Many hospitals are making efforts to improve the quality of care but there isn’t consensus on how to measure the progress, says Dr. Peter J. Pronovost, Johns Hopkins patient safety expert.
In the April issue of the journal Health Affairs, Pronovost calls for more attention to the accuracy and reliability of the measures. Without this, patients can't be sure any improvements have been made.
"There is bipartisan support behind efforts to start paying for value rather than volume," Pronovost said. "This is great, but we act as if there's a whole library of reliable outcome measures for us to use, and the fact is that serious work needs to be done to create them. We can't shrink from doing this science. We need to be guided by it."
Pronovost said there are still shortcomings in hospital quality and patients are still being needlessly harmed. This is increasing health care costs.
And past efforts at assessing improvement have not always proven consistent or useful.
Pronovost said some hospitals measure overall death rates but they are not always a reflection on the quality of care. And other research that compared four different measurement services found that they reported the same data differently – 43 percent of hospitals showed higher-than-expected mortality in one metric and lower-than-expected in another.
He and a fellow researcher called for the creation of an independent agency to create standardized measures. "The goal is to make the process of determining quality standard and transparent, and make data meaningful for consumers and usable by clinicians, ultimately improving patient outcomes," Pronovost said.