THOT members are committed to quality health care and driving quality improvements within their health systems. See below for a sampling of these initiatives.
In Texas, state measurements of hospital quality currently focus primarily on process measures of potentially preventable complications and readmissions, two serious issues. THOT members believe in the importance of reducing and ultimately eliminating these events. However there are strong indications that some of these events are outside the control of the hospital, and are much more likely to occur in hospitals treating patients with various sociodemographic characteristics. This could mean that a hospital See below for additional information and evidence.
Potentially Preventable Readmissions
Readmissions, Observation, and Improving Hospital Care By ASHISH JHA, MD Because hospitals are expensive and often cause harm, there has been a big focus on reducing hospital use. This focus has been the underpinning for numerous policy interventions, most notable of which is the Affordable Care Act’s Hospital Readmissions Reduction Program (HRRP), which penalizes hospitals for higher than expected readmission rates. The motivation behind HRRP is simple: the readmission rate, the proportion of discharged patients who return to the hospital within 30 days, had been more or less flat for years and reducing this rate would save money and potentially improve care. So it was big news when, as the HRRP penalties kicked in, government officials started reporting that the national readmission rate for Medicare patients was declining. [Read More]
Association of American Medical Colleges January 2016
The Patient Protection and Affordable Care Act (PPACA) established three Medicare hospital quality performance programs designed to improve clinical outcomes, patient experience, and efficiency. Each of these uniquely structured programs ties Medicare payment for health care services to hospital quality: • Hospital Value-Based Purchasing Program (HVBP) is a program with two-sided incentive payments— both penalties and bonuses—based on performance on a variety of quality measures. • Hospital Readmissions Reduction Program (HRRP) is a program with incremental penalties for excess readmissions for selected conditions. • Hospital-Acquired Condition Reduction Program (HACRP) mandates that 25 percent of all hospitals are penalized 1 percent of their diagnosis-related group (DRG) payments1 (including policy add-on payments) for relatively poor performance on patient safety and infection measures. [Read More]
JAMA Forum: We Need to Use Better Data to Measure Quality
October 7, 2015 by Aaron Carroll
For some time, there has been a push for health insurance to pay for quality and not quantity. This has been a mantra of the current administration as it has begun to alter Medicare payment reform to reflect this philosophy. Not long ago, the Centers for Medicare & Medicaid Services (CMS) committed to making 50% of Medicare payments tied to metrics of quality by 2018. Of course, such decisions are predicated on the idea that we are good at measuring quality. If we are going to pay hospitals differently based on their performance, then it’s absolutely mandatory that we be able to differentiate between those who deserve higher payments and those who do not. Many are concerned that our ability to do so isn’t adequate. [Read More]
THOT Testimony
THOT Testimony on Quality to MCAC on February 18, 2016
Quality Initiative Sampling from THOT Members
UMC Health System of Lubbock: “At UMC, the safety of our patients is our priority. UMC’s Fall Prevention Campaign is aimed at spreading awareness throughout UMC that yellow gowns indicate a patient at risk for falls. We should be mindful of these patients, and offer our help.”
University Health System (San Antonio): “At University Hospital, our dedicated stroke team treats all types of stroke – even the most complex cases – through our comprehensive stroke center and medical team’s extensive expertise. We are the only hospital in San Antonio with a dedicated Neuro Critical Care Unit where patients receive specialized care from a trained neurocritical team during the most critical stages of the recovery process. Our stroke team spends extensive time engaging in research and reviewing data, quality, outcomes and patient satisfaction reports so that we take the necessary steps to offer every patient the best care for the best possible outcome. [Read More]”
Parkland Health & Hospital System (Dallas): “At Parkland, quality, safety and service are at the core of everything we do. But how do you measure quality in health care? How do you know where the care you receive ranks in terms of quality and safety? Parkland wants to help. This online tool provides quality measures for the care provided at Parkland, describing how we are performing in areas such as surgery, infection prevention or other core quality indicators.” [Read More]