AAMC Reporter: May 2005

Hospital Compare Gives Teaching Hospitals High Marks

The nation's teaching hospitals are joining forces with hospitals nationwide with an initiative that gives individuals increased access to data that could affect their health care decisions, specifically which hospital they might choose for treatment.

The Hospital Compare Web site, launched April 1, enables individuals to view how a hospital performs on 17 performance measures dealing with heart attack, heart failure and pneumonia. All of the eligible Council of Teaching Hospitals (COTH) hospitals have submitted data for 10 of the 17 measures. The remaining seven are newly added measures and therefore not all hospitals have submitted data.

Hospital Compare shows teaching hospitals as scoring at or better than the national average in 12 of the 17 measures. Performance is high in the heart failure and heart attack measures. For example, 94 percent of heart attack victims receive a beta-blocker at admission in teaching hospitals, compared to the national average of 89 percent.

The site is a public-private partnership between the AAMC, the Federation of American Hospitals, the American Hospital Association, and the Centers for Medicare and Medicaid Services. National health care accreditors, employer and patient-advocacy groups — including the AFL-CIO, AARP, and Consumer-Purchaser Disclosure Project — also support the venture.

The ultimate goal of Hospital Compare is to provide a wide range of standardized quality measures including patients' perception of care from hospitals nationwide that would be useful to the public and the clinical environment. More measures will be added to the site.

Keeping track of hospital performance on a public Web site will push teaching hospitals to improve their performance, according to Elliot Sussman, M.D., immediate past chair of the Council of Teaching Hospitals and CEO of Lehigh Valley Hospital in Pennsylvania.

"In general, teaching hospitals do a very good job of outperforming everybody else. We have much to be proud of as a group on most of the measures," Sussman said. "But, we're all competitive, and the goal will be to outperform everyone on all measures. We've got a lot of work to do, and we have to be humble and recognize it is difficult to provide excellent, increased quality care."

At Lehigh, Sussman said participating in Hospital Compare has been both evolutionary and confirmatory. The hospital can now judge its performance against other institutions, and patients can also glean information about how to improve their own health habits. Although it is difficult to compile and analyze data on additional quality measures, Sussman said Lehigh regularly updates its information and is pushing to add other outcomes measures.

Northwestern Memorial Hospital in Chicago also supports the Web site as an effective way to disseminate performance information to the public, said Julie Creamer, the hospital's vice president of operations and quality. In fact, Northwestern has tracked quality measures for four years and records data on 39 measures, including some measures that are not yet part of Hospital Compare.

"We like the fact that the Web site reports measures that are evidence-based," Creamer said. "We're always on the watch for measures that have research to support that if you do things a certain way, patients outcomes are better."

Quality improvement is a long-standing tradition at Northwestern that permeates all departments, including those not directly associated with patient care. The hospital recently received the National Committee for Quality Health Care award, a national accolade given to one hospital with best practices for ensuring quality treatment. To maintain such high standards, Creamer said that any area that does not sustain a 95 percent to 100 percent successful performance rating, such as discharge instructions for congestive heart failure patients or pneumonia treatment, is marked for improvement.

Other hospitals have also embraced the need to be transparent about their performance so patients can make the most informed decisions regarding their healthcare. Dartmouth-Hitchcock Medical Center reached for openness last year with its own Health Information and Quality Reports Web site, including data about breast cancer treatment, pediatric care and bone marrow transplants.

According to Paul Gardent, executive vice president at Dartmouth-Hitchcock, the Web site was designed to be just one healthcare tool available to incoming patients. The hospital strives for high accuracy, so patients can be confident they received complete data about outstanding performance measures and those that have room for improvement.

"We have a long history of supporting informed decision making," Gardent said. In addition to patient outcomes, Dartmouth-Hitchcock also posts information about much it costs the hospitals to perform certain procedures.

"The patients and their families want and need this information, so it's easy for them to go to our Web site and get it."

—Whitney L.J. Howell, whowell@aamc.org

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