Hospitals use a wide array of methods to measure care quality, but there are several key considerations that must be included in creating those metrics.
Elizabeth Mort, M.D., senior vice president of patient safety and quality at Massachusetts General Hospital, and hospital President Peter Slavin, M.D., write for U.S. News & World Report that hospitals must move on from older, less effective methods of measuring quality and take a few steps to use new approaches.
“The industry is developing exciting new measures of functional status and measures of health care disparities, all of which identify new opportunities to focus on the needs of specific patient populations,” they write. “As the prospects for new measures improve, we should challenge ourselves to abandon suboptimal metrics and methods and plan for the adoption of new approaches.”
Their suggestions include:
- Stop using patient safety indicators. PSIs, as billing codes, are not particularly effective measures for measuring clinical quality, according to Mort and Slavin, and research has indicated their shortcomings. Despite this, PSIs are the basis for many national measures, including those from the Centers for Medicare & Medicaid Services. New metrics should be developed, according to the article.
- Don’t use statistically meaningless categorization. Some report cards may force clinical data into categories where it doesn’t belong, which can make results inaccurate. Mort and Slavin suggest only dividing data when clinical differences are meaningful.
- Refine readmission rates as a metric. While Mort and Slavin do not entirely discount the value of readmission rates as a measure of care quality, they do call the measure “crude.” They write that there are indicators in 30-day readmission rates that may be important for improving quality of care, but that the way such rates are used requires work. They call this is one of the greatest challenges CMS faces.
- Consider making research available to patients. The image that doctors are involved in research projects is positive to patients, and more clinical data may make it easier for them to determine where to receive care.