Methodology for Quality Metrics

The Agency for Healthcare Research and Quality (AHRQ) supports a framework put forth by the Institute of Medicine (IOM)4 that highlights six aims for the health care system: safe, effective, patient-centered, timely, efficient and equitable.  NH HealthCost has gathered quality information from the Center for Medicare and Medicaid that displays quality metrics in the available four areas:

Quality Metric Areas
Overview

NH HealthCost uses quality data from three secondary data sources: The Centers for Medicare & Medicaid Services, the National Healthcare Safety Network and the Joint Commission.

Better than Average, Near the Average, and Below the Average are used to indicate how a hospital performs in comparison to the state average. When a hospital performs within 5% of the state average, it is considered Near the Average. When a hospital performs greater than 5% in either direction of the state average, it is ranked Better than Average or Below the Average.

The Centers for Medicare & Medicaid Services

The Centers for Medicare & Medicaid Services (CMS) collects a variety of quality information through the Hospital Quality Initiative. This Initiative makes use of a variety of data sources to provide a more complete picture of hospital quality including inpatient and outpatient data, Medicare payment data, and consumer surveys. The intent is to help improve hospitals' quality of care by distributing objective, easy to understand data on hospital performance, and quality information from consumer perspectives.

On NH HealthCost, we report on CMS measures from the following categories and data sources:

Framework Domain Category Data Source Performance
Patient-Centered Care Patient Experience CMS HCAHPS The more stars, or higher the percentage, the better.
Timely Care Emergency Department CMS Hospital Inpatient and Hospital Outpatient Quality Reporting Program The lower the wait time, in minutes, or higher the percentage, the better.
Timely Care Heart Attacks CMS Hospital Inpatient and Hospital Outpatient Quality Reporting Program The higher the percentage, the better.
Effective Care Colonoscopy CMS Hospital Inpatient and Hospital Outpatient Quality Reporting Program The higher the percentage, the better.
Effective Care Low Back Pain CMS Outpatient Prospective Payment System, CMS Hospital Outpatient Quality Reporting Program The lower the percentage, the better.

Learn more about the methodology used by CMS.

The National Healthcare Safety Network

The National Healthcare Safety Network (NHSN) is a data tool operated by the Centers for Disease Control and Prevention (CDC) used to track Healthcare-Associated Infections (HAIs), including C.diff and MRSA, at over 17,000 medical facilities. It is used to measure progress with the goal of eliminating HAIs. Data are made available to medical facilities on the CDC website and to consumers on CMS's Hospital Compare website.

The HAI quality ratings use a Standardized Infection Ratio (SIR) which accounts for the differences between hospitals and patients. The lower the ratio, the better the facility is at preventing infections. The SIR can be interpreted as follows:

  • A ratio less than 1 - fewer infections than predicted.
  • A ratio equal to 1 - as many infections as predicted.
  • A ratio greater than 1 - more infections than predicted.
Framework Domain Category Data Source Performance
Safe Care Healthcare-Associated Infections NHSN The lower the ratio, the better.

Learn more about the methodology used by the NHSN.

The Joint Commission

The Joint Commission is an organization with a long-proven ability to identify, test, and specify standardized performance measures. The Joint Commission's National Quality Improvement Goals (NQIGs) data collection initiative obtains data on quality of care indicators in up to five treatment areas: Heart attack, heart failure, community acquired pneumonia, pregnancy and related conditions, and surgical infection prevention. These conditions are the most common reasons that patients go to the hospital and they affect hundreds of thousands of patients each year. Patients who are treated according to the guidelines stated in the NQIGs are more likely to improve or and have good outcomes of care.

On NH HealthCost, we report on one measure for pregnancy care from the Joint Commission.

Framework Domain Category Data Source Performance
Effective Care Pregnancy Care The Joint Commission The lower the percentage, the better.

Learn more about the methodology used by the Joint Commission

Updated 6/29/18