Guest Blog: Marie Dotseth, Executive Director, Minnesota Alliance for Patient Safety (MAPS)

Guest Blog: Marie Dotseth, Executive Director, Minnesota Alliance for Patient Safety (MAPS)

The title of the lead patient engagement story in the March 2015 issue of Health Affairs caught my attention: “National Hospital Ratings Systems Share Few Common Scores and May Generate Confusion Instead of Clarity.” The authors compared four national hospital rating systems and discovered, for example, that not a single hospital was rated as a high performer by all four.

We need to clear things up for consumers. We need to make sense of the incomprehensible so consumers actually stand a chance of using this information to make informed decisions. At MAPS, we work to achieve our mission of “Safe Care Everywhere” by focusing on educational programming, original projects, Culture Road Map work, and facilitation of safety innovation and collaboration across all care settings.

Highlights of the Health Affairs Article

  • Recent analysis of four national safety and quality reports found very little overlap and some serious inconsistencies in several.
    • The reports include US News Best Hospitals, Leapfrog Group, Consumer Reports, and Health Grades.
    • The analysis did not include state or regional reports.
  • There was very little alignment among the reports.
    • Not one of the hospitals scored in the top tier of rankings in all four reports (only three hospitals nationwide scored in the top tier of three of the reports).
    • None of the hospitals ranked scored in the bottom tier of all the reports.
    • In 27 cases, hospitals that scored on the top tier of one report scored in the bottom of another.

Minnesota Adverse Health Events Report (March 2015)

  • The top performer nationwide on one of the ranking reports analyzed in the Health Affairs article had one of the highest numbers of reported adverse events last year.
  • The other Minnesota hospitals that showed up in the top tier of the national ratings reports also reported significant numbers of adverse events.
  • This tells us that these top performing hospitals are also good at identifying and reporting events, but the average patient or purchaser might not know that without some inside information or assistance.

Historical Perspective

  • Within the past 10-15 years, the challenge before the community when it came to quality and reporting was to “just do it:” To find valid, comparable measures that could be reported.
    • We have made progress. In the early days, providers told us, “what we do can’t be measured…well maybe it can be measured, but we can’t be compared — our patients are too different…well maybe we can be measured and compared, but we can’t publicly report.” These hurdles have been cleared.
    • Minnesota did a good job and proved to be a national health care leader once again.
    • Now we have a proliferation of measures, and some providers feel they are drowning in them with no good way to prioritize.
    • As the analysis from Health Affairs shows, it would be extremely difficult for patients (or any stakeholder) to sort through the current set of reports and come up with an actionable take away.

Taking Action to Help Minnesotans

  • It’s time for Minnesota health care leaders (private and public sectors) to set new policy direction for quality and safety measurement and reporting. We need shared goals for reporting and we need to make sense of this for all stakeholders. For:
    • Patients/consumers, so they can make good choices about where to receive care.
    • Payers and health plans, so they can align incentives and pay for the highest quality.
    • Providers, so they can focus and align their improvement work around what matters
  • MAPS “You, Your Own Best Medicine” patient research found that patients are willing to be engaged, but are rarely told they matter to the process and are not told and shown how they can participate in the process. This needs to change. We need to have a shared understanding about WHY we do all this measurement and reporting (what’s the end result we desire?) and we need to make it clear to the end users — patients and their families.