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Improving Quality of Care for Hospitalized
                                                                                                 Children and Adults
                                                                          Naomi S. Bardach, Renée Asteria-Peñaloza, Michael D. Cabana, and R. Adams Dudley




    Policy Issue:                 Capturing and Improving Quality
                                      in Pediatrics
 PRL-IHPS develops quality measures for hospitalized pediatric
 patients, to help identify high and low performing hospitals

   There are few pediatric quality measures for inpatient stays,
   which account for 1 out of 6 hospital stays nationally

   There is a national call for pediatric quality measures, with a
   priority placed on readmissions measures

   We are developing pediatric readmissions measures, using
   them to measure quality for hospitals in a multi-state database,
   and will conduct interviews with high and low performers to
   explore potential reasons for variations in quality




                                                                                   Policy Issue:                 Activating Patients and Amplifying the Patient
                                                                                                                      Voice to Improve Outcomes
                                                                                  PRL-IHPS is exploring how timely and actionable patient feedback regarding
                                                                                  their care may improve outcomes

                                                                                     There is a correlation between patient experience scores and hospitals
                                                                                     mortality and readmissions.

                                                                                     It is possible that patients are observing variations in care that have a
                                                                                     meaningful impact on their health

                                                                                    Capturing those observations and sharing them with others might lead to
                                                                                     better outcomes




Higher Patient Scores from Online Reviews Correlate with
Lower Hospital Mortality and Readmissions
Outcome                                                Correlation with p-value   Correlation with                                    p-value
                                                       Percent High Yelp        Percent High Ratings
                                                            Score                   on HCAHPS

Mortality rate, Heart Attack                                    -0.19                    0.005                -0.13                        0.052

Mortality rate, Pneumonia                                       -0.14                      0.03               -0.18                        0.004

Readmissions, Heart Attack                                      -0.17                      0.01               -0.39                      <0.001

Readmissions, Heart Failure                                     -0.31                  <0.001                 -0.39                      <0.001

Readmissions, Pneumonia                                         -0.18                    0.005                -0.27                      <0.001

Hospitals with >5 Yelp ratings (N=270) were analyzed. Weighted Pearson’s product moment correlation coefficients, using weights
inversely proportional to the number of Yelp raters.
Data for 30-day mortality and readmission rates come from the Center for Medicaid and Medicare Services public reporting website,
HospitalCompare.hhs.gov.
Bardach et al. “The Relationship between Commercial Website Ratings and Traditional Hospital Performance Measures in the US” (BMJ Quality and
Safety, November 2012).

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Improving Quality of Care for Hospitalized Children and Adults

  • 1. Improving Quality of Care for Hospitalized Children and Adults Naomi S. Bardach, Renée Asteria-Peñaloza, Michael D. Cabana, and R. Adams Dudley Policy Issue: Capturing and Improving Quality in Pediatrics  PRL-IHPS develops quality measures for hospitalized pediatric patients, to help identify high and low performing hospitals  There are few pediatric quality measures for inpatient stays, which account for 1 out of 6 hospital stays nationally  There is a national call for pediatric quality measures, with a priority placed on readmissions measures  We are developing pediatric readmissions measures, using them to measure quality for hospitals in a multi-state database, and will conduct interviews with high and low performers to explore potential reasons for variations in quality Policy Issue: Activating Patients and Amplifying the Patient Voice to Improve Outcomes  PRL-IHPS is exploring how timely and actionable patient feedback regarding their care may improve outcomes  There is a correlation between patient experience scores and hospitals mortality and readmissions.  It is possible that patients are observing variations in care that have a meaningful impact on their health Capturing those observations and sharing them with others might lead to better outcomes Higher Patient Scores from Online Reviews Correlate with Lower Hospital Mortality and Readmissions Outcome Correlation with p-value Correlation with p-value Percent High Yelp Percent High Ratings Score on HCAHPS Mortality rate, Heart Attack -0.19 0.005 -0.13 0.052 Mortality rate, Pneumonia -0.14 0.03 -0.18 0.004 Readmissions, Heart Attack -0.17 0.01 -0.39 <0.001 Readmissions, Heart Failure -0.31 <0.001 -0.39 <0.001 Readmissions, Pneumonia -0.18 0.005 -0.27 <0.001 Hospitals with >5 Yelp ratings (N=270) were analyzed. Weighted Pearson’s product moment correlation coefficients, using weights inversely proportional to the number of Yelp raters. Data for 30-day mortality and readmission rates come from the Center for Medicaid and Medicare Services public reporting website, HospitalCompare.hhs.gov. Bardach et al. “The Relationship between Commercial Website Ratings and Traditional Hospital Performance Measures in the US” (BMJ Quality and Safety, November 2012).