Improving hospital quality scores is essential for operational success, particularly in patient safety.
Why do patient safety quality scores matter?
Patient safety quality scores really started being discussed around 2000 with the “To Err is Human” report (IOM, 2000). That report provided that “as many as 98,000 patients die from preventable medical errors in U.S. hospitals each year” (IOM, 2000). That means around 270 patients every day suffer from harm that could have been prevented. Therefore, one reason to address patient safety quality scores is to make sure patients are free from harm within the organization.
Are there adverse financial effects to low quality scores and patient safety events?
Yes! One study (Adler, 2018) found that, approximately, each safety event:
- Lengthened the patient stay by 3 days,
- Increased the cost of care by $5,000,
- Increased risk of mortality by 60%, and
- Increased the risk of re-admission by 74%.
Therefore, a proactive quality – and patient safety program – is vital for both the patient and the organization.
Where to start?
In addition to the guidance provided by both state and federal licensing and certification, there are several organizations and resources that provide training and quality data related to patient safety, including accreditation organizations such as TJC and DNV. Another resource is The Leapfrog Group. Leapfrog, as an organization committed to providing transparent data about healthcare providers also offers valuable tools for providers serious about improving patient safety. The Advis team is experienced with working to achieve quality initiatives, whether hospitals are utilizing all the above tools and guidance or just starting out.
Here are three scenarios detailing items to consider and steps to take to address each quality issue:
Scenario 1– Pharmacy – Bar Code Medication Administration Assessment in a Small Teaching Hospital
- Problem Statement and Goal: The Pharmacist in Charge and Chief Nursing Officer are assessing the effectiveness of their newly installed bar code medication administration (BCMA) hardware and software.
- What questions can be asked to measure the problem/goal?
- How many medications were scanned?
- How many medications should have been scanned?
- Has there been a decrease in the following errors:
- Wrong patient
- Wrong medication
- Wrong dose
- Wrong time
- Wrong sign-off
- What are the general benchmarks? Where should the organization be scoring?
- Generally, higher scoring hospitals should be seeing a decrease in error reports if the BCMA was implemented successfully because the BCMA should alert staff prior to the error occurring.
- How should the organization “close the gap” between what was measured and where the organization should be scoring?
- This is a great example of how interdisciplinary teamwork and conferencing can problem solve. In this case, it may be necessary to involve pharmacy, nursing, medicine, and IT to help improve the BCMA project.
Scenario 2– Nursing Staffing Assessment in a Large Teaching Hospital
- Problem Statement and Goal: The Chief Nursing Officer received employee feedback surveys where there were multiple comments regarding safe nursing staffing ratios.
- What questions can be asked to measure the problem/goal?
- What are the total nursing care hours (RN, LPN/LVN, CNA) per patient day?
- What are the RN nursing care hours per patient day?
- What are the general benchmarks? Where should the organization be scoring?
- Generally, for a single acuity unit/department in a large teaching hospital, the total nursing care hours (RN, LPN/LVN, CNA) per patient day should be around 7 to 9. And the RN hours should be around 4 to 6.
- How should the organization “close the gap” between what was measured and where the organization should be scoring?
- Safe staffing ratio discussions are incredibly complex and require input from many stakeholders. Each organization is unique and therefore, each needs their own assessment and narrowly tailored recommendations to improve efficacy and efficiency of care to ultimately keep patients safe.
- Today, more than ever, organizations are still suffering from post-pandemic operating margins. It is vital that organizations maximize staffing efficiency while keeping patients safe.
Scenario 3 – Improving Healthcare Equity in a Critical Access Hospital
- Problem Statement and Goal: Health equity is a safety priority. A new CEO wants to ensure this Goal is being met.
- What are some questions that can be asked to measure the problem/goal?
- What demographic information is being collected on patients at registration?
- Does the hospital offer training to staff on cultural awareness?
- What programs exist that are actively trying to decrease healthcare disparities?
- Are Notices of Available Language Assistance Services and Auxiliary Aids and Services posted and compliant with the Affordable Care Act?
- What are the general benchmarks? Where should the organization be scoring?
- Generally, higher performing hospitals – and safer care – is found where hospitals:
- Ask patients about their race, ethnicity, and preferred language.
- Have established programs in place to train staff on both health equity and decreasing health disparities.
- Actively pursue, through both policies and practices, programs to identify and address healthcare disparities within their market.
- Meet the Affordable Care Act standards related to Language Assistance Notices.
- Tips on Healthcare Equity.
- Improving health equity means decreasing disparities, which are generally a preventable disease or injury among a particular population. So, active awareness and action plans to target these areas will not only benefit the organization, but the entire community.
- Generally, higher performing hospitals – and safer care – is found where hospitals:
How can Advis help?
Continuously evaluating quality scores and benchmarks is crucial, especially for patient safety. Advis’ healthcare operational experts can help any healthcare organization improve efficiency and quality. The Advis team has experienced consultants with various training and certifications including ACHC and Leapfrog coach certification to ensure your patients and organization remain safe and harm-free. Contact Advis today to enhance your operational success.
References
Adler, L. (2018). Impact of Inpatient Harms on Hospital Finances. Journal of Patient Safety
IOM. (2000). To Err is Human. IOM.
The Leapfrog Group. (N.D.).
Published: June 11, 2024
