Do you get better or worse?

Taking the Pulse, a newly released paper by the Atlantic Institute for Market Studies (AIMS), examines indicators used as tools to measure, compare and improve the quality of care in hospitals. It is a growing practice in the health care field to collect and sometimes report performance data on how a hospital provides care to its patients.

Author Julia Witt points out that existing reports often concentrate on whether hospitals perform above or below average on numbers or types of procedures. She suggests other indicators would be more important to patients; ones that quantify desirable health outcomes rather than focusing on processes within the hospital.

She says giving patients the knowledge of which hospitals have high rates of surgical site infections is information that they have the right to know.

“This is information patients should know so that they can make a more informed choice about the hospital in which they will be treated,” Witt writes. “At the same time, such information provides added incentive to a facility to determine the cause of the problem and correct it, thereby improving the quality of health care.”

Indicators are collected and published in different countries for a number of reasons. In the United Kingdom, they often are used to rank hospitals in relation to each other, so patients can make informed choices and decide where they will likely get the ‘best quality’ care. In the United States, there are a number of agencies at both the state and national level that publish data on indicators to evaluate and compare the performance of hospitals. In Canada, there are report cards published. But Witt suggests that it would be better for patient understanding and knowledge if more and better indicators were used.

Witt recommends more emphasis be placed on outcomes when examining hospital indicators and that more attention be paid to the underlying case mix of individual hospitals and the underlying nature and severity of the condition of the patients themselves. As an example she says whether wait times are long or short, the more critical information for people is whether the wait is inappropriate given the patient’s clinical condition. Similarly she suggests that the outcomes of care should be measured by determining whether patients have better comfort, functionality and life expectancy following care.

AIMS acting President Charles Cirtwill says, “Patients want to know whether a hospital can help them; whether they will get better or worse after they are treated. While assessing hospital processes against the average can help improve efficiencies, best practices in health care need to balance efficiency with effectiveness – do your patients actually get better?”

To read the complete paper, click here.

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