Small systems: Making sure they measure up

Mercy Health Southwest Ohio Region in Cincinnati has succeeded in raising quality by setting at least 10 specific performance goals every year for all of the system's 11 hospitals and medical centers.

“We measure everything,” says Jim May, president and CEO of Mercy Health.

And the results of those assessments show that Mercy Health has been successful at meeting its goals, which May calls “emblematic of what Truven measures.” That performance allowed Mercy Health to make Truven's list of best-performing small hospital systems (those with under $750 million in operating expenses) for the first time.

Truven Health Analytics, formerly the healthcare unit of Thomson Reuters, releases an annual list of 15 Top Health Systems, based on quantitative data provided from the CMS' Hospital Compare and Medicare Provider Analysis and Review. Truven looks at eight criteria to determine which systems had the best clinical performance, highest efficiencies and greatest patient satisfaction in the past year.

Other first-time winners in the small-systems category included Asante in Medford, Ore., and Roper St. Francis Healthcare in Charleston, S.C. Cape Cod Healthcare in Hyannis, Mass., and Poudre Valley Health System in Fort Collins, Colo., made the list for the second time.

The five benchmark health systems performed better than their peers on all of Truven's metrics. For these systems overall, that meant an 11.8% advantage on the patient-safety index; a 12.7% shorter average length of stay; a 3.8% advantage on patient satisfaction; and 3.5% lower overall mortality rates.

“The more you measure something, the better you get at it,” says Jean Chenoweth, senior vice president of performance improvement and 100 Top Hospitals at Truven. “Is performance perfect? No. But these top systems are driving consistency and uniformity in their performance, and they are moving toward balanced quality, customer satisfaction and efficiency, and that can only benefit the communities they serve.”

One of the ways Mercy Health is doing that is through the CMS' accountable care organization program. An ACO links doctors, hospitals and other healthcare providers to provide coordinated care in ways that aim to ensure their Medicare patients receive the appropriate care at the appropriate time. They are designed to eliminate medical errors and duplicate services, which increases quality and lowers costs.

Mercy now ties payments to achieving these goals. Launched in July 2012, Mercy Health's ACO is the only one in Cincinnati, serving 24,000 patients through the program.

“You want to give great care and you want to give it at lower costs,” May says. “That means you're not doing unnecessary procedures, you're being efficient in how you handle paperwork … We do all our back-office things together, as opposed to doing things individually.”

That collaborative approach is also evident in the use of CarePATH, the electronic health-record system that Mercy's parent, Catholic Health Partners, has deployed across the region. CarePATH maintains a single and continuously updated record for each patient that can be accessed by any provider in the network.

Implementation of CarePATH improves safety, quality and efficiency as it provides access to legible and current patient data; alerts caregivers to allergies and drug interactions; standardizes procedures; offers real-time clinical decision support; reduces the likelihood of duplicate tests; and eliminates the need to store, file and retrieve paper records, system officials say.

“We're continuing to create this network and break down the silos,” May says. “We're making sure people have access to great knowledge and sharing opportunities with fellow caregivers across our system.”