Essentials of Strategic Planning in Healthcare

Essentials of Strategic Planning in Healthcare

 

on the cause of these problems and how to address them. Healthcare executives must part- ner with physicians, nurses, and other clinicians to determine the best metrics to improve quality and to ensure positive patient outcomes and financial success for the organization.

 

c O m pa r at i v e O u t c O m e s

In the early 1900s, Dr. Ernest Codman, a pioneering surgeon and an advocate of healthcare reform, researched healthcare quality by measuring quality outcomes. His end results theory advocated measuring patient care to assess hospital efficiency and to identify clinical errors or other problems. The American College of Surgeons adopted his theory as a minimum quality standard. Based on this theory, the college created the Hospital Standardization Program, which later evolved into the Joint Commission on Accreditation of Healthcare Organizations (now simply the Joint Commission). Codman also believed in public report- ing of quality, a concept being embraced today, a century later.

 

The American Hospital Association has also encouraged providers to establish qual- ity assurance programs to audit outcomes of care. The most comprehensive evaluation of hospital quality today is the CMS’s Hospital Comparing website (www.medicare.gov/ hospital compare/search.html). Hospital Compare allows for the comparison of up to three hospitals on measures of quality. The measures are grouped into six categories: survey of patients’ experiences, timely and effective care, complications and death, unplanned hospital admissions, psychiatric unit services, and payment and value of care. Other public reporting agencies and sites use data from the CMS measures. Hospital Compare has a consumer orientation, providing information on how well hospitals provide the recommended care to their patients. It also enables organizations to benchmark their performance against that of other hospitals in their community or state or nationally.

 

Organizations’ initial purpose for the transparency of publicly reported healthcare processes and outcomes was to help patients make informed decisions. Today’s consumer wants to consider the advantages and risks of recommended treatments. Besides gathering data from patient-satisfaction measures, healthcare organizations must also understand, define, and measure quality of care themselves. While patient satisfaction is not the only indicator of quality care, it is a significant goal. Providers could achieve exemplary clini- cal outcomes but have negative patient satisfaction scores if they have poor interpersonal skills or lack sensitivity to cultural differences among their patients. Public and private groups, such as the National Committee for Quality Assurance (NCQA), have developed tools for measuring and reporting healthcare quality. The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS; see highlight 12.1) and the Healthcare Effectiveness Data and Information Set (HEDIS; see highlight 12.2) are two other examples. Many hospitals use HCAHPS to assess patient experience and HEDIS to measure clinical performance in the outpatient setting.

 

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Harrison, Jeffrey P.. Essentials of Strategic Planning in Healthcare, Third Edition, Health Administration Press, 2020. ProQuest Ebook Central, http://ebookcentral.proquest.com/lib/apus/detail.action?docID=6349384. Created from apus on 2022-03-25 01:06:10.

 

 

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C h a p t e r 1 2 : Q u a l i t y , S a f e t y , P a t i e n t E x p e r i e n c e , a n d V a l u e 2 6 1

 

HIGHLIGHT 12.1 Hospital Consumer Assessment of Healthcare Providers and Systems

 

HCAHPS (typically pronounced “H-Caps”) is a survey used to measure patient expe-

 

riences with healthcare providers. Use of this standardized survey allows providers

 

to compare their patients’ experiences with those of other patients across the United

 

States. All patients are asked the same questions, and all results are measured accord-

 

ing to the same rating scale. Patients respond by answering “always,” “usually,” “some-

 

times,” or “never” to most of the survey questions. Without a standardized survey,

 

comparisons of quality of care would be impossible.

 

The survey focuses on the following areas:

 

• How often did nurses communicate well with patients?

 

• How often did doctors communicate well with patients?

 

• How often did patients receive help quickly from hospital staff?

 

• How often did staff explain about medicines before giving them to patients?

 

• How often were the patients’ rooms and bathrooms kept clean?

 

• How often was the area around patients’ rooms kept quiet at night?

 

• Were patients given information about what to do during their recovery at home?

 

• How well did patients understand the type of care they would need after leaving

 

the hospital?

 

• What number would patients use to rate the hospital during their stay?

 

• Would patients recommend the hospital to friends and family?

 

CMS implemented the HCAHPS survey in October 2006, and hospitals first publicly

 

reported the results in March 2008. The survey, its methodology, and its results are in

 

the public domain and can be found on the Hospital Compare website. Since July 2007,

 

hospitals receiving Medicare payments must collect and submit HCAHPS data to receive

 

their full annual payment. The Affordable Care Act of 2010 (ACA) requires HCAHPS to be

 

included among the measures used to calculate incentive payments in the value-based

 

purchasing program.

 

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Harrison, Jeffrey P.. Essentials of Strategic Planning in Healthcare, Third Edition, Health Administration Press, 2020. ProQuest Ebook Central, http://ebookcentral.proquest.com/lib/apus/detail.action?docID=6349384. Created from apus on 2022-03-25 01:06:10.

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