DATE: August 8, 2002

TO:      Quality Directors
            Performance and Core Measurement Liaisons
            QIO and JCAHO Liaisons

SUBJECT:  Upcoming Performance Measurement Updates

This update includes information on:
- Consider Using Templates
- Chicago Tribune article

Consider Template Usage
As requested many times, I will urge you to consider the value of using templates for concurrent or quasi concurrent abstraction for your performance measurements now.  Templates allow one to track concurrently the processes and care guidelines at time of care, rather than retrospectively abstracting information after the patient has left your facility.

As many of you know, IHA has tried to remind you that any hospital data used for any 2004 release will be coming from the data you will be collecting and reporting on for the end of this year and next year.  Due to the timing of the JCAHO Core Measurement process, feedback from JCAHO on national comparisons or performance for 3rd quarter 2002 data will not be available until 7 to 9 months after the data has been collected.  That is, for data collected in July 2002, hospitals will not have feedback until after the JCAHO deadline of January 31, 2003.  This means that nearly a full 7 to 9 months of data will have passed through before your facility knows to make changes to their processes for caring for patients.  The templates allow one to monitor patients as they are going through the care delivery process at your hospital.

While we fully recognize that 75% of the Acute myocardial infarction, pneumonia, and heart failure patients start their process of care in the emergency room, there are ways in which hospitals can utilize the templates in a concurrent or quasi-concurrent abstraction approach - which serves as a reminder for delivering care.  In the next few weeks, we will profile some successful approaches to implementing the templates within organizations.

If you have not seen the templates or need the latest version, please see the following web site for the AMI, heart failure, and pneumonia templates  http://www.ihatoday.org/compdata/perfmeas/index.htm
under the abstraction templates headline.

Chicago Tribune Article
The Chicago Tribune has an article featuring remarks made by Tom Scully, Administrator for CMS, in its Business section today.  This highlights and confirms much of the discussion and information IHA has been providing you with for the last year - may be helpful in your discussions with CEOs, medical staff directors, and board members to highlight the importance of the performance measurement initiative.


INSIDE HEALTH CARE
U.S. agency to issue nursing home critique

BRUCE JAPSEN
Published August 8, 2002

The federal government will soon provide a way for consumers to compare quality of nursing homes as part of a much-anticipated effort to provide information on performance of care providers.

"We want to measure quality, publish quality and get people to focus on quality," said Thomas Scully, administrator for the Centers for Medicare & Medicaid Services, in an interview at this week's Catholic Health Association meeting in Chicago.

"Even if no consumers see this stuff, boards of directors of nursing homes will see it and demand their administrators do something about it," Scully added. "Right now, the perception is that nursing home quality stinks and it is going to get worse."

On Oct. 15, consumers will get a glimpse of certain quality measurements for nursing homes through full-page advertisements the government is taking out in major newspapers across the country, Scully said.

Most nursing homes will be listed for the particular newspaper's audience, with a complete list available on the Internet that measures nine quality standards ranging from average number of bed sores to how patients' pain is managed.

Scully said the measurements are one way nursing homes can prove they are deserving of increased funding from Medicare, the federal health insurance program for the elderly, and Medicaid, the federal-state health insurance program for the needy. Health-care funding in particular has been squeezed in recent years as part of the Balanced Budget Act of 1997, as well as other spending reductions.

Other health-care categories will soon follow.

By next year, the government will begin publishing information on quality of home-health-care providers. And by 2004, the government hopes to provide such information on hospitals, Scully said.

The government, employers and consumer groups are increasingly demanding providers of medical care measure the quality of their services.

For example, a recent report by the Chicago-based Midwest Business Group on Health said low-quality health care in the U.S. is costing nearly $400 billion a year, or about 30 percent of the total $1.3 trill ational comparisons or performanceion in annual medical expenditures.

The government, too, is tiring of paying for services that don't measure up.

"If you want the federal government to increase funding, the argument has got to be focused on results," Scully said. "We want to have aggressive nursing home, home health and hospital quality standards."

If you have questions on any of the issues highlighted, please contact Pat Merryweather at pmerryweather@ihastaff.org