Quality and Safety Key Performance Results
HOSPITAL QUALITY PERFORMANCE
Accredited U.S. hospitals continue to demonstrate measurable improvements in quality. Still, much room for improvement remains. Also, significant variability exists in the performance of hospitals by state, as well as between the highest- and lowest-performing hospitals.
The Joint Commission measures quality improvement by tracking hospital performance in providing common treatments shown by scientific evidence to lead to the best outcomes for patients. The data demonstrate that patients are more consistently receiving these “evidence-based” treatments. Quality improvement in hospitals contributes to saved lives, better health and quality of life for patients, as well as to lower health care costs.
All improvements in performance are statistically significant. Many of the smaller percentage improvements occurred within large patient populations, meaning that significantly more patients received the benefits of evidence-based treatments. Also, in some cases, performance was already quite high and there was less room for improvement.
Hospitals Improved Performance On 19 individual Measures of Quality
Between 2002 and 2006, hospitals consistently improved the quality of care provided for heart attack, heart failure and pneumonia, according to an analysis of 13 individual measures of performance quality by The Joint Commission. Improvement also was demonstrated on six other measures of quality relating to heart attack care, pneumonia care and surgical care* tracked from 2005-2006. There were two new pneumonia care measures tracked for the first time in 2006. More than 3,000 hospitals contributed data. Six of the 13 measures analyzed from 2002-2006 apply to heart attack care, four to heart failure care and three to pneumonia care. Of the six measures tracked during 2005-2006, one relates to heart attack care, three to pneumonia care and two** to surgical care. There were two new pneumonia care measures tracked for the first time in 2006.
The magnitude of national improvement on individual evidence-based measures tracked from 2002-2006 ranged from 3.6 percent to 52.2 percent, and improvement has increased steadily since 2002. The performance of hospitals improved the most on measures where performance was lower at the beginning of the tracking period. On measures tracked for the first time in 2005, performance is generally lower and more variable than on the performance for measures tracked since 2002, showing a correlation between performance measurement and quality.
There were some dramatic improvements over the five-year period of data collection, especially in providing smoking cessation advice. For example, hospitals provided this advice to 89.4 percent of pneumonia patients in 2006 compared with 37.2 percent in 2002. Hospitals also showed greatly improved results from 2002 to 2006 in providing this advice to heart attack patients (to 96.6 percent from 66.6 percent) and heart failure patients (to 92.1 percent from 42.2 percent). Other strong improvements included providing discharge instructions to heart failure patients (to 70.3 percent from 30.9 percent) and providing pneumococcal screening and vaccination to pneumonia patients (to 75.8 percent from 30.2 percent).
For more detail on these results, see the Quality Performance Detail section of the report.
* In 2006, the Surgical Infection Prevention Project was renamed the Surgical Care Improvement Project to encompass more areas of surgical care.
** There are two surgical care measures that each report rates on seven specific surgical procedures, as well as the overall measure rate. Improvement was seen in all 16 measure rates.