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A Publication of WTVP

In the cover story of the July 7 issue of Modern Healthcare, Jeff Tieman opens, "Under pressure from the hospital lobby, the Centers for Medicare and Medicaid Services has backed off its controversial proposal to require all Medicare-certified hospitals to publicly report what patients think of the services they provide." Pekin Hospital, Proctor Hospital, Methodist Medical Center, and OSF Saint Francis Medical Center all are Medicare-certified hospitals. And all of us regularly measure our respective patients’ (of all ages, not just those 65 and over) satisfaction.

While we make that data available to our national accrediting organization-the Joint Commission on Accreditation of Healthcare Organizations-the chief reason we survey our patients is to understand how well we’re meeting their needs. We use this data, "the voice of our patients," to target processes of care and to prioritize our improvement initiatives.

We in health care are very interested in our patients’ evaluations of their experiences, whether they’ve received care on a nursing unit or the emergency department in the hospital, in an outpatient setting, or in their physicians’ offices. We’ve been actively surveying patients for more than 20 years.

Different hospitals use different surveys, and while there’s consistency among the various patient satisfaction surveys, there’s variation in the method of administration-telephone, mail, or Internet-and the respective response rates which affect the results. So much so that some findings may be an accurate reflection of the true levels of patient satisfaction and some may be a major distortion. 

Perhaps this potential inconsistency became a compelling reason to not mandate hospitals to participate. It’s certainly one of the factors that make comparisons of numeric results on satisfaction surveys hard for even experts to understand. The tools are very helpful to hospitals, but not so helpful for making comparisons.

Concurrent with examination of publicly reporting on patient satisfaction, there was an initiative launched in December 2002 focusing on public reporting of hospital quality information. According to the CMS Web site, "The American Hospital Association’s, the Federation of American Hospitals’, and the Association of American Medical Colleges’ efforts to make critical information about hospital performance accessible to the public, payors and providers of care is being actively supported by the JCAHO, CMS, the National Quality Forum, and the Agency for Healthcare Research and Quality. NQF, JCAHO, CMS, and AHRQ will provide technical assistance in developing and/or identifying quality measures; and assist in making the information accessible, understandable and relevant to the public."

The Hospital Quality Information Initiative is voluntary and will get started with measures dealing with heart attacks, heart failure, and pneumonia. Hospitals that choose to participate will be sharing their results publicly, so both consumers and payors will know how well hospitals are doing along 10 measures. Locally and nationally, health care leaders are embracing the concept of public accountability and are supporting this initiative. It’s a part of the evolving effort being lead by the National Quality Forum, a foundation made up of consumers, payors, provider associations, regulatory agencies, and national quality leaders.

It’s a reasonable expectation that this effort will evolve into a really meaningful way to make comparisons of hospital quality over the next few years and as it matures, expand to encompass the full continuum of health care. Willing participation by providers will make it unnecessary for CMS to make it mandatory. We willingly participate because all want to understand how best to create the safest, most effective, most efficient, most patient-centered system that delivers equitable care in the most timely fashion. It’s a national imperative. IBI

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