How Hospitals' Data Transparency Can Spur Quality Improvement

Hospitals are facing pressure to increase transparency from both patients, who are playing a larger role in choosing their healthcare providers, and the federal government, which requires regular reporting on quality. While making quality and patient safety data available to the public has raised concerns that consumers will misinterpret the data, transparency may ultimately spur improvement. Roger A. Ray, MD, executive vice president and CMO of Charlotte, N.C.-based Carolinas HealthCare System, explains how the health system embraced transparency to drive higher quality.

Dr. Roger Ray describes how Carolinas maintains transparency with its quality data.Transparency on the website
The front page of CHS' website has a link to the system's quality report card, which shows a chart of Hospital Compare data for its six hospitals compared to the U.S. and state average. Each CHS data point is color coded based on whether the rate is better than, the same as or below state average.

In areas where CHS is below state average, the website explains steps the system is taking to improve performance. For example, on the measure "percent of surgery patients whose urinary catheters were removed on the first or second day after surgery," some of CHS' hospitals' were one to 10 percentage points lower than the state average. The website shows that to improve their score, the hospitals have developed a daily electronic reminder for physicians to continue or discontinue urinary catheter use. "What many patients and families want to know is, 'So what are you doing to improve?' Being able to create a linkage between the data and that discussion for improvement has power," Dr. Ray says.

This easy access to quality data is new for CHS, as its new website launched May 1. "We took that opportunity to freshen our approach, bringing quality front and center," Dr. Ray says.

Improving care

The transparency of CHS' quality data has helped drive improvement efforts throughout the system, according to Dr. Ray. "We believe that learning to better share information and be more transparent with data over time is effective at improving the quality and safety of care we provide." For example, this reporting allows the system to easily identify areas for improvement, which encourages action. "With the awareness of anything short of perfect care, healthcare professionals are very much engaged," Dr. Ray says. "People are very energized about pursuing improvement."

Data transparency can also improve quality by increasing patients' awareness of safety risks and standards of care. "The healthcare environment is complex, and we understand that we all have a role to play in improving quality and safety, including patients and families," Dr. Ray says. "Being transparent with information is a way of engaging them and enabling them in that journey." For example, he says one medication safety best practice is to check patients' arm bands before administering medication. The hospital could place signs in the hospital notifying patients of this practice and encouraging them to remind providers to check the armband if the providers ever forget.

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