Hospitals in Quality Initiative Not More Likely To Improve Safety

February 19, 2015 in News

Hospitals participating in a national quality improvement initiative were no more likely to improve surgical safety and outcomes than hospitals not participating in the program, according to a new study published in the Journal of the American Medical Association, Health Data Management reports.

Details of Study

A team of researchers from the University of Michigan Medical School compared the performance of 263 hospitals participating in the American College of Surgeons’ National Surgical Quality Improvement Program with that of 526 hospitals not involved in the initiative.

The study included data from more than 1.2 million Medicare beneficiaries who had undergone one of 11 major operations at the hospitals over a 10-year period.

Under the ACS-NSQIP effort, nurses at participating hospitals record and send to a secure database information on every operation performed at the facilities. ACS-NSQIP then shares quality reports so that hospitals and doctors can see how they compare with other providers.

Findings

Overall, the researchers found no indication that ACS-NSQIP hospitals performed better than non-participating hospitals.

The study found that participating hospitals saw slight improvements in four areas, but the researchers said that the changes were not statistically significant (Goth, Health Data Management, 2/19).

For example, the study found that among ACS-NSQIP hospitals:

  • 12.8% of Medicare beneficiaries were readmitted within 30 days before the hospitals enrolled in the program, compared with 13.3% after three years of participation;
  • 11% of Medicare beneficiaries suffered serious complications before hospitals enrolled, compared with 11.1% after three years of participation;
  • 4.5% of Medicare beneficiaries died within 30 days before hospitals enrolled, compared with 4.3% after three years of participation; and
  • 0.45% of Medicare beneficiaries had a second operation before hospitals enrolled, compared with 0.49% after three years of participation (Osborne et al., JAMA, 2/3).

In comparison, rates for such adverse events were slightly higher at hospitals that never participated in the program. For example, about 5% of Medicare beneficiaries at non-participating hospitals died within 30 days of their operation.

However, rates also dropped at non-participating hospitals over the study period.

Meanwhile, the cost for operations was similar across all hospitals in the study.

Comments

Lead author Nicholas Osborne said that hospitals participating in ACS-NSQIP “are improving over time,” but “so are other non-participating hospitals.”

He added, “Our study suggests that the ACS-NSQIP is a good start, but that reporting data back to hospitals is not enough” (Health Data Management, 2/19).

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