Voluntary public reporting by hospitals targeted by the Leapfrog Group did not have a significant impact on quality improvements, partly due to a lack of market pressure, according to a study in Health Affairs.
The authors studied hospitals that were asked by the Leapfrog Group to publicly report their progress on certain safety measures, including the use of computerized drug order entry and staffing intensive care units with intensivists. Data showed little progress on both the rate of reporting and the adoption of the safety measures.
The authors said the findings provide four lessons for policymakers and healthcare purchasers on publicly reporting quality data:
1. Interventions need strong evidence. Proposed quality improvement projects must have a strong evidence base. There was some doubt regarding the impact of computerized drug order entry and intensivist staffing, which may have affected hospitals' lack of progress in adopting these measures, according to the study.
2. Federal support is necessary. "Given the composition of hospitals' revenues across payers, it seems essential that any major purchasing effort have the backing of the Medicare and Medicaid programs," the authors wrote. Support from these federal programs provides an incentive for hospitals to change behavior because they perceive a threat to their market share.
3. Consistent expectations would encourage change. Hospitals and health systems may be more likely to implement interventions if quality- and safety-related organizations espoused clear, standard priorities for quality and safety, according to the study.
4. Mandated public reporting may produce more accurate data. "Mandated public reporting of progress on safety standards might yield more complete information than voluntary public reporting," the authors wrote. However, the authors caution that there is no clear evidence for supporting one reporting scheme over another, and that many factors influence public reporting of quality data.
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The authors studied hospitals that were asked by the Leapfrog Group to publicly report their progress on certain safety measures, including the use of computerized drug order entry and staffing intensive care units with intensivists. Data showed little progress on both the rate of reporting and the adoption of the safety measures.
The authors said the findings provide four lessons for policymakers and healthcare purchasers on publicly reporting quality data:
1. Interventions need strong evidence. Proposed quality improvement projects must have a strong evidence base. There was some doubt regarding the impact of computerized drug order entry and intensivist staffing, which may have affected hospitals' lack of progress in adopting these measures, according to the study.
2. Federal support is necessary. "Given the composition of hospitals' revenues across payers, it seems essential that any major purchasing effort have the backing of the Medicare and Medicaid programs," the authors wrote. Support from these federal programs provides an incentive for hospitals to change behavior because they perceive a threat to their market share.
3. Consistent expectations would encourage change. Hospitals and health systems may be more likely to implement interventions if quality- and safety-related organizations espoused clear, standard priorities for quality and safety, according to the study.
4. Mandated public reporting may produce more accurate data. "Mandated public reporting of progress on safety standards might yield more complete information than voluntary public reporting," the authors wrote. However, the authors caution that there is no clear evidence for supporting one reporting scheme over another, and that many factors influence public reporting of quality data.
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