Hospital quality now on Web site

Michelle Swafford

Friday, April 1, 2005 | 11:11 a.m.

Starting today, patients can find out how Nevada hospitals rate when it comes to patient care for heart attacks, heart failure and pneumonia.

The Hospital Quality Alliance -- a public-private partnership made up of the Centers for Medicare & Medicaid Services, the American Hospital Association, the Federation of American Hospitals and the Association of American Medical Colleges -- led the effort to make hospital procedures more transparent to the public. A host of other doctors' and nurses' organizations locally and nationally and the AFL-CIO and AARP are supporting the efforts.

Las Vegas Valley residents can see how local hospitals did through one of two federal Web sites -- www.hospitalcompare.hhs.gov or www.medicare.gov -- or by calling (800) 633-4227. Information is available at a state, county, zip code and hospital level.

A few years ago, CMS launched a similar program for home-health agencies and skilled-nursing homes and those programs have been successful in improving quality, Regional CMS Administrator Jeff Flick said.

"We're hoping we'll look back in two years and say the same about hospitals," he said, adding that hospitals would one day compete based on the quality of care they provide.

"Lots of people believe that the primary beneficiary is the consumer, but the really big news and the people who really work on this are the people inside the hospital -- the board of directors, physicians, nurses," Flick said. "Everybody wants their hospital to do the best. It's that process that drives people to pay closer attention and that's what makes health care improve."

The information shows how often hospitals are meeting industry standards for treating heart attacks, heart failure and pneumonia. Hospital information is available for 17 measures, which are recommended procedures for those conditions.

For example, it is commonly accepted in the hospital industry that aspirin should be given to heart attack patients when they arrive and a beta-blocker should be given at discharge, Flick said.

The three medical conditions were chosen because they affect numerous people and the procedures for treating those illnesses are agreed upon in the medical community, he said. Other conditions would be added to the quality program and current measures could change as medicine changes, Flick said.

The national alliance is the latest group to release patient safety and quality measures to improve health care. There are several other programs that rank hospitals on their procedures or patient outcomes, but the newest one relies on data from adult patients from all payer types.

"Every hospital in Nevada agreed to voluntarily participate in this quality initiative," said Bill Welch, president and chief executive of the Nevada Hospital Association. "We are concerned and we consciously and proactively look for ways to improve quality of care and the safety of care in our hospitals."

The incentive for hospitals to participate is that they receive a 0.4 percent increase in their Medicare reimbursements, which offsets any administrative costs associated with compiling, verifying and reporting the information, Flick said.

HealthInsight, the local quality-improvement agency that provides quality-improvement assistance to doctors, hospitals, home-health agencies and skilled-nursing homes is working with Nevada hospitals to improve their quality scores, HealthInsight spokeswoman Kristen Boucher said.

One local hospital chain that benefited from reporting its quality outcomes for heart attacks was St. Rose Dominican Hospitals.

St. Rose Dominican Hospitals -- Rose de Lima and Siena campuses brought doctors, lab technicians, nurses and other health professionals together to discuss what procedures should be used for heart attack patients, said Tamara Winkler, a registered nurse and the quality consultant for St. Rose Dominican Hospitals.

The hospitals created a standardized checklist of procedures for heart attack patients when they are admitted and discharged, Winkler said, adding that typically a doctor has to write orders for each patient.

Although it happens infrequently, there are times when a nurse forgets to administer aspirin when a heart attack patient arrives, but the checklist minimizes those chances, Winkler said.