Federal Web site for consumers also to update readmission, mortality rates

In the next couple of weeks, information on care provided in hospital outpatient settings will be publicly available for the first time on Hospital Compare, a U.S. Department of Health and Human Services Web site (www.hospitalcompare.hhs.gov).

Comparative data on patients who have outpatient surgery and patients who receive outpatient imaging services will be part of the addition. New data on the Web site will also include clinical information about patients who go to the emergency department because of chest pain or other heart attack symptoms.

In addition, all of the other information on Hospital Compare is being updated, including hospital readmission and mortality rates for patients with heart attack, heart failure and pneumonia. The Centers for Medicare & Medicaid Services (CMS) will release the data.

The new information may generate interest in hospitals from patients, communities surrounding hospitals and the media. The Minnesota Hospital Association advises member hospital leaders to discuss the issue with their communications team, quality improvement team, physician and nursing leaders and trustees to prepare them to respond to questions. Leaders are encouraged to identify quality improvement efforts that they can highlight with the media and the public.

The heart attack and chest pain measures are based on patients who received initial evaluation and treatment in hospital emergency departments and then were discharged or transferred to another facility for further care. The measures are similar to those used in assessing heart attack care for patients who were admitted to a hospital.

The data available for outpatient surgery are similar to the measures currently featured on Hospital Compare for inpatient procedures.

In the past, all of the measures on Hospital Compare were endorsed by the National Quality Forum (NQF) and adopted by the Hospital Quality Alliance. The new surgical and heart attack and chest pain measures follow that same process. However, none of the medical imaging services use measures that have been adopted by the HQA, although two have been endorsed by the NQF, according to an American Hospital Association (AHA) advisory.

"The HQA did not approve the measures because they are measures of the frequency of tests performed without any way to know what frequency is appropriate or indicative of quality," AHA said. "Imaging tests are performed on a case-by-case basis after a clinician reviews a patient's symptoms, the potential to rule in or out a likely diagnosis and the risk and benefits to the patient of the test. It is impossible to make judgments from the data that will be displayed by CMS on whether or not clinicians ordered too many, too few or just the right number of imaging tests."

Updated 30-day readmission and mortality information
As a result of the updates to 30-day readmission and mortality rates for heart attack, heart failure and pneumonia, some hospitals may see their categorization on the site change. The AHA said that there are likely to be small shifts in the numbers of hospitals in the following categories: "better than the national rate," "no different than the national rate," and "worse than the national average."

Other Hospital Compare information
A quarterly update will take place for all other measures on Hospital Compare, including:

• steps to treat heart attack, heart failure and pneumonia patients;
• steps to prevent surgical infections; and
• patients' views about their hospital care.

Hospitals began publicly reporting quality of care information on heart attack, heart failure and pneumonia on Hospital Compare in 2004. Since then, the information has been expanded to include information on 30-day hospital readmission and mortality rates, patients' feedback on their hospital care and hospitals' steps to prevent surgical infections.

For more information, contact Jan Hennings, MHA director of communications, at (651) 603-3549 or Mark Sonneborn, MHA vice president of information services, at (651) 659-1423.