joint Commission makes more accreditation details available on website
Filed under: Health data, Health journalism, Hospitals
Angie C. Marek, a member of AHCJ’s Right to Know Committee, contributed this update.
The Joint Commission, the largest nonprofit organization to accredit hospitals in the United States, has improved the quality of information available to consumers and journalists on its website. 
In response to a request by AHCJ’s Right to Know Committee, the agency has made it easy to tell whether a facility has recently lost accreditation or is in danger of losing it.
In the site’s Quality Check section, the search page now has a filter allowing viewers to select “Type of accreditation.” (The filter only appears in areas where there are hospitals that are not fully accredited.) Previously, to find hospitals with less-than-full accreditation, users had to examine each hospital’s record individually. Now the few that have not met standards can be quickly located.
“We’re pleased that the Joint Commission responded to our suggestion to make its website more useful,” said Charles Ornstein, president of AHCJ’s board of directors. “Reporters and consumers will now find it somewhat easier to learn about the institutions to which they entrust their health.”
Data Mine reports on access to practitioner data
The Center for Public Integrity’s Data Mine focuses on the National Practitioner Databank and the lack of public access to information in the database, which contains information about loss of privileges for medical professionals, malpractice payments and license revocations.
The public can access and use statistical information from the database but it cannot find out information about specific professionals. The American Medical Association, opposes making information in the database public because it “is riddled with duplicate entries [and] inaccurate data,” according to the Data Mine’s report.
A report last year from Public Citizen revealed that hospitals take advantage of loopholes to avoid reporting disciplined physicians to the database.
AHCJ Resources
- Access to list of disciplined health workers in limbo
- A road map for covering your local hospital’s quality
- How well does your state oversee nurses?
- State oversight of health professionals
- Records show ‘dangerous doctors’ rarely face discipline
- Health reporting resources for reporters covering state and local government
- Investigating health care: Essential public records
Some Mass. hospital quality measures online
Elizabeth Cooney, writing on White Coat Notes, alerts us to a change in data provided by the Massachusetts Hospital Association and the Massachusetts Organization of Nurse Executives.
PatientCareLink, the new site, adds examples of hospitals improving their performance and, for patients, gives advice on choosing a doctor or hospital, according to Cooney.
The site allows you to view hospital staffing plans and performance measures, such as prevalence of bedsores, patient falls, heart attack care, pneumonia care and surgical care.
Some of the data comes from Hospital Compare (also participating hospitals. And there’s no apparent way to download the data for analysis, as you can from the Hospital Compare site (and AHCJ).
Of course, ratings of Massachusett’s hospitals also are available from the Massachusetts Health Care Quality and Cost Council.
Tulsa World reports on disciplining doctors
More than 300 Oklahoma doctors have been disciplined by the Oklahoma Board of Medical Licensure and Supervision, according to an analysis of the board’s database by Tulsa World reporters Kim Archer and Gavin Off.
Their series focuses on “the consequences doctors face in Oklahoma for medical errors and unethical behavior” and looks at its program to help doctors with addictions. It also tells the stories of several disciplined doctors and reports on why Public Citizen has ranked the board as one of the ten best in the country.
Other stories in the series explain to consumers how to check a doctor’s history and get additional information when choosing a doctor. Off also writes about a federal database used to track incompetent and unprofessional health professionals. “Although the full database is open to hospitals, managed care organizations and state licensing agencies, the public can view only limited information, such as the lawsuit’s allegation and the patient’s health.”
Archer reports that few people who sue for malpractice in Oklahoma win their cases. “Some cases are settled out of court, but most of those cases come with nondisclosure agreements to protect doctors and health practitioners from being exposed, several Oklahoma malpractice lawyers told the Tulsa World.”
The World also made a searchable directory of doctors available on its Web site, though it does not include more than 1,600 osteopaths practicing in the state who are governed by the Oklahoma Osteopathic Board.
Related
Tip sheets
A road map for covering your local hospital’s quality
How well does your state oversee nurses?
Sorting out hospital rankings
Intro to investigating health data using spreadsheets
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.
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
- Access to list of disciplined health workers in limbo
- Hospitals avoid reporting disciplined docs
- When quality matters to boards, hospitals do better
- 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
Markets offer examples to improve costs, quality
In a New York Times op-ed, Atul Gawande, Donald Berwick, Elliott Fisher and Mark McClellan discuss a recent meeting of doctors and leaders from 10 U.S. regions that are providing high-quality care for lower costs.
“Our criteria were simple: find regions with per capita Medicare costs that are low or markedly declining in rank and where federal measures of quality are above average.”
They found a number of idea that could be applied nationally to reduce health care costs and improve the quality of care, including:
- using electronic systems to improve communication among physicians
- investigating the overuse of CAT scans
- tracking measures of quality and meeting cost-reduction goals
- merging two underutilized hospitals
- adopting electronic systems for patient data
The writers say that, in these more efficient areas, “neither the physicians nor the citizens reported feeling that care is ‘rationed.’”
Study: Hospital quality rankings inconsistent
A study published in the November/December 2008 issue of Health Affairs finds that five consumer-oriented Web sites that rank hospital quality are inconsistent and likely to confuse consumers.
The study involved rankings provided by Hospital Compare, HealthGrades, Leapfrog Group, U.S News and World Report, and Massachusetts Healthcare Quality and Cost (a state-run service). Researchers compared community-acquired pneumonia, total hip replacement, percutaneous coronary intervention, and coronary artery bypass grafting at nine Boston-area hospitals.
In American Medical News, lead author Michael B. Rothberg, M.D., M.P.H., said, “I don’t think these ratings are at the point where doctors or patients can really use them.”
Rothberg, an assistant professor of medicine at Tufts University School of Medicine in Boston, also said that “Public reporting was created to be a tool for consumer choice and to improve quality, but the inconsistency in these systems does a disservice to patients rather than achieve its true potential.”
The American Medical News article also includes reactions from representatives of the rankings.
Note: Remember, AHCJ members can sign up for free access to Health Affairs.
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