The document discusses two policy issues related to improving quality of care for hospitalized children and adults. The first is developing quality measures for pediatric inpatient stays, including readmission measures, to help identify high and low performing hospitals. The second is exploring how timely and actionable patient feedback during hospitalization could improve outcomes by capturing patient observations about variations in care. A study found higher scores on online hospital reviews correlated with lower mortality and readmission rates for conditions like heart attack and pneumonia.

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).