Hospital Compare leads hospitals to focus on wrong measures?

With the proliferation of public quality reporting, Health & Human Services' Hospital Compare website is causing hospitals and health systems to hone in on new improvement targets, such as the patient experience. But are the targets the right ones?

Updated this month, Hospital Compare provides a wealth of information, including data on rates of pneumonia, heart failure, blood clots after surgery, or collapsed lungs, among other quality measures. Patient safety advocates laud the transparency. While the public reporting allows patients to investigate care choices, Hospital Compare also allows hospitals to compare performance against each other.

"It allows patients and doctors to make better informed choices," said Don McLeod, spokesperson for the Centers for Medicare & Medicaid Services, in a Register Citizen article. "That's the heart of it."

In addition to the standard clinical quality measures, the website also includes patient hospital experience data, such as how well patients thought their nurses communicated, how well patients' pain was managed, and how quiet and clean patients' rooms were, according to the Hospital Compare website.

The newfound emphasis on the patient experience has lead hospitals to pay particular attention to these quality measures.

For example, Connecticut's Charlotte Hungerford Hospital--although above average in bathroom cleanliness--is far below national averages of night-time quietness, according to the Register Citizen. In response, the hospital created a noise-reduction committee to improve the care of its night-time patients and is experimenting with a smartphone paging system to be less intrusive.

"We've learned that by making this public, the hospitals want to make improvements. It improves quality of care and it improves patient services," McLeod said.

When asked if current quality measures focus too much on experience and not clinical care, Disney Institute's healthcare consultant Patrick Jordan told FierceHealthcare, "It's a matter of approaching the patient where she is and what's in front of her. And what's in front of her is her experience."

Another qualm with the website that some hospitals have is that Hospital Compare doesn't offer timely data. The website launched in 2004, and there are delays in the time hospitals submit data and when they are posted, according to the Register Citizen.

"The thing that's frustrating to us is that while we start seeing improvements in [the] next few months, it won't be reflected on the site for a year," Dr. Sally Houston, Tampa General Hospital's chief medical officer, said in a Tampa Tribune article. "So we'll just have to take our lumps right now."

For more information:
- read the Register Citizen article
- read the Tampa Tribune article
- check out the Hospital Compare website

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