Did the HEN lay an egg?
Slow progress on quality goals
The Hospital Engagement Network (HEN) — a joint effort of the American Hospital Association and the Health Research and Educational Trust — released its annual report last month, showing some slow progress on key quality metrics, but a lack of progress on many of the goals touted by the organization.
It could be the last year for the network, although there is a potential for another year to be optioned. Thus far, 1500 hospitals in 31 states are participating. According to the network, there were some 70,000 patients helped to get better care, with an associated cost savings of more than $200 million.
It sounds appetizing, but the data in the report (available at http://www.hret-hen.org/index.php?option=com_content&view=article&id=103&Itemid=256) shows that a lot of the measures of quality are lagging. For example, goals were not met related to adverse drug events, central line-associated blood stream infections (CLABSI — down 23% in intensive care units), falls, early elective deliveries (although there was a decline of 57% in this), hospital-acquired pressure ulcers (which decreased by a quarter, but didn't make goal), venous thromboembolism (VTE), ventilator-associated pneumonia (VAP — down 13% in ICUs and 34% across all units), and unplanned readmissions.
Indeed, the only two items that met goals were surgical-site infections (SSI) and catheter-associated urinary tract infections (CAUTI).
The network reports did fire off a list of lessons learned though, including:
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Just because hospitals are already collecting a ton of data doesn't mean reporting some more is easy.
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One-on-one coaching helps teach organizations time-saving tricks for data collection and reporting.
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Chief nursing officers are underutilized resources for spreading new processes and as a conduit between leadership and frontline staff.
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Showing leadership their data and status is a way to increase interest in a project or program like HEN.
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Hospitals are stretched thin by all the different quality initiatives they belong to.
Should the option year of 2014 be granted to HEN, there are some lofty goals set, including 80% reporting for the 1,500 participating hospitals and specific goals for each topic area. Examples include
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expanding efforts for CAUTI reduction to all hospital settings and avoiding catheter placement in emergency departments;
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getting early elective delivery rates below 2%;
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adding OB hemorrhage and preeclampsia prevention to obstetric adverse events list;
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expanding VTE to all surgical settings;
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creating a national readmission reduction campaign.
Other areas of interest include working with hospitals to reduce sepsis and MRSA, and working with the American Hospital Association Institute for Diversity on issues of healthcare disparity as they relate to HEN topics.
