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Hospitals Seek Policy Changes to Remove Barriers to Quality Improvement Efforts

October 26, 2018

Hospitals and health systems have made great strides to improve quality of care, such as reductions in hospital-acquired infections and early elective deliveries.  

The significant amount of actionable data and information that is now available through public reporting efforts has contributed to these improvements. Public policies can help or hurt hospital efforts to improve quality. The movement from volume-based health care to value-based health care––in which payment is based on quality and outcomes––has resulted in many changes.

In order to sustain and continue quality improvement efforts, the hospital community is seeking policy changes to alleviate complexity, unnecessary burden, and lack of alignment. An American Hospital Association (AHA) October 2018 TrendWatch delves into these issues and identifies solutions. 

A rapid growth of quality measures; increasing and unaddressed inconsistencies in reporting requirements for measures; and concerns about the soundness of electronic clinical quality measures can impede progress and negatively impact quality of care.1,2,3

HAP supports the AHA’s request that policymakers such as the Centers for Medicare & Medicaid Services, the Centers for Disease Control and Prevention, Food and Drug Administration, Agency for Healthcare Research and Quality, the National Quality Forum, and The Joint Commission, focus on:

  • “Measures that matter” the most to improving outcomes and health in measurement and pay-for-performance programs
  • Continuous quality improvement that makes care safer and more effective
  • Standards that enable innovation and require adherence to fundamental principles necessary to protect patients
  • Alignment of measurement, CoPs, and infrastructure to support quality improvement efforts

Health care transparency is critical to ensure patients can make informed decisions. They deserve accurate, meaningful information about the quality of care in hospitals. But public quality report cards that present inaccurate information pose more problems and lead to confusion. In fact, a hospital may perform well on one report card and poorly on another.

Four national hospital associations, including the AHA, support principles developed by the Association of American Medical Colleges that call for quality report cards to:

  • Have a clearly stated purpose, with measures selected to fit this purpose
  • Demonstrate transparency by using a scoring methodology that can be replicated by others
  • Clearly identify data sources and describe limitations of quality scores
  • Demonstrate validity by using statistical methods that are supported by evidence and are field tested

A recent blog by HAP President and CEO Andy Carter outlines the broad spectrum of federal regulatory relief sought by the Pennsylvania hospital community, including the provisions specified in this detailed “Red Tape Reduction Wish List.”

Pennsylvania hospitals are committed to continuous quality and safety improvements. They are constantly identifying and adopting best practices to improve care and sharing those practices with colleagues across the state. HAP’s Hospital Improvement Innovation Network (HIIN) serve as convener, collaborator, and educator, working to improve patient care in the hospital setting.

The HIIN’s core emphasis is on reducing preventable hospital-acquired conditions and readmissions, but HIIN professionals are engaged in other quality initiatives including patient and family engagement, health literacy, and depression screening.

For additional information about the HIIN, contact Rob Shipp, HAP’s vice president, population health strategies. For information about quality policy issues, contact Kate Slatt, HAP’s senor director, innovative payment and care delivery.

 

1 Kaiser Family Foundation. Claxton, Gary, et al. (Sept. 10, 2015). Measuring the quality of healthcare in the U.S. Health Systems Tracker.
2 National Academy of Medicine. (April 2015). Vital Signs: Core Metrics for Health and Health Care Progress.
3 Bipartisan Policy Center. (April 2015). Transitioning from Volume to Value: Consolidation and Alignment of Quality Measures.

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