Where does the LNC find out information about hospital quality of care?
Legal nurse consultants who help attorneys handling medical malpractice and personal injury cases soon develop an understanding of the quality of care rendered by local hospitals – those who appear over and over in the plaintiffs’ medical records.
Reporting Hospital Quality of Care Measures
According to their website, The Leapfrog Group is an initiative driven by organizations that buy health care who are working to initiate breakthrough improvements in the safety, quality and affordability of health care for Americans.” In their white paper entitled, “The Hidden Surcharge Americans Pay for Hospital Errors”, Leapfrog reported this fact:
“One in four Medicare beneficiaries admitted to a hospital suffered some form of unintended harm. Every year, more than 180,000 of these beneficiaries die from hospital-acquired infections (HAIs), errors, accidents, and injuries.”
Statistics like this are frightening, to say the least. Patients go to the hospital to get better, and could end up far worse. Not all hospitals deliver the same quality of care. The rate of unintended harm to patients can be higher in some hospitals.
There are several tools available online to LNCs (and the public) that have some great information.
Leapfrog launched the Hospital Safety Score which rates patient safety efforts and outcomes of more than 2,500 general acute care hospitals in the US. Hospitals receive letter grades (A, B, C, D, and F).
You can also click on “View the Full Score” to get details about outcome measures and process measures. Outcome measures included errors, accidents, and injuries that the hospital publicly reported. Process measures included the management structure and procedures a hospital had in place to protect patients from errors, accidents, and injuries.
Hospital quality of care outcome measures included:
- Foreign object retained after surgery
- Air embolism
- Pressure ulcers – stage 3 and 4
- Falls and trauma
- CLABSI (Central Line-Associated BloodStream Infections)
- Death from serious treatable complications after surgery
- Collapsed lung due to medical treatment
- Breathing failure after surgery
- Postoperative PE/DVT (Pulmonary Embolism/Deep Vein Thrombosis)
- Wounds that split open after surgery
- Accidental cuts or tears from medical treatment
Hospital quality of care process measures included:
- Computerized Prescriber Order Entry (CPOE)
- ICU physician staffing
- Leadership structure and systems
- Culture measurement, feedback, and intervention
- Teamwork training and skill building
- Identification and mitigation of risks and hazards
- Nursing workforce
- Medication reconciliation
- Hand hygiene
- Care of the ventilated patient
- Patients received antibiotic within 1 hour prior to surgical incision
- Patient received the right antibiotic
- Antibiotic discontinued after 24 hours
- Urinary catheter was removed on postoperative day 1 or 2
- Surgery patients received appropriate treatment to prevent blood clots at the right time
The measures are explained on the website. Each of the measures then shows the scores of the hospital you are researching, the worst performing hospital, and the best performing hospital, as well as the data source and the time period covered.
Another great resource for hospital quality of care is Hospital Compare provided by the Centers for Medicare and Medicaid Services. It provides information about the quality of care at over 4,000 Medicare-certified hospitals in the US. It also has a tool so that you can compare up to three hospitals at a time.
Information available includes:
- General information about the hospital and its services
- Results of patient surveys
- Timely and effective care for certain conditions where time impacts patient outcomes, including heart attack, heart failure, and pneumonia
- Rate of readmissions, complications, and deaths
- Use of medical imaging
- Medicare payments per hospital patient
- Number of Medicare patients
This information is useful both for researching a specific facility as well as to help make decisions about our own health care. Although our goal is certainly to remain healthy and out of the hospital, when we require their services, and we have time to make a more informed decision, it’s nice to know that there are resources to help us make the best possible choice for our care.
By the way, even when we don’t have the luxury of time to make a decision, the fact that these types of tools are available to the public keeps the hospitals “on their toes” and gives them incentive to provide the best possible quality of care…free of unintended harmful outcomes.
Jane Heron, RN, BSN, MBA, LNCC authored this post.