Making It All Public

Cheryl Clark, for HealthLeaders Media , May 13, 2014
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The clinic also is one of 113 hospitals participating in an American College of Surgeons' surgical improvement program that have agreed to let Hospital Compare post its rates of death or serious complications within 30 days for three procedures—even though for one of them, lower-extremity bypass, the Cleveland Clinic's rates put it among three hospitals that were "worse than average."

Cleveland Clinic did that, he says, "because our lower-extremity bypass surgeries need improvement."

To hospitals thinking of similar initiatives, Henderson says, "Do it. I have not seen a downside. It's valuable for patients and it's valuable to help push us toward improvement. As soon as you start measuring these things in detail, you find gaps and opportunities" to get better.

In mid-2013, 1,713-bed Baptist Health South Florida, a Coral Gables–based six-hospital system serving South Florida, revamped and expanded its website to dramatically change the way it presents four types of quality data for its six adult hospitals: outcomes, patient experience, safety, and accountability.

Now, it shows in bright green and yellow charts in what areas the hospital is best, where it's average, and what types of care falls "below average," and hospitals within the system compete with each other for better scores.

"It's a healthy sibling rivalry among our senior and performance improvement leadership teams,"
says Emily Ruwitch, assistant vice president for Baptist's Center for Performance Excellence. "Our CEO, Brian Keeley, told us a couple of years ago that we need to be bold and audacious and put our performance data out there."

But there was "trepidation on a number of levels," she says. "Some asked if people will be able to understand it, and if we're not performing as well as we could be, highlighting an opportunity where we need to improve—is that something we really want to put out there?" she says. "There were definitely conversations about posting mortality rates. That can be a scary thing to look at. "

But the plan prevailed, in part because the same type of information was available elsewhere. "And it would look kind of funny if they can find it somewhere else but we don't have it on our website. We wanted our revamped website to be a single source for patients and their families to get a true sense of our performance in those four domains."

As hospital leaders say all the time, a culture change is underway, and it's apparent in quality data transparency. "Five years ago, like most places, this was not at the top of our radar," says the Cleveland Clinic's Henderson. Hospital organizations believed they were good, and they didn't need to say why or how.

Now, that attitude is changing. "The culture change is acknowledging and accepting that no matter how good you are, you have opportunities to improve if you know where they are."

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This article appears in the May 2014 issue of HealthLeaders magazine.

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