What is "quality" health care?
“Quality” health care has a wide variety of meanings. To some people, sitting in the waiting room a short time to see a doctor means “quality” health care. To others, being treated politely by the doctor's staff means “quality” health care. There are those who define “quality” health care by how much time the doctor devotes to examining you.
While these are important, "clinical" quality health care is even more important. For instance, if you take your car to a mechanic, the people in the auto shop can be friendly and listen to your complaints but the most important factor is whether or not they fix the problem with your car. Similarly, when you go to a hospital or provider, you want them to fix your problem and help make you better.
There are many ways to measure "clinical" quality health care. The New Jersey Department of Health (NJDOH) has assembled a range of ways to identify "clinical" quality health care in hospitals. These measures are based on national practices that measure the clinical performances of hospitals by examining data gathered from hospitals.
How do you know if a hospital is delivering "quality" health care?
By examining the number of times a hospital has provided care that has been scientifically proven to improve a medical condition and looking at the outcome after a patient has received the recommended care, you can get a picture of how well a hospital is providing quality of care. Using definitions of care that can be measured with numbers is one way to gauge the success or failure of a treatment.
What kind of quality information is on this web site?
The quality information presented on this web site uses clinical performance measures based on national standards that define “best practices” or “recommended care”. “Best practices” or “recommended care” can be a single activity or a set of processes that have been documented by research and experience to lead to the best outcomes. The measures used on this web site can be classified as either Recommended Care (also known as Process of Care Measures), Outcome of Care Measures, Patient Safety Indicators (PSIs), or Healthcare-Associated Infections (HAIs).
- Recommended Care (Process of Care) Measures refer to the actions taken to care for the patient. Using the correct process, such as diagnosing, treating, or educating patients, is likely to lead to better outcomes.
Examples of inpatient recommended care measures are “a heart patient receiving an aspirin within 24 hours before or after arrival at the hospital” and “a heart patient prescribed an aspirin at discharge from the hospital.”
- Outcome of Care Measures refer to the results of the specific treatment on a patient’s health. An example of an outcome of care measure is “mortality rate”, which measures the patient death rate of a particular health condition. Other NJ hospital reports on Outcomes of Care Measures include:
- Patient Safety Indicators (PSIs)
PSIs are a type of Outcome of Care measure, but since their purpose is for a very specific reason, we list them separately. PSIs were developed by the Agency for Healthcare Research and Quality (AHRQ) to screen for complications or medical errors that patients experience in hospitals but are potentially preventable. PSIs look at the number of occurrences of medical errors and examine those procedures or operations identified by AHRQ as vulnerable to medical errors. There is strong evidence that hospitals can reduce patient injuries by implementing certain actions to prevent the medical error from taking place.
- Healthcare-Associated Infections (HAIs)
Like PSIs, an HAI is a type of Outcome of Care measure. Because preventing HAIs is a top priority in the State and federal governments, we list them separately. HAIs are infections that patients get while staying in a hospital or other healthcare facility – infections that the patients did not have before being admitted. For this section of the web, we focus on hospital HAIs. These measures, which were developed by the Centers for Disease Control and Prevention (CDC) after years of research, show the number of HAI events that occurred in the Intensive Care Unit (ICU) and/or Critical Care Unit (CCU) of each NJ hospital.
Why do you have so many measures on the quality of hospitals?
To get the entire picture of quality care being delivered by a provider, it is important to know the results of both recommended care/process of care and outcome of care measures in addition to other information. Each measure is based on national standards developed by different federal agencies looking at different parts of quality. Data gathered from different sources show different aspects of care and treatment.
Can I use the information on this web site to draw conclusions about New Jersey hospitals?
This information is not intended to be used alone. The scores, rates, and ratios on this web site are intended to provide important information to help you make informed decisions. Use this information in conjunction with other information in making decisions about hospitals.
What should I do with the information I learn from these reports?
Use this information to ask your doctor questions. Be informed. Gather more information, and make informed decisions about which hospital is most appropriate for your health care needs.
Why should I care about quality?
Hospitals and doctors differ in how well they provide appropriate care to patients. The quality of the care provided by your doctor and hospital may influence your health.
If doctors make decisions on where a patient should get care, why should I look at hospital performance?
Many consumers want a doctor’s recommendation on hospitals. Frequently, people collect as much information as possible to make informed decisions. The information on this web site will provide some of that information.
Many people choose doctors according to their doctor’s hospital affiliation. A doctor must have privileges at a hospital to admit patients. Your doctor may admit patients to several hospitals.
If you decide that you would like to go to a hospital with which your doctor is not affiliated, you may want to ask your doctor for a referral or call the hospital of your choice and ask for a list of doctors.
If you are enrolled in a managed care plan, use the information on this website to help review your hospital network. Managed care insurers usually offer several choices of hospitals in an area.
Aren’t all doctors and hospitals the same?
No. Hospitals differ in their specialties and expertise. Some are better equipped than others to handle different conditions and levels of care. Not all hospitals have state approval to perform certain services. Hospitals employ doctors with different specialties, expertise and abilities. These differences will influence the quality of the care that you receive.