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Home arrow Op-eds arrow New website helps patients make good decisions about hospital care
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New website helps patients make good decisions about hospital care
Posted: 04/15/08 06:55 PM [ET]

Most of us wouldn’t make a major purchase, such as a car or a major appliance, unless we had first gotten some basic information about its quality and cost relative to similar products. That’s just common sense. Unfortunately, we really aren’t able to apply the same common sense principles to making healthcare purchasing decisions, despite the potentially life-threatening ramifications of choosing poor quality healthcare.

We need to make our healthcare system one that rewards quality and value, rather than volume. One critical element of a healthcare system focused on value rather than volume is transparency: making more information available for healthcare consumers. The shared commitment of the public and private sectors to transparency of quality information has begun to yield tangible benefits.

For the past 15 years, measurement of healthcare quality has been evolving, and in the past five years, that trend has accelerated. Physicians, hospitals, employers and consumers all have recognized the importance of using consistent information so providers know where improvements are most needed and so consumers can make informed choices. The federal government has recently committed to making more information about healthcare quality available to the public.

Last month, the Department of Health and Human Services updated an online tool that will help Americans make better-informed decisions about hospital care. It has two important components.

First, the new website now provides information on 26 quality measures, including process of care — which report how well a hospital provides care — and outcome measures — which reflect the results of the care patients receive. Second, the site adds detailed information about patient experiences with their hospital care.

The new website is the evolution of Hospital Compare, originally launched in 2005. It was developed through a public-private partnership between the Centers for Medicare & Medicaid Services and the Hospital Quality Alliance. The Hospital Quality Alliance consists of organizations that represent consumers, hospitals, doctors and nurses, employers, accrediting organizations, and federal agencies. This strong and effective partnership affirms the commitment that our nation — the public and private sectors alike — has to high quality and safe health care.

Particularly notable on the site is the feature that reports on patients’ experiences with their healthcare. Asking patients for their opinion is nothing new. Hospitals have been conducting patient satisfaction surveys for more than a decade; however, the results of those surveys weren’t usually made public. What is revolutionary about this new information is that it goes beyond questions concerning patient satisfaction and asks patients to assess their experience.

To collect the information, patients were asked 27 questions from the Hospital Consumer Assessment of Healthcare Providers and Systems survey, developed by the Agency for Healthcare Research and Quality, a unit of HHS. The questionnaire focuses on questions such as: Did the doctor or nurse explain things in a way you understand? How often did they listen carefully to you? Did they treat you with courtesy and respect? Did the hospital help you control pain? Was the hospital clean?

It is critical to include these and other patient experience questions on hospital surveys for two reasons: These are questions that only patients can answer and the issues they explore have a powerful impact on the quality and safety of care. Indeed, the source of many common quality and safety missteps is poor communication.

For example, a discharged patient who can’t follow home care instructions because she doesn’t understand them could end up being readmitted to the hospital. Research shows that 15 percent of patients who don’t understand discharge instructions are readmitted to the hospital or end up in the emergency room within two weeks. Our initial survey results found that 20 percent of patients reported that they had not received printed information about their illness and required follow-up care.

The information on the website is presented in a way that allows patients to make comparisons among hospitals.

Consider this: Instead of just relying on a physician’s recommendation or word of mouth for a hospital recommendation, you can now go to a website and see the collective experiences of people in your community who have received care at local hospitals. You might think that this information isn’t always helpful; people having heart attacks aren’t going to stop and consult a website to determine patient assessment of care — they’re going to want to go directly to an emergency department, and they should. But 61 percent of hospital patients in 2005 had an elective procedure — not an emergency — and could have used the site to pick the best hospital for their needs.

This new information arrives at a time when an ever-increasing number of Americans report that they search the Web and other sources for information on treatments and the cost and quality of care.

While this is only a step in our efforts to create a healthcare system that provides value and quality for what we spend, it is an important step. For the first time, consumers have the two critical elements — quality information and patient experience survey information — they need to make effective decisions about the quality and value of the healthcare available to them through local hospitals.

Clancy is director of the Agency for Healthcare Research and Quality in the Department of Health and Human Services.

 
 
 
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