Yesterday, HCFA and the MA Coalition for the Prevention of Medical Errors cosponsored an event focusing on the potential to use hospital mortality data in general – and the Hospital Standardized Mortality Ratio in particular – for internal hospital quality improvement and for public consumer information.
80+ people listened to presentations, including an HSMR overview from Sir Brian Jarman, developer of the measure which is used by the Institute for Healthcare Improvement (www.ihi.org) to help hospitals improve quality. See Sir Brian’s slides by clicking here. The UK – and soon Canada – publish hospital HSMRs.
Sir Brian was followed by four speakers (Paul Levy, Beth Israel Deaconess CEO, Dr. Gregg Meyer of MGH, HCFA’s John McDonough and Ken Sands of BIDMC). Beth Israel is the only MA hospital that publicly posts its HSMR (on Paul’s blog, among other places), a move that triggered a negative response from other hospital CEOs. He argues nonprofit hospitals, as tax-exempt institutions, have a moral obligation to be open and transparent. He suggests hospitals should publish their HSMRs through IHI’s website. He said: with IHI posting the info, and HCFA and BIDMC linking to the IHI webpage, “To quote Arlo Guthrie…We’ve got three of us. It’s a movement!”
Gregg Meyer (click here his slides) and Ken Sands (click here) said this measure can be useful for internal improvement, and should not be publicly available because of its complexity and because it is not useful for consumer decision-making. Ken said individual hospitals should disclose their own numbers if they wish.
John McDonough talked about seeing a scatter plot of HSMR numbers for all MA hospitals (without names) and noted that some hospitals had rates way above than the average. He said consumers should know about this and hospitals should know their own HSMRs (which many of them don’t) so they know if there is a problem that needs to be corrected. John also wondered, who’s paying attention to hospitals with mortality rates way above the state average?” He also noted, on average, Massachusetts hospitals perform worse than all US hospitals.
The event was cut short by a fire alarm. We look forward to continuing the conversation with interested parties, including the MA Coalition and IHI and all of those in attendance at today’s event.
The burning question is this: why should consumers not have access to numbers which tell us how how well or poorly a hospital does in keeping patients alive?