# Presentation: 170041

## The Hospital Quality Alliance  

- Nancy Foster
- VP for Quality and Patient Safety Policy, AHA

##  Multitude of Activities Confronting Hospitals

- National
- Patient Safety
- Efforts

- Institute for Healthcare Improvement

- Health Plans

- Institute for Safe Medication Practices

- JCAHO

- AHRQ

- CMS

- National Quality Forum

- Partnership for Patient Safety

- LeapfrogGroup

- National Patient Safety Foundation

- Ambulatory Quality Alliance

- National Committee for Quality Assurance

** ****Multitude of Activities Confronting Hospitals**

**100K Campaign**

**Collaboratives**

**HCUP**

**PSOs**

**Safety Goals**

**Data Collection**

**Hospital Core**

**Safe Practices**

**Serious Reportable Events**

**Nursing Sensitive**

**Thoracic Surgery**

**Cancer Care**

**Measurement**

**Safe practices**

**Rewards Program**

**SCIP**

**8****th**** Scope of Work**

**ACE**

**HCAHPS**

**Sentinel Event Reporting**

**PSIs**

## Partners In HQA

- Hospitals
- American Hospital Association
- Federation of American Hospitals
- Association of American Medical Colleges
- National Association of Childrens’ Hospitals
- National Association of Public Hospitals
- Other Providers
- American Medical Association
- American Nurses Association
- Government
- Centers for Medicare and Medicaid Services
- Agency for Healthcare Research and Quality

**Employers/Consumers/ Purchasers**
- AARP
- AFL-CIO
- Consumer/Purchaser Disclosure Project
- US Chamber of Commerce
- General Electric
- Blue Cross
- National Business                     Coalition on Health
- America’s Health Insurance Plans
- Quality Groups
- JCAHO
- National Quality Forum

## Hospital Participation in HQA(As of June 2006)

- Total hospitals reporting – 4238
- 3628 Acute Care
- 610 Critical Access
- Breakdown of reporting hospitals
- No cases to report --- 202
- Initial 10* only --- 429
- Initial 10* plus some others --- 2393
- All measures --- 1214

## Measures Requested

- Heart Attack
- Aspirin at arrival
- Beta blocker at arrival
- Aspirin at discharge
- Beta blocker at discharge
- ACE Inhibitor/ARB for LVSD
- Heart Failure
- LV function assessment
- ACE/ARB for LVSD
- Pneumonia
- Antibiotic timing
- Oxygenation assessment
- Pneumonia vaccination

- Heart Attack
- PCI within 120 minutes
- Thrombolytic within 30 minutes
- Smoking cessation
- Heart Failure
- Smoking Cessation
- Discharge instructions
- Pneumonia
- Smoking Cessation
- Blood Culture
- Selection of antibiotic
- Flu vaccination
- Surgical Infection Prevention
- Antibiotic timing
- Antibiotic selection
- Stopping antibiotic

**Initial Group**

**Measures Already Added**

## HQA Measures In Process 

- Next Phase
- HCAHPS (patient survey)
- AMI,Heart Failure, Pneumonia 30 Day Mortality
- Surgical Care VTE, infection
- Subsequent Phases
- Pediatric Asthma Measures
- Surgical Care Improvement Project Measures
- Perioperative heart attack prevention, respiratory complication prevention
- Critical Care Measures
- Ventilator Associated Pneumonia Prevention, central line associated blood stream infection

## HQA Work Underway

- Consolidating data stream to reduce burden, expand capacity for measurement
- Analysis of cost
- Identification of priorities for measurement
- Identification of more measures to use
- Coordination with AQA on efficiency, harmonization of measures, pricing transparency, pilots
- Infrastructure for sustainability

## Quality Improvement

**Set Vision**

**Create Improvement **
**Framework**

**Endorse Measures**

**Collect Data**

**Select Measures**

**Create **
**Measures**

**Validate Data**

**Analyze & Display**
** ****Data**

**Link to Improvement **
**Strategies**

**Promote Attention **
**To Results**

**Monitor Impact**