Trends in Hospital Performance: Looking Behind the Numbers

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<p>In the past several years, hospitals have made great strides in measuring the quality of care they provide and instituting necessary improvements. Still, little is known about the dynamics of hospital performance--the degree to which hospitals are improving (or not) over time, and how hospitals are achieving and sustaining that improvement.<br><br>Two new reports from The Commonwealth Fund examine trends in hospitals' performance and their strategies for change. In <a href="/cnlib/pub/enews_clickthrough.htm?enews_item_id=27675&return_url=http%3A%2F%2Fwww%2Ecmwf%2Eorg%2Fpublications%2Fpublications%5Fshow%2Ehtm%3Fdoc%5Fid%3D471264%26%23doc471264">Hospital Performance Improvement: Trends in Quality and Efficiency</a>, analysts Eugene Kroch and Michael Duan of CareScience, Inc., and Sharon Silow-Carroll and Jack A. Meyer of Health Management Associates note significant improvements across hospitals in reducing mortality and increasing efficiency, with mixed results in reducing complications and morbidity. Lower mortality, the authors say, is likely due to better diagnostic techniques and earlier interventions, as well as more conscientious record "coding" and revised discharge practices.<br><br>The characteristics of hospitals that have improved the most indicate that quality improvement is occurring "at least as much among small, non-teaching institutions as among their larger, more prominent counterparts," the report finds.<br><br>In <a href="/cnlib/pub/enews_clickthrough.htm?enews_item_id=27674&return_url=http%3A%2F%2Fwww%2Ecmwf%2Eorg%2Fpublications%2Fpublications%5Fshow%2Ehtm%3Fdoc%5Fid%3D471265%26%23doc471265">Hospital Quality Improvement: Strategies and Lessons from U.S. Hospitals</a>, Silow-Carroll, Meyer, and Tanya Alteras take an in-depth look at how four hospitals achieved and sustained improvements over time. The authors describe the hospitals' impetus for focusing on quality; the structural and organizational changes that were implemented to create a "culture of quality"; and reforms in protocol and practice. The report also examines barriers to change, and identifies policy reforms that could facilitate hospital quality improvement efforts.<br><br>You can also read commentaries on the reports by Harvard University's <a href="/cnlib/pub/enews_clickthrough.htm?enews_item_id=27676&return_url=http%3A%2F%2Fwww%2Ecmwf%2Eorg%2Fpublications%2Fpublications%5Fshow%2Ehtm%3Fdoc%5Fid%3D466306%26%23doc466306">Ashish K. Jha and Arnold M. Epstein</a> and by <a href="/cnlib/pub/enews_clickthrough.htm?enews_item_id=27677&return_url=http%3A%2F%2Fwww%2Ecmwf%2Eorg%2Fpublications%2Fpublications%5Fshow%2Ehtm%3Fdoc%5Fid%3D465169%26%23doc465169">Dale W. Bratzler</a> of the Oklahoma Foundation for Medical Quality. Also be sure to check out the Fund's <a href="/cnlib/pub/enews_clickthrough.htm?enews_item_id=27689&return_url=http%3A%2F%2Fwww%2Ecmwf%2Eorg%2Ftopics%2Ftopics%5Fshow%2Ehtm%3Fdoc%5Fid%3D469093%26%23doc469093">E-forum</a> on hospital improvement, which features synched slides and audio from presentations by the report authors and commentators.</p>