Dear Colleagues:
Our longstanding commitment to collecting, analyzing and sharing our quality data has served us well in recent years both in improving patient care and securing favorable contracts with private payers. In addition, this data has quantified our commitment to delivering the safest patient care, which has been recognized in recent years by the Leapfrog Group, the National Quality Forum and the University Health Consortium, to name a few.
We hope our commitment to delivering excellent care and measuring it proves helpful as the Center for Medicare and Medicaid Services expands reportable measures as part of the hospital’s annual payment update (See page 9). At first, we had to report measures related to acute myocardial infarction, heart failure and pneumonia. Last year, 11 additional measures were added, including two measures as part of the Surgical Care Improvement Project. In the next two years, it’s likely 11 more measures will be added, including patient satisfaction data from the HCAHPS national satisfaction survey.
At present, CMS only requires that we report this data, and while some of this information is publicly available on the “Hospital Compare” Web site, it is not publicly available in its entirety. However, we expect that to change, and we also need to be prepared for when CMS ties its reimbursement rates to these data in coming years.
Through the Center for Clinical Excellence, we have improvement teams, comprised of physicians, nurses, therapists and other clinical and administrative staff, in place to make sure we remain on target for all the various measures through exhaustive chart reviews of our performance.
For starters, please be sure to ask your patients if they smoke or have smoked within the past 12 months. If they do, please document in their medical record that you have counseled these patients to quit smoking. It really is that simple.
Thank you.
Sincerely,
Andy Whittemore, MD
Chief Medical Officer