How Hospitals Perform on Quality

The  measures currently reported on the site are tied to three conditions: heart attack, heart failure and pneumonia. These are "quality of care" measures, meaning they report how often certain best practices for patient care have been followed. Many of the practices being measured are hard for someone who isn’t a physician or nurse to understand. What’s important is that these are practices that are well accepted nationally as steps that should be taken in the care of the conditions. For example, some measures include whether a heart attack patient was given aspirin upon arrival at the hospital or if a blood test was performed on a patient with pneumonia, or if a patient received an assessment of his or her heart function for heart failure. You can read more about Heart Attack, Heart Failure, Pneumonia and Surgical Care by clicking on the appropriate link.

This data is currently collected and reported by the federal government, through Hospital Compare. The Minnesota Hospital Quality Partnership is developing this Web site to make this data more accessible and understandable to Minnesota consumers through a Minnesota-specific report.

Hospitals have voluntarily reported their data to be posted on this site, which in turn is updated every quarter. The site displays the data reported for the most recently available 12 months.
The measures that appear on this Web site include:

Appropriate Care Measures

The Appropriate Care Measure (ACM) is a patient-focused measure that provides a way of looking at whether a patient received ALL of the "appropriate or right care" (recommended treatments) that they should have received, based on their clinical condition. Each patient is unique and may not be eligible for every type of care for a condition. The ACM takes patient individuality into consideration, looking at one patient and their episode of care at a time, related to their specific condition.

Appropriate Care Measures Calculation Method

How is the Appropriate Care Measure calculated? The Appropriate Care Measure is calculated in the following manner: All patients who are eligible for at least one heart attack, heart failure, or pneumonia measure are counted in the denominator. Only patients who receive ALL the care they are eligible for are included in the numerator. The ACM is expressed as a percent at the hospital level, and is calculated in the following manner: Denominator: All patients eligible for at least one of the measures in that clinical topic. Numerator: The patients who received all of the care specified by the measures for that area of care that the patient was eligible to receive.

Quality of Care Measures

The quality measures report on the site are "quality of care" measures that describe how often certain practices of care have been followed. Unlike the Appropriate Care Measure, the quality measures illustrate hospitals’ work on each measure by combining all patients treated for a particular condition. The quality measures broadly describe the care provided by a hospital.

How Patients Rate Their Care

The newest information on the Minnesota Hospital Quality Report is patients’ ratings of their hospital care. The data comes from a national survey called the Hospital Consumer Assessment of Healthcare Providers and Systems, or HCAHPS. The survey was developed by the Hospital Quality Alliance, of which the Centers for Medicare and Medicaid Services (CMS) is a partner.

The information is reported on a national Web site, Hospital Compare. The data was added to the Minnesota Hospital Quality Report site to make the information more accessible to consumers looking for information about Minnesota hospitals.

The HCAHPS survey is administered 48 hours to six weeks after discharge to a random sample of adult patients across medical conditions. Participating hospitals may either use an approved survey vendor, or collect their own HCAHPS data (if approved by CMS to do so). To accommodate hospitals, HCAHPS can be implemented in four different survey modes: mail, telephone, mail with telephone follow-up, or active interactive voice recognition (IVR). Hospitals can either integrate the HCAHPS survey with their own patient satisfaction survey, or use HCAHPS by itself. Hospitals must survey patients throughout each month of the year.

Hospitals voluntarily participate in the survey process. The data now reflects the most recent nine months of available surveys.

The survey doesn’t ask patients their level of happiness or satisfaction. Instead, the survey asks patients to identify the frequency by which important elements of care occurred.

The survey has 27 questions. Besides the demographic questions, the other questions are combined into eight key areas, including:

• Communication with doctors
• Communication with nurses
• Responsiveness of hospital staff
• Pain control
• Communication about medicines
• Cleanliness of hospital environment
• Quietness of hospital environment
• Discharge Instructions

The data will also include patients overall rating of the hospital and their willingness to recommend the hospital to others.