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.
I think it is a big deal that the National Quality Forum endorsed these, said Angela Ward, a quality executive for Alegent Health, Omaha, Neb. She added that the endorsement adds another layer of credibility to using the measures and surveys, plus it also helps shine a national spotlight on the issues of patient satisfaction and infection control.
Ward said the satisfaction surveys Alegent uses cover all aspects of a patients stay, including questions on the quality of the food, how well doctors and nurses worked together, and how well pain was managed.
Weve been surveying patients for forever, Ward said. We find it very useful to make sure were providing the care that our patients want and expect.
The NQF previously had endorsed other patient-satisfaction surveys, including the Consumer Assessment of Healthcare Providers and Systems hospital survey, known as HCAHPS (See related story, p. 26), and the Family Evaluation of Hospice Care survey for cancer care. The newly endorsed surveys cover areas such as adult primary care, health plans, children with chronic conditions, behavioral health and managed care.
Since the surveys help provide a means for self-assessment as well as a way for hospitals to measure themselves against others, Ward said there is little resistance to their use.
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.
The AMA did not comment on the time-limited endorsement, but association President-Elect Nancy Nielsen in a written statement hailed the NQFs action.
The American Medical Association applauds the National Quality Forum for endorsing these new quality measures for hospital care and patient experience with care, which will allow us to continue to evaluate and improve key components of healthcare quality, Nielsens statement said.
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? Well have to see how they play out.
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.
Wed 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 theyre discontinued when they dont.
But its not essential, he said. You can have 100% compliance with this without any IT.