Quality check on quality reporting

How do we know if today’s quality measures are accurate? That is the question that Peter Pronovost, MD, director of the Johns Hopkins Medicine Armstrong Institute for Patient Safety and Quality, discussed in a recent opinion piece published in The Journal of the American Medical Association. Pronovost concludes that we don’t know, since there aren’t any standards for determining the accuracy and timeliness of quality data. If you aren’t sure about the data, then there’s no way of telling if you have a truthful representation of quality, he wrote.

“What is striking is that there has been an increase in the number of measures that are publicly reported and [in] the amount of money at risk for performance on those, but no standards on how accurate or inaccurate a measure needs to be before you are paid,” Pronovost told HealthLeaders Media.

He pointed to the use of readmission rates as a quality measure, even though not all readmission cases are preventable. The end result of this is a measure that is both imprecise and encourages hospitals to do crazy things to avoid financial penalties, said Pronovost. Meanwhile, only one out of the six most common causes of patient safety problems, hospital-acquired infections, has a nationally validated approach for measuring quality.

 “CMS should task an agency with defining standards of what makes good measures and setting accuracy requirements before implementing measures in pay-for-performance and public reporting,” he wrote in the opinion piece. “Such an agency would serve a similar role for healthcare as the Federal Accounting Standards Advisory Board does for financial reporting. Under this system, professionals set accounting standards, performance is audited and transparently reported, and journalists report on validated measures, working from a common source of standards.”

Pronovost followed up by suggesting that the National Quality Forum is the natural agency to play such a role in healthcare, though he said another agency or organization could also fill the void.

CMS recently had to delay its newly proposed five-star hospital rating system until July due to public outcry. Many argued that the five-star system was too simplified to be an accurate portrayal of quality.

Read the full article on quality reporting standards at HealthLeaders Media.