If you are a hospital, it’s time to talk about your grades. Every year hospitals are evaluated and rated by outside organizations, with two of the most important being the hospital Star Ratings by the Centers for Medicare & Medicaid Services (CMS) and Best Hospitals ranking by U.S. News & World Reports.
CMS’s overall star ratings are based on forty-six quality measures in five categories: mortality, safety, readmission, patient experience, and timely/effective care. Each overall rating shows how well the hospital performed on these quality measures compared to other hospitals in the U.S. The more stars, the better a hospital performed.
U.S. News & World Report’s rankings, in turn, are broken into two subcomponents: specialty rankings and procedure and condition ratings. Specialty rankings are intended for those with life-threatening or rare conditions needing top-level care for complex cases. Procedure and condition ratings focus on commonly needed procedures or conditions (e.g., hip replacement, heart failure). For both subcomponents, the ratings are based on quality of care with a focus on the relationship between structure (hospital resources connected with patient care), process (the way in which diagnoses, treatments, and practices are built into routine), and outcomes (the results of the care).
Not surprisingly, hospitals often turn to external expert consultants to help them achieve a better ranking/rating. Typically, these consultants provide a gap analysis to identify opportunities for improvement along with specific recommendations in the form of corrective actions and best practices to be taken. These recommendations may range from policy/procedure changes to operational processes and steps based on these policies/procedures to be taken.
While expert recommendations can be a great step, many hospitals still do not achieve the ranking/rating they hoped for, or if they do are unable to sustain it over time. Why? The answer is simple really. No matter how detailed corrective action and best practice recommendations are, each step must be operationally implemented and consistently performed. In actual practice, this is much more difficult than it sounds. The key is establishing an operational infrastructure that ensures transparency, accountability, and unrelenting diligence from the top down –without increasing daily workload or making things more complicated. Terlumina provides a single, powerful enterprise-wide solution that simplifies the process. Proactively monitor compliance metrics and key performance indicators (KPIs) based on tasks and assessments. Target identified risks, implement corrective actions, and objectively measure improvement.