Measure Type: Outcome, Patient Satisfaction, Volume
Colorado’s Hospital Association provides updated information to consumers on the quality and changes in their healthcare system. They use all types of hospitals for their reports, including: private and government-operated facilities, metropolitan and rural, large and small, investor-owned and also non-for-profit organizations. Their mission is to provide “advocacy and leadership, fosters communication, collaboration and consensus; provide technical assistance and information about emerging tools and trends to improve patient safety, hospital efficiency and effectiveness.”
Colorado’s Department of Public Health and Environment has provided data to Colorado’s Hospital Association to create the hospital report cards. This has been recently developed and as of November 2007, been available to the public. They provide several quality measures for hospitals, which include: mortality, patient safety, pediatric inpatient volume, prevention, and procedure volume measures.
There data is collected from Colorado’s Hospital Association Discharge Data Program. The database (a.k.a. Databank) consists of hospital information on the average length of stay, outpatient statistics, charges and expenses, uncollected charges, etc. This database is not available to the public. They also use a second database for their discharge data. It contains information on all inpatient and ambulatory surgeries from the participating hospitals.
Mortality: This measure records the amount of deaths that occur in a hospital due to a medical condition. Colorado’s mortality measures include the following medical conditions: Bleeding Stomach/Intestine (GI Bleed), Heart Artery Repair (PTCA), Heart Attack (AMI), Heart Bypass (CABG), Heart Failure (CHF), Hip Fracture, Hip Replacement, Neck Artery Surgery (CEA), Pneumonia, Skull Surgery (Craniotomy), and Stroke. The measures are risk-adjusted to account for the increase/decrease in the amount of death for a particular procedure (e.g. variables such as age/sex can change the outcome of recovery).
Patient Safety: This measure aids hospitals to identify unfavorable events that occur to patients while in the hospital. For example, a patient’s safety may prevent complications when they are admitted to receive treatment. The measure is used on patients with: Bloodstream Infection (Sepsis), Blood Clot (DVT)/Lung Artery Clot (PE), and Pressure Sores (Decubitus Ulcer).
Pediatric Inpatient Volume: The total number of pediatric patients admitted to a hospital for a medical condition is recorded for this measure. It does not provide the number of procedures that have been performed. The pediatric inpatient volume measures are: Appendectomy, Asthma, Diabetes, Gastrointestinal (GI) Illness, Live Births, and Respiratory Illnesses.
Prevention: Prevention examines ambulatory conditions. In order to establish excellent outpatient care this measure informs hospitals where more services are needed to prevent complications of treatments. The prevention measures are on: Amputations (diabetic-associated), Asthma, Chest Pain (Angina), Chronic Lung Disease (COPD), Dehydration, Diabetic Complications (long-term), Diabetic Complications (short-term), Heart Failure (CHF), High Blood Pressure (Hypertension), Low Birth Weight Deliveries, Pneumonia, Ruptured Appendix, Uncontrolled Diabetes, and Urinary Tract Infection (UTI).
Procedure Volume: The last measure looks at Procedure Volumes. It illustrates the number of procedures performed in a hospital. They believe (based on scientific research), that a higher volume of procedures performed in a hospital is correlated to a lower death rate. It includes data on: Abdominal Artery Repair (AAA), Heart Artery Repair (PTCA), Heart Bypass (CABG), and Neck Artery Surgery (CEA).
2008 New Measures:
For the summer of 2008, Colorado hospitals will be reporting on hospital-acquired infection measures that include: central line-associated bloodstream (CLABSI), heart bypass (CABG), hip replacement, and knee replacement. In the future they are looking to add patient satisfaction responses using HCAHPS (a Hospital’s Consumer Assessment of Healthcare Providers and Systems) measure. They also would like to improve the efficiency of care using the Joint Commission Nursing Sensitive measures.