In a world where a consumer can collect encyclopedic knowledge about a car or home electronics purchase, the need for useable, measureable quality data grows every day, particularly in healthcare.
More organizations are focusing on quality data collection, said Stephanie Iorio, RN, CPHQ, CPC, during her presentation "The Impact of Quality Data on the External Environment" during September's National Association for Healthcare Quality national conference in Grapevine, TX.
Current themes in quality measurement include an absence of standardization of measures and data element definitions, a need to harmonize measures across healthcare settings, a growing demand for measures of efficiency, and use of administrative and other electronic data.
There has also been a movement toward "episodes of care," Iorio said. Other themes include:
"Are we measuring the right processes?" said Iorio.
There are more than a half-dozen regulatory or reporting agencies tracking quality data in the acute care setting—not just CMS and The Joint Commission, but such staples as the National Quality Forum, the Agency for Healthcare Quality Research, the Institute for Healthcare Improvement, Leapfrog, and Healthgrades.
And yet, "today you can find out more about a TV you want to purchase than about your own healthcare online," said Iorio.
The crux of quality is data, Iorio said. Data analysis reveals a great deal about quality and patient safety. Reviewing data can show trends in appropriateness of care, variations in practice and outcomes, and resource utilization.
Movement away from manual chart reviews—which are both time- and resource-intensive—to the electronic record has revolutionized the availability and usefulness of administrative data, said Iorio.
So where does The Joint Commission play into all of this? In 2009, ORYX reporting required four measure sets. Additional measure sets are in development, and measures are being reworked for capture through the electronic health record system.
Also beginning this year, The Joint Commission considered introducing "paired mandatory reporting requirements"—that is, certain measures would be tied together in required reporting. For example, if your facility reports cardiac care measures, either myocardial infarction or heart failure measures would also be required. Alternately, surgical services measures would then mean Surgical Care Improvement Project infections would need to be reported.
Most hospitals would meet the remainder of reporting requirements by choosing to report some combination of nursing sensitive, pneumonia, children's asthma care, and pregnancy measures, said Iorio.