If hospitals feel like they’re being watched, they are.
Health plans, healthcare groups and the federal government are tracking how hospitals care for patients and making results available to employers and workers.
One area that’s getting a lot of attention: care for heart patients.
The Department of Health and Human Services has started tracking hospital care for three illnesses, including heart attacks and heart failure. The figures include whether a patient gets an aspirin upon entering the hospital and the percentage of heart failure patients who get discharge instructions.
The extra attention has brought changes at hospitals.
At Mission Hospital Regional Medical Center in Mission Viejo, heart attack patients get into the facility’s catheter lab for interventional treatment in 120 minutes or less, said Michael Beck, vice president of quality and systems improvement.
Mission Hospital is among some 250 participants in Hospital Compare, a federal project to make healthcare quality data more available.
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Mission Hospital catheter lab: most heart patients in within 120 minutes |
“A year ago, if you were to go to Hospital Compare, you’d see that 64% of our patients met that criteria,” Beck said. “In our most recent reporting period, we’d be at 90%.”
Even with that, Beck said the hospital still is going for getting patients into the catheter lab in 90 minutes or less.
The public reporting isn’t the only trigger for trying to improve care, Beck said.
“We started these initiatives before public reporting began,” he said.
Additionally, Mission is part of a coalition called the California Hospital Assessment and Reporting Task Force, which aims to come up with standards for reporting on care, Beck said.
Oakland-based Kaiser Permanente, which has about 342,000 Orange County members, has put together guidelines for heart patients, said Carolyn Days, vice president for quality and risk management for the health system’s Southern California region.
“It’s really critical that the most current and best care gets communicated widely so that all patients get the opportunity to receive it,” Days said.
Kaiser, even before the public reporting effort, was comparing care among its own hospitals, she said.
Kaiser distributes clinical practice guidelines to doctors “to make sure they are doing the care consistently,” Days said.
The health system also has “pre-printed orders” to track whether its patients receive consistent health education, including anti-smoking warnings.
Electronic medical records, which are being adapted across the hospital industry, have played into the standardization reporting movement.
“By introducing or overlaying an electronic medical record, we can change the way we work,” said Mary Kingston, executive director of performance improvement and patient safety at Anaheim Memorial Medical Center, part of Long Beach-based Memorial Health Care System.
Memorial’s work change, according to Kingston, looks to “evidence-based medicine” to treat heart ailments and other problems.
Evidence-based medicine is a movement that’s based on application of scientific methods to medical practice, including long-established traditions that haven’t been subjected to what its advocates call adequate scientific scrutiny.
Fixing a Broken Heart
Edwards Lifesciences Corp.’s been busy with new products.
Shortly after the Irvine heart device company recently introduced a Perimount Magna mitral heart valve in Europe, it came out with a mitral valve repair technique intended to treat leaking mitral valves of patients suffering from congestive heart failure.
Clinical trials showed that GeoForm, Edwards’ new annuloplasty ring, was able to successfully treat mitral valve regurgitation caused by cardiomyopathy, as well as improving the function of the heart’s left ventricle.
Edwards developed the ring with Dr. Steven Bolling, director of the University of Michigan Health System’s Mitral Valve Clinic and Dr. Ottavio Alfieri of St. Raffaele Hospital in Milan.
Bits and Pieces:
Susan Bryant and Mahtab Jafari, professors at the University of California, Irvine, and Shane Smith, a consultant to the university, are discussing “Perspectives on Stem Cell Research” at the Oct. 20 meeting of the Orange County Forum at the Hyatt Regency Irvine. Information: (949) 588-9884 The Cough Center, Mission Viejo, a medical practice modeled after university-affiliated cough clinics, opened across the street from Mission Hospital in Mission Viejo. The practice is geared toward children and adults with persistent coughs.
