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Hospital Quality Information Initiative
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Executive Summary
The Hospital Quality Initiative is a voluntary reporting effort by hospitals on a selected group of clinical measures. Initiated in 2003, CMS adopted this model for public reporting in 2005. The Iowa performance information presented here is for 2004 and the latest available. To be presented in this report, measures must have the number of cases meet or exceed the CMS limit for statistical significance (N<24 cases). Iowa clinical performance met or exceeded national clinical performance in 11 of the 19 categories reported.
Introduction
The American Hospital Association (AHA), the Federation of American Hospitals (FAH), and the Association of American Medical Colleges (AAMC) have launched a national voluntary initiative to collect and report hospital quality performance information.
This effort has been known by many names as it has evolved over the past three years. It is described as the Hospital Quality Information Initiative (HQII) by the Department of Health and Human Services, but also known as the Hospital Quality Initiative (HQI) and the Hospital Quality Alliance (HQA).
It is intended to make critical information about hospital performance accessible to the public. It also aims to inform and to invigorate efforts to improve quality, and it builds upon previous CMS and QIO strategies.
The Joint Commission on Accreditation of Healthcare Organizations (JCAHO), the National Quality Forum (NQF), the Centers for Medicare & Medicaid Services (CMS), and the Agency for Healthcare Research and Quality (AHRQ) support this initiative. It is the beginning of an ongoing effort to make hospital performance information more accessible to the public, payers, and providers of care. NQF, JCAHO, CMS, and AHRQ provide technical assistance in developing and/or identifying quality measures and assist in making the information accessible, understandable, and relevant to the public.
The following illustrates the metrics:
Description of Iowa Data
- Hospital-submitted clinical data that the QIO Clinical Warehouse received by the quarterly deadline (4 months, 15 days following the quarter). Hospital Compare data from the Department of Health and Human Services (HHS) for 2004 discharges was reformatted by the IFMC to provide Iowa, national, and top national comparisons.
- All Payors
- Calendar year 2004 discharges
- Hospital data submission and sampling is indicated by footnotes. Hospital specific rates are shown when there are 25 or more cases.
Data Display Descriptors
- Bar Graph- Individual Hospital Data
- Represents all data (not suppressed) submitted for CY2004
- Percentage of performance on each measure
- Total number of cases eligible
- Statewide Average- Average of all reporting hospitals statewide
- National Average- Average of all reporting hospitals nationally
- Top National Hospitals- Represents the top 10% of hospitals nationwide
Specific Measures and Care Reporting
- Thrombolytics- (AMI-7)
- There is no thrombolytic data for 1st and 2nd quarter of 2004
- No hospitals using Thrombolytics (AMI-7) as the preferred method of intervention achieved NNo hospitals using Thrombolytics (AMI-7) as the preferred method of intervention achieved N
- Transferring AMI patients are excluded from all arrival AMI measures at receiving hospitals, and ALL measures from transferring hospital
- PCI- (AMI-8)
- There is no PCI data for 1st and 2nd quarter of 2004.
- JCAHO/CMS alignment on the definition of metrics started for 3rd quarter 2004 (PTCA within 90 minutes of arrival to PCI within 120 minutes of arrival). Few hospitals achieved N JCAHO/CMS alignment on the definition of metrics started for 3rd quarter 2004 (PTCA within 90 minutes of arrival to PCI within 120 minutes of arrival). Few hospitals achieved N>
- Transferring AMI patients are excluded from all arrival AMI measures at receiving hospitals, and ALL measures from transferring hospital
- Influenza Vaccination- (PN-7)
- Public reporting suspended due to vaccine shortage
- Prophylactic Antibiotic Selection for Surgical Patients- (SIP-2)
- Public reporting suspended due to antibiotic unavailability
Iowa Data
AMI-1: Patients given Aspirin at arrival
AMI-2: Patients given Aspirin at discharge*
AMI-3: Patients given ACE Inhibitor for Left Ventricular Dysfunction (LSVD)
AMI-4: Patients given adult Smoking Cessation Advice/Counseling
AMI-5: Patients given Beta Blockers at Discharge*
AMI-6: Patients given Beta Blockers at Arrival
AMI-7: Thrombolytic Agent Received within 30 Minutes of Arrival**
AMI 8: Mean Time to PCI**
AMI-8a: Patients given PCI within 120 of Arrival*
HF-1: Patients given Discharge Instructions*
HF-2: Patients given Assessment of Left Ventricular Function (LVF)
HF-3: Patients given ACE Inhibitor for Left Ventricular Systolic Dysfunction
HF-4: Patients Given Adult Smoking Cessation Advice/Counseling
PN-1/PN-7: % of PNE Patients given Oxygenation Assessment*
PN-2/PN-5: % of PNE Patients Assessed and given Pneumococcal Vaccination*
PN-3b/PNE-3b: % having Blood Culture done prior to 1st ATB*
PN-4/PN-6: % of PNE Patients given Adult Smoking Cessation Advice PN-5b/PNE-1: % PNE Patients given Initial ATB within 4 hours of arrival*
PN-6/PNE-2: % PNE Patients given most appropriate Initial ATB*
PN-7: Influenza Vaccination***
SIP-1: % of Surgery Patients who received Preventative ATB 1 hour before incision*
SIP-2: Prophylactic Antibiotic Selection for Surgical Patients***
SIP-3: % of Surgery Patient whose Preventative ATB are stopped within 24 hours after surgery*
* Iowa performance met or exceeded national clinical performance
** Inadequate numbers in Iowa to report in 2004
*** Measurement suspended nationally in 2004
Back to top
Main section of the 2005 Iowa Report .
The Hospital Quality Initiative is a voluntary reporting effort by hospitals on a selected group of clinical measures.
The AHRQ database is comprised of administrative data voluntarily reported since the 1990s.
The National Quality Forum (NQF) identified the set of 30 safe practices in May of 2004.
Through conferences, meetings, and site visits, providers are sharing best practice and are working to reduce preventable deaths in Iowa.
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