Executive Notes

Medical Staff Updates Danbury/New Milford Hospitals

Sohel Islam, MD
Medical Staff President – Danbury/New Milford Hospitals

Measuring Quality in Healthcare

The internet has ushered in an era of ratings. Anyone – including our patients -- can find ratings and reviews for almost anything. Everything from dishwashers to hotels can be evaluated by placing a set of stars next to it. So, it should come as no surprise that healthcare, including hospitals and physicians, are now under the same scrutiny.

Patients have the ability to look at evaluations of their providers and networks prior to deciding on treatments. While this can profoundly affect the delivery of healthcare, are these ratings accurate? What methodology is used to come up with the ratings? What’s in it for the ratings agencies?

There is a veritable alphabet soup of ratings agencies-Joint Commission, CMS, Leapfrog, Healthgrades, Consumer Reports, U.S. News. etc. Consumers are understandably confused as to which source to rely on for accurate information.

So, how do we educate our patients about so called “hospital report cards”? Like most of what we do, we need to listen to patients’ questions and concerns and try to answer them.

To do that, we ourselves have to become educated. Hospital report cards, no matter how comprehensive, contain inherent inaccuracies, as most measure specific points in care instead of looking at the entirety of care received by individual patients throughout their stay.

Physicians should all be aware that some reporting agencies are for-profit entities. They require payment from hospitals to purchase licensing fees to use their ratings. This is an inherent conflict of interest in their reporting. We know that some agencies use outdated data or data which does not undergo validity testing. One factor that we physicians understand is that there is often no risk adjustment made, taking into consideration illness severity or demographic factors which can impact outcomes.

As Connecticut physicians some of you may not know that HANYS Healthcare Association of New York State) reviewed and developed a report card on the various ratings agencies. They recommended several guiding principles: transparent methodology, evidence-based measures, measure alignment, appropriate data source, most current data, risk adjusted data, and using quality data. Go to: http://www.hanys.org for more information.

Using these guidelines, they recommended the following as the most reliable sources for ratings: Joint Commission Quality Check, CMS Hospital Compare, Department of Health Hospital Acquired Infection Report, and Department of Health Hospital Profile Quality Section.

Conversely, the lowest grades went to the commercial ratings agencies: Leapfrog, Healthgrades, Consumer Reports, and U.S. News.

As patients become more savvy healthcare consumers, we physicians will have to become more sophisticated in our understanding of ratings and ratings agencies. In fact, we as individual practitioners will certainly face the same ratings quandary as hospitals do currently. We all need to become more comfortable in explaining these methodologies to our patients in order to guide them toward making the smartest choices on what quality care means and where best to go to receive it.

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