Performance Measurement

NR 447 Week 6 Performance Measurement PowerPoint

What is Hospital Compare?

Hospital compare has information about the quality of care at over 4,000 Medicare-certified hospitals, including over 130 Veterans Administration (VA) medical centers, across the country. You can use Hospital Compare to find hospitals and compare the quality of their care. (Medicare.gov)

We will be comparing Lincoln and Jacobi hospitals, both located in Bronx, NY in very different neighborhoods.

Is there a major difference in care?

Are patients more satisfied with the quality of care in one hospital over the other?

This Photo by Unknown Author is licensed under CC BY-ND

Reasons to recommend the website hospital compare to consumer/patient.

Patients can see the ratings of the facilities near them from other patients.

They can see if the hospital has any experience with their condition.

They can see what the hospital strengths and weaknesses are.

They can see how patients rate their overall visit at the hospital, from communicating with the doctors and nurses to the cleanliness of the facility.

They can see if the hospital uses patient surveys and checklists to identify areas for improvement.

Patients can compare hospitals side by side for an easier way to see how they compare to one another.

List reasons to recommend the hospital compare to staff who may seek employment.

It can show all hospitals in the area.

They can find out what services the hospital offers.

They can see how previous patients rate the staff and facility.

This Photo by Unknown Author is licensed under CC BY.

Lincoln Hospital Medical and Mental Health Center.

Patient surveys

Lincoln Hospital received a one-star overall rating, but 51% of patients surveyed gave it a rating of 9/10.

They scored fairly close to the national average in communication with physicians. Communication with nursing staff was lower than both the New York and national averages.

Only 43% of patients surveyed understood their care upon discharge, while 76% reported that they were given discharge instructions to take home, which usually include information about the care they received in the hospital.

Effective care data for two conditions:

Sepsis is a complication that occurs when your body has an extreme response to an infection. It can cause organ damage and may be life-threatening if not treated. Sepsis can sometimes progress to septic shock, which carries a higher risk of death. Identifying sepsis early and starting appropriate care quickly increases the chances of survival. 31% out of 507 patients were effectively treated for sepsis according to Medicare.gov.

Data for readmission and complications and deaths.

Unplanned readmissions for conditions like COPD, heart failure, and pneumonia were no higher than the national average. However, the overall rate of readmission after hospital discharge is worse than the national average of 15.3%.

Cases for complications and deaths were either too small to calculate or were lower or comparable to national results.

Lincoln Hospital Medical and Mental Health Center

A colonoscopy is one test doctors can use to find precancerous polyps or colorectal cancer. Scientific evidence shows that the following measures represent best practices for follow-up colonoscopies. 97% of patients receive recommended treatments and follow-ups, and 100% of those patients have follow-up colonoscopies for history of polyps.

Effective care data for two conditions

Jacobi Medical Center

Patient surveys

Received 2/5 stars and 58% of patients rated the hospital a 9/10.

Scored 78% for physician communication, which is the same percentage as the New York average.

Nurses were rated a little higher in communicating with patients than Lincoln, 69% to 65%.

79% of patients said they were given discharge instructions, yet only 43% reported that they understood their care upon discharge, the same as Lincoln.

Effective care data for two conditions:

35% of patients received appropriate sepsis care which is only 4% higher than Lincoln and still lower than NY and national averages

Only 67% of patients who had a colonoscopy received the appropriate recommended care compared to Lincoln’s 97% rate.

Out of the 67% of patients who received the recommended treatments- 100% of them followed up.

Data for readmission and complications and deaths

Jacobi and Lincoln readmission rates are equal as Jacobi’s rates are no different than the national average in the same areas

Rate of readmission rated no different from national averages meaning Jacobi has a lower rate than Lincoln in this area.

As with Lincoln, Cases for complications and death were either to small to calculate or they were lower or comparable to national results

List recommendations for improving data for one selected facility

I worked at Lincoln hospital and know first hand that improvements are definitely needed. Some recommendations I would suggest are:

Doctors improving communication with patients explaining their care in terms they understand

Better nursing to patient ratios so nurses can give more time to each patient 

More staffing to ensure patients are seen in a timely fashion 

Patient updates to patients waiting in ER or outpatient setting. Estimated wait times so the patient does not feel forgotten.

Summarize what you learned from the experience 

Using the hospital compare website I learned a great way to check out hospitals on one page. I learned that some hospitals that I thought would rank high received a lower patient satisfaction rating. Being a nurse I want to ensure my patients are receiving the best care. After seeing some of the low ratings on nurses communicating with patients I want to take this as a motivation to ensure my patients feel like I am explaining everything that is happening with their care. I want them to be informed and have a better understanding of their care before discharge so we need to close the communication gap. This highlights the importance of patient-centered communication as a key factor in improving overall healthcare outcomes.

After comparing these two hospital’s I am surprised to see there was no major differences if we are just looking at the data. I was sure Jacobi was going to receive a higher patient satisfaction rate and the results were similar. Patients are no happier at Jacobi than Lincoln hospital.