Process Analysis Hospitals

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U.S. News & World Report unveiled the new Best Hospitals for Common Care ratings that rates hospitals in five common surgical procedures and medical conditions; three common operations – heart bypass (CABG), hip replacement and knee replacement – and two widespread chronic conditions – congestive heart failure (HF) and chronic obstructive pulmonary disease (COPD). The definitions for these conditions and procedures were created for this report and are not the same as those used by CMS for its performance indicators. More than 4,670 hospitals nationwide were evaluated in at least one of the five procedures or conditions. Hospitals were not rated in a procedure or condition if they treated too few patients, analysis was inappropriate or data …show more content…

Outcome measures were in the three major categories: Complications following orthopedic procedures, rate of Healthcare- Associated Infections (HAIs), and Mortality complications and process- related metrics following heart bypass. Process indicators were not used in any of published cohorts. However, a process measure related to cardiac surgical technique was used in the CABG methodology. Four structural indicators (Nurse Staffing, Nurse Magnet Recognition, Staff Intensivist, Cardiac Intensive Care Unit were employed along with a measure of Volume of Operation performed. The ratings rely on the Centers for Medicare & Medicaid Services (CMS) administrative claims data for patients 65 and older covered by traditional fee-for-service Medicare, American Hospital Association annual survey, clinical registry data from the Society of Thoracic Surgeons (STS), and patient survey data (HCAHPS). Seven of the 11 domains in HCAHPS were used; doctor’s communication skills, nurse communication skills, staff responsiveness, preventing medical harm, quality if discharge information, and engaging patient in their …show more content…

Risk Banding and Z- score was used to extract inferences and create a five- tier banding system to create the overall hospital score according to the degree of confidence of where a hospital ranks relative to the mean score (zero). A hospital may be rated as “High Performing”, “Average Performing” or “Below Average Performing.” Approximately 90 percent% of the hospitals rated in each condition or procedure were High Performing or Average Performing. When comparing outcomes between different healthcare providesproviders, it is impossible to know with certainty whether unmeasured differences in patient risk are responsible for differences in outcomes. While risk- adjustments can be used to take account of the major known risk factors, it is always possible that the results confounded in the patient’s chance of survival are not captured in the data. Through the data validation process, the following conclusions were drawn: 1. The length of stay measure was systematically biased against teaching hospitals and those with residency programs. This also affect Event- Free Admission (EFA) rate if length of stay was

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