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Hospital Mortality Rates Improve, but Quality Gap Persists


 

Risk-adjusted mortality and complication rates have decreased nearly 11% from 2006 through 2008, according to the12th annual HealthGrades Quality in America Study. However, the report found a wide gap between the nation’s best hospitals and all others. To save thousands of lives, the authors suggested focused improvement in sepsis, pneumonia, heart failure, and respiratory failure.

The report showed patients at highly rated hospitals have a 52% lower chance of dying, compared with the U.S. hospital average, according to the study authors. The rankings used 40 million Medicare patient outcomes from 2006 to 2008, and analyzed more than 5,000 U.S. hospitals. The scoring was based on 30 common procedures and diagnoses.

Patrick Torcson, MD, FHM, chair of SHM’s Performance and Standards Committee, says hospitalists may be one reason highly rated hospitals did well. “We’re on-site to evaluate patients and facilitate transition of care,” Dr. Torcson says. “I think that’s where the biggest impact is going to be.”

At Christ Hospital in Cincinnati, one of the nation’s top performers, hospitalist Rajan Lakhia, DO, credits the “absolute attitude everyone around here has—a dedication to quality.”

Berc Gawne, MD, the hospital’s chief medical officer, agreed. “Hospitalists know the people, policies, and politics. They know the barriers and where to go to get things done,” he says. “It’s their hospital and they take ownership for the order sets, the critical pathways, and performance improvement.”

Scottsdale Healthcare in Arizona has improved its ratings in recent years. Perhaps not coincidentally, the facility hired a hospitalist group two years ago to improve the quality of care. According to hospitalist Barry Freeman, MD, each quarter, the hospital publishes quality measures, and goals are established as part of a scorecard. Results are regularly reviewed and improvement discussed. In taking care of almost all medical and surgical patients, the hospitalists “can further educate the nonhospitalist staff on quality efforts and initiatives under way,” Dr. Freeman explains.

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