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by Anthony Cirillo
FierceHealthcare recently reported on the latest report that identifies the best-performing hospitals that offer the highest quality of care. The research firm that came up with the list says it's the "first comprehensive index to compare the value of care that hospitals provide."
They measure quality, including CMS's Core Measures, patient safety, mortality and readmission rates; efficiency, including the relative measure of the cost to the hospital for providing services; affordability, a relative comparison of prices charged for inpatient and outpatient services; and patient satisfaction as measured by CMS' patient satisfaction survey (known as HCAHPS).
From a cursory view, this latest ranking list does appear to be the most rigorous I've seen. That said, this whole arena of consumerism and health leaves me baffled. And I'm sure I'm not alone.
For instance, on the one hand, there's a popular magazine rating hospitals and hospitals hanging on to every word they publish (U.S. News and World Report). And on the other hand, we also have patient satisfaction data from Health Grades, the Joint Commission, CMS, and even Angie's list. Talk about confusing the public!
How about coming up with just one authoritative list that consumers could use to help them choose a hospital, physician, home health agency, nursing home, etc.?
And while we're at it, it would also be great if providers would stop adding to the confusion with their myriad of mass media mania touting their latest score in the latest hot list.
Finally, let's take a second look at the data collection tools themselves. Have you ever read any of the HCAHPS questions? For example, one question asks, "During this hospital stay, after you pressed the call button, how often did you get help as soon as you wanted it?" Another question asks, "How often did nurses treat you with courtesy and respect?"
They're rather broad and vague, wouldn't you say? And when you have hospitals scoring fairly close in the results--my hospital scores a 94, while my competitor scores a 92, for instance--there is no real "meat," in my estimation, for the public to actually gauge which hospital truly provided a better patient experience and thus, higher satisfaction.
If you believe the scores, hospital experiences are pretty peachy keen. But talk to a neighbor who just experienced the system and you'll hear a different story that causes you to wonder where these scores really came from.
Of course all of the rating agencies have a business interest to do so. Arriving at one standard will be quite impossible unless perhaps they all put their heads together to see how their data complements one another and work together to actually help the public.
People do not pay attention to this data until there is a crisis. Even then, they may review the data hastily, without a clear understanding of how to use it or which data is the most accurate. I have witnessed this firsthand during my sister's recent bout with breast cancer. Hospitals need to educate people around these issues, too--rather than advertise their patient satisfaction scores to compete with neighboring institutions.
What is interesting is even with the educated boomer consumer, perceptions of hospitals span decades. If your local hospital was "the place where my grandmother died," chances are you're not going to step foot in there as a patient if you can help it. Funny how that works.
So what do you think? Do we need to come up with one solid way to measure and report quality and satisfaction versus just satisfaction alone? I'd love to hear your thoughts!
Anthony Cirillo, FACHE, ABC, is president of Fast Forward Consulting, which specializes in patient- and person-centered care and strategic marketing for healthcare facilities.
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