QIOs go beyond typical quality initiative
QIOs go beyond typical quality initiative
Expand target areas for critical care improvement
The national network of Medicare quality improvement organizations (QIOs) has done more than merely support a new initiative by several national organizations to improve critical care; it is in the process of going beyond the basic scope outlined in the initiative.
A QIO is an organization funded by Medicare, Medicaid, and private payers to evaluate and improve the quality of health care services.
The initiative recently was announced by the American Hospital Association (AHA), the Federation of American Hospitals, and the Association of American Medical Colleges, with support from the Joint Commission on Accreditation of Healthcare Organizations, the Centers for Medicare & Medi-caid Services (CMS), the Agency for Healthcare Research and Quality (AHRQ), and the National Quality Forum.
Its intention is to put leaders in the medical community on the same path to improving critical areas of care through voluntary public reporting of hospital performance data.
Over the next three years, under contract to CMS at the U.S. Department of Health and Human Services, QIOs nationwide will:
- Help hospitals develop the capacity to collect and report quality performance data.
- Assist hospitals and physicians in using performance data to identify opportunities for improvement, and then improving systems of care, so every patient reliably gets top-quality service.
To lay the groundwork, CMS has asked QIOs in Arizona, Maryland, and New York to launch a two-year pilot project to work with hospitals to test a broader set of standardized performance measures and develop a consumer-friendly, web-based display of performance data.
"We were awarded this contract in November 2002, and have been working with the CMS folks and with the other two QIOs that have pilot projects — the Health Services Advisory Group Inc. in Arizona, and the Del Marva Foundation for Medical Care in Maryland," reports Tom Hartman, project director for the Hospital Public Reporting Pilot for IPRO, the QIO for New York State, based in Lake Success.
Working concurrently
The three QIOs will be working on 10 clinical areas:
• Acute myocardial infarction (AMI)
• AMI/coronary artery bypass graph depression
• Asthma
• Breast cancer
• Congestive heart failure
• Diabetes
• Immunization
• Nursing homes
• Pneumonia
• Surgical infection prevention
IPRO will focus specifically on three areas: congestive heart failure, AMI, and pneumonia. "The 10 measures we are talking about are recommended by the AHA," says Hartman. "The pilot projects will be evaluating the use of other measures that go beyond these 10."
This phase currently is in process. "We will test new measures, and the ones that look promising in terms of being useful, valid measures of hospital quality will be added," he says.
Candidate measures will include those currently being used at the local, regional, or statewide level — especially those included in the list of measures endorsed by the National Quality Forum. "We will determine what looks useful to us and what might appeal to purchasers and consumers, as well as those that are regarded as valid by hospitals and physicians," Hartman says.
Ultimately, CMS and the QIOs will make the final determinations. "The intent is to be fairly well uniform," he explains.
Hospitals being recruited
All three QIOs are now recruiting hospitals in their states to volunteer for the pilot project.
"We expect a very high level of participation because we have the support of the Health Care Association of New York State, the statewide hospital trade association, as well as the Greater New York Hospital Association," says Hartman, who notes there are about 230 general acute care hospitals in the state.
"The hospitals will feed us data, and we, in turn, will feed back the results on all these measures both statewide and to all the other states," he says. The data will include performance norms according to size of hospital, as well as region.
"Teaching hospital status will probably be another strata," Hartman notes. Ultimately, these results will be posted on a publicly available Internet site.
Another component of the pilot will be a patient satisfaction survey, which will be provided by AHRQ. "AHRQ and CMS have been working for a number of months to develop a standardized patient experience survey," he reports. "So, the hospitals will not only collect clinical data, but they will test patient satisfaction."
The instrument will be sent to recently discharged patients of each hospital, he explains, and ultimately will be part of the report card that will be posted on the web site.
"This will help consumers make informed choices, and ultimately spur improvement in hospitals," Hartman posits.
Need More Information?
For more information, contact:
- IPRO, 1979 Marcus Ave., Lake Success, NY 11042-1002. Telephone: (516) 326-7767. Fax: (516) 328-2310. Web site: www.ipro.org. E-mail: [email protected].
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