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Hospital Patients Report Greater Satisfaction with Care
According to Press Ganey survey research published in November, hospital patients' satisfaction with their care reached a record high in 2008. Press Ganey also found an increase in the number of patients who would recommend their hospital to family and friends.

The findings are based on responses from nearly 3 million patients at some 2,000 U.S. hospitals. Patient satisfaction has steadily increased since 2003, a trend the researchers attribute to hospitals' efforts to respond to demands for improvements from both payers and patients. Most of the areas identified as still in need of improvement relate to communication with patients, such as providers' responsiveness to patients' concerns and their efforts to include patients in decision making.

The researchers note that the increase in satisfaction scores coincides with the period when the federal government began publicly reporting information on hospital patients' care experiences on Hospital Compare, using data from the Hospital Consumer Assessment of Healthcare Providers and Systems. "As of October, seven months after the start of public reporting, inpatient satisfaction scores had climbed more significantly than at any other point in the 24 years that Press Ganey has been tracking that data," they note.

Hospital Compare to Add Measures of Outpatient Quality
The Centers for Medicare and Medicaid Services announced in November that it will begin reporting hospitals' performance on 11 measures of outpatient quality on Hospital Compare. The measures relate to emergency department transfers for heart attack patients, surgery and infection prevention, and imaging efficiency. Hospitals have been voluntarily submitting data on these measures for the past two years.

EHR Use Not Yet Linked to Large Quality, Cost Differences
As reported Nov. 15 in the New York Times, a new study assessing the impact of electronic health record systems on hospital care found only marginal differences in quality and cost measures among hospitals that have advanced, basic, and no electronic health record systems.

For the study, Ashish Jha of the Harvard School of Public Health and colleagues compared 3,000 hospitals with different levels of EHR adoption. They examined how well the hospitals performed on measures of providing evidence-based care for congestive heart failure, pneumonia, and surgical infections. They also compared hospitals' average length of stay. For the heart failure category, the researchers found that hospitals with advanced EHRs met standards 87.8 percent of the time; hospitals with basic EHRs met the standards 86.7 percent of the time; and hospitals without EHRs met the standards 85.9 percent of the time. For other measures, there were similarly small differences among the hospitals.

The findings show that health information technology, on its own, will not necessarily improve quality or control costs, the researchers said. The federal government has pledged $19 billion in incentive payments to help hospitals and other health care providers deploy health information technology, but the providers must show they are making "meaningful use" of such technology to receive them.

Quality Not a "Top Priority" for Half of Hospital Boards
A study in the November/December issue of Health Affairs found that quality of care is not a top priority for board members at nearly half of U.S. nonprofit hospitals.

Just over half of the 922 board chairs of nonprofit hospitals surveyed by Harvard School of Public Health researchers during 2007 and 2008 identified clinical quality as a top priority for board oversight. Chairs of high-performing hospitals—based on their performance on 19 core measures of evidence-based care for heart attacks, heart failure, and pneumonia—were more likely to identify quality as a priority than chairs of low-performing facilities.

Given tight profit margins at nonprofit facilities, it is perhaps not surprising that board chairs focused more on financial performance than quality, the researchers said. Still, they suggested that efforts to engage and educate boards in quality improvement "may be an important target for policymakers hoping to improve care."

FDA Announces Initiative to Reduce Medication Errors
In early November, the Food and Drug Administration (FDA) announced an initiative to reduce preventable medication errors. Millions of people are harmed each year through inappropriate medication use—often the result of lack of information about a medication, a patient, or patient's condition, the agency said.

In the "Safe Use Initiative," FDA officials will reach out to health care professionals to identify the drugs and therapeutic scenarios that are most often associated with adverse events. The agency will generate national estimates of error rates for specific drugs and therapies, and develop targeted programs to improve medication safety by ensuring both prescribers and patients have access to information at the point of care.

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