The National Quality Forum last week endorsed seven surveys for assessing patient satisfaction and five surgical-care standards aimed at infection prevention, a move that experts said could lead to better hospital performance comparisons.
While these standards and surveys are already widely used, experts said the endorsement will lead to more uniformity in measurements. That could then create a larger database for hospitals to use to see how they stack up against their peers.
John Anderson, chief medical officer for Catholic Health Initiatives in Denver, said that the perioperative standards are basically refinements of quality measures developed as part of the American College of Surgeons' National Surgical Quality Improvement Program.
"Are they useful? Yes," Anderson said. "Are they more regulation? We'll have to see how they play out."
The perioperative-care standards involve the use, selection and discontinuation of antibiotics to prevent infection before and after surgery, and were developed by the American Medical Association-convened Physician Consortium for Performance Improvement and the National Committee for Quality Assurance under a CMS contract. According to an NQF news release, these standards have not undergone significant field-testing and were given only a two-year endorsement. Once the measures have been field-tested and demonstrated reliable results, the NQF would remove the time limit from its endorsement.
Rather than measure how a hospital does in the timing of antibiotic ordering and administering, the new standards drill down to the clinician level, which Anderson said can help individual institutions with their quality-improvement programs.
"We'd look at these measures at a hospital levelnot a system level," he said. "A quality committee would see we have eight of 10 complying and two that are not."
Doctors found not in compliance would then get some type of intervention counseling to bring them into the fold, he said. Ward agreed with that approach, and said the measures are more for focusing education efforts and not on assessment.
Anderson said information technology can help with compliance by tracking patient care, sending informational alerts to physicians, aggregating data and "making absolutely certain that, if a patient is supposed to be on antibiotics, they get them, and they get the right dose when they need them and then they're discontinued when they don't."
"But it's not essential," he said. "You can have 100% compliance with this without any IT."
This story initially appeared in this week's edition of Modern Healthcare magazine.
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