# Presentation: 148702

## Inpatient Quality Reporting In Colorado

- Sept. 2005 HCUP User Group Meeting

## Background

- Demand For Transparency and Accountability
- By 2003 Hospital Quality Reporting Is Becoming  Common Place – Most Notably Among Health Plans
- Methodologies Vary Widely - Hospitals Can’t Authenticate Results
- Autumn 2003 CHA Board Begins to Consider Voluntary Public Reporting

- Colorado Health and Hospital Association

- September 27, 2005

## Principles

- Broad Based Effort – Not Just Hospitals
- Reliable – Proven Methodology
- Risk Adjusted
- Open Methodology Available To Hospitals
- Common Data Source Available To Hospitals
- Report Trends Over Time
- Applicable To Both High and Low Volume Hospitals
- Long Term Effort

- Colorado Health and Hospital Association

- September 27, 2005

## Performance and Quality Coalition

- Colorado Health and Hospital Association
- Colorado Hospitals Quality Managers
- Colorado Business Group on Health
- Colorado Medical Society
- Colorado Department of Public Health and Environment
- Centers for Medicare and Medicaid Services
- Colorado Foundation for Medical Care (QIO)
- Colorado Association of Health Plans
- Business Council on Health Care Competition
- Physician Health Partners
- Colorado Health Institute

- Colorado Health and Hospital Association

- September 27, 2005

## What To Report

- Patient Experience Measures – No Standardized Data
- Capabilities Measures – Leapfrog
- Process Measures – CMS
**Outcomes Measures – AHRQ Tools**

- Colorado Health and Hospital Association

- September 27, 2005

## Focus on Higher Volume Indicators for Public Report

- Mortality Rates For Conditions
- Acute Myocardial Infarction (AMI)
- AMI Without Transfer
- Congestive Heart Failure (CHF)
- Gastrointestinal Hemorrhage
- Hip Fracture
- Pneumonia
- Stroke
- Mortality Rates For Procedures
- Abdominal Aortic Aneurysm Repair (AAA Repair)
- Coronary Artery Bypass Graft (CABG)
- Esophageal Resection
- Hip Replacement
- Pancreatic Resection
- Pediatric Heart Surgery
- Craniotomy
- Percutaneous Transluminal Coronary Angioplasty (PTCA)
- Carotid Endarterectomy (CEA)

- Hospital-level Procedure Utilization Rates
- Cesarean Delivery
- Primary Cesarean Delivery
- Vaginal Birth after Cesarean Section (VBAC) – Uncomplicated
- VBAC - All
- Incidental Appendectomy in the Elderly
- Bi-lateral Cardiac Catheterization
- Laparoscopic Cholecystectomy
- Hospital-level Volumes
- Esophageal Resection
- Pancreatic Resection
- Pediatric Heart Surgery
- AAA Repair
- CABG
- PTCA
- CEA

- Colorado Health and Hospital Association

- September 27, 2005

## Smaller Volume Hospitals

- Need At Least 30 Cases For Statistical Validity
- For Hospitals w/ Less Than 30 Cases Combine All Three Years

- Colorado Health and Hospital Association

- September 27, 2005

## The Reports

- Start w/ Consumer Oriented Formats
- Use Common Language (Heart Attack vs AMI)
- Provide Context
- Included Detail For Those That Need It

- Colorado Health and Hospital Association

- September 27, 2005

## “Consumer Reports” Format

**“****Consumer Reports” Format**

- Colorado Health and Hospital Association

- September 27, 2005

## Context

- Colorado Health and Hospital Association

- September 27, 2005

## Detail

- Colorado Health and Hospital Association

- September 27, 2005

## Publication

- Hospitals Received Reports 6 mos. In Advance
- Series of Education Programs 2 Weeks Prior to Publication (Hospitals, Physicians, Payers, Press)
- Hospital’s Prepared Communication Tools
- Joint Press Conference April 4, 2005 –  w/ CMS and QIO
- Coordinated w/ CMS Process Indicators
- Emphasis On Heart Attack, Heart Failure and Pneumonia

- Colorado Health and Hospital Association

- September 27, 2005

## Small Splash / Wide Ranging Ripples

- Initial Intense State Wide Coverage
- Print As Well As Broadcast Media
- Some National Coverage Including Modern Health Care and Wall Street Journal
- No Fire Storm – Probably Result of Communications Plan
- Continued Interest

- Colorado Health and Hospital Association

- September 27, 2005

## Next Steps

- Publish 2004 Data In Autumn 2005
- Share Learnings / QI Initiatives Among Hospitals
- Opportunities Related To Best Practices
- Look At Care Prior To Hospitalization (PQIs)

- Colorado Health and Hospital Association

- September 27, 2005