Postoperative complications were the most expensive, accounting for 35 percent of costs for medical errors and 39 percent of costs for preventable medical errors. There are many ways to measure errors and the economic impact. A recent study of over nurses, administrators, and physicians revealed that 20 percent believe a large impact on patient and staff safety has occurred due to the recession and its fall out.
In the case of healthcare, communities must be able to identify opportunities for reducing costs and improving quality, and monitor whether those opportunities are being successfully addressed. RHICs across the country are publishing reports on many aspects of quality and cost that are unavailable to the public and healthcare providers through any other source.
This involvement increases the willingness of providers to change care processes in order to improve their performance. Types of Performance Measurement: Quality of Physician Services Most Regional Health Improvement Collaboratives collect and publicly report data on the quality of care delivered by physician practices.
The types of measures reported include both clinical processes of care e. Most of these measurement systems rely on health plan claims data, but some include clinical data. The Wisconsin Collaborative for Healthcare Quality has pioneered a methodology to obtain clinical data directly from physicians, thus enabling more comprehensive quality measurement.
This methodology does not depend on physicians having electronic health record systems, thereby allowing broad-based participation. While RHICs typically use nationally-endorsed measures where they exist, they have also pioneered the development of new and improved measures where needed.
Pioneering New Measures to Determine the Quality and Cost of Care The California Cooperative Healthcare Reporting Initiative conducts a telephone survey of primary care physician offices to assess after-hours physician availability and access to appropriate emergency and urgent care information.
Minnesota Community Measurement has developed MN Healthscoresa website produced by Minnesota Community Measurement to report information about the healthcare provided in clinics, medical groups and hospitals to share comparable, useful and trusted information about healthcare quality.
RHIC reports on the quality of physician services: Here again, the measures range from processes e. The Iowa Healthcare Collaborative issues a detailed report with extensive measures of the quality and safety of patient care in hospitals in Iowa.
The Greater Detroit Area Health Council issues reports on a wide range of measures of the quality and safety of patient care in hospitals in southeastern Michigan. RHIC reports on the quality of hospital services: The Washington Health Alliance issues an extensive analysis of health plan quality and services, rating health plans on over three dozen different items.
Regional Health Improvement Collaborative reports on the quality of health plan services: Information for more than 20 measures are available to consumers, employers, providers, policymakers, health insurers and others.
Many of the measures are publicly reported on the website www. Q Corp has also built a provider portal with clinic, provider and patient-level detail for the measures to help primary care practices improve care.
It included more thanpatient-completed surveys on patient experience of care from clinics around Minnesota. The next round of results will be released in Regional Health Improvement Collaborative reports on patient experience: Minnesota Community Measurement reports on the costs at different healthcare providers for procedures ranging from colonoscopies to labor and delivery.
Quality Quest for Health reports on the rate at which physicians prescribe generic drugs for their patients. Generic prescribing rates are reported for primary care physicians and a number of specialties.
Read article Regional Health Improvement Collaborative reports on cost of healthcare services: The Washington Health Alliance compiles quality measures separately for patients with commercial insurance and patients whose healthcare is paid for by the state Medicaid program, and the Alliance highlights areas where there are significant differences.
Better Health Greater Cleveland compiles separate quality measures for patients who are uninsured as well as for patients who are covered by Medicaid.
RHIC reports on disparities in performance: Cleveland, SeattleRegional Health Improvement Collaborative Using Measurement to Improve Performance It is important to recognize that Regional Health Improvement Collaboratives are not only collecting and publicly reporting an extensive array of quality measures, they are also actively using those measures with providers to encourage improvements in the quality of healthcare in their communities.
In many cases, the measures have been developed specifically to support a local quality improvement initiative, rather than the other way around. Minnesota Community Measurement is measuring the remission rate from depression as part of a major, successful community initiative to improve the treatment of individuals with depression.
IHA is responsible for collecting and aggregating data, deplying a common measure set, and producing results that are used for health plan incentives to physician organizations, public reporting, and awards.
Integrated Healthcare Association IHA has been measuring the total cost of care and resource use for over a year and reporting the results to physicians. As one physician said: I was able to use the data from Partner for Quality Care and compare it to my own patient registry.
Our office has already instituted a change in our phone advice protocol that affect how asthma medication refills are handled. Download Report More information on the roles Regional Health Improvement Collaboratives are playing in helping healthcare providers improve their performance is available here.
I find my confidence increases when I have the opportunity to discuss leadership challenges and opportunities with my peers.Pay-for-Performance / Quality Incentives May 24, MMA §e: ESRD Bundled Payment Demonstration Page 1 identified opportunities for quality improvement and have achieved notable improvements in Break-through Initiative in the area of quality.
. However, because pay-for-performance rewards performance directly in markets where there are few hospitals, and thus little competition to spur quality improvement through public reporting, pay-for-performance may be needed to generate sufficient financial incentives for improving quality.
Public reporting and pay for performance are intended to accelerate improvements in hospital care, yet little is known about the benefits of these methods of providing incentives for improving.
When quality is considered from the IOM's perspective, then an organization's current system is defined as how things are done now, whereas health care performance is defined by an organization's efficiency and outcome of care, and level of patient satisfaction.
Quality is directly linked to an organization's service delivery approach or underlying systems of care. Evaluation, Performance Management, and Quality Improvement: Understanding the Role They Play to National Public Health Improvement Initiative OSTLTS Performance Management/Quality Improvement Resource page.
Discussions of hospital quality, efficiency, and nursing care often taken place independent of one another. Activities to assure the adequacy and performance of hospital nursing, improve quality.