State Releases 2009 Hospital Performance Report
The state Department of Health and Senior Services released the 2009 Hospital Performance Report on Oct. 14. For the first time, the report describes individual hospital performance on 12 nationally recognized patient safety measures. In addition, the sixth annual report provides a 2008 update on how well hospitals performed on quality-of-care measures for treatment of heart attack, heart failure, pneumonia and patients undergoing surgery. Download a copy of the 2009 report.
“New Jersey is a national leader in promoting healthcare quality and transparency by giving consumers the facts they need,” Gov. Jon S. Corzine said. “This landmark report will contribute to safer health care for everyone in our state.”
“The ultimate goal is to eliminate medical errors,” DHHS Commissioner Heather Howard said. “By publicly reporting hospital’s scores, we encourage all hospitals to improve care. Over the last six hospital performance reports, quality of care has improved dramatically in the areas we report on. This year, New Jersey met or exceeded national averages in 24 of 25 measures of quality care.”
Earlier this year, Corzine signed legislation requiring hospitals to publicly report medical errors using specific “Patient Safety Indicators” developed by the federal Agency for Healthcare Research and Quality. The law required patient safety updates in each year’s Hospital Performance Report.
According to the patient safety section of the performance report, hospitals reported 9,381 adverse events for 2007. Using hospital discharge records, the report gives the number of adverse events for each Patient Safety Indicator, as well as both New Jersey and national average rates for that indicator. The report notes when a hospital’s score is statistically significantly better or worse than the statewide rate.
Results vary widely among hospitals and even among the patient safety indicators for each hospital. Statewide, New Jersey performed better than, or as well as, the nation in 10 of 12 patient safety measures, using the most recent available national data (2004).
Among the most rare events statewide are those considered “never events” by the federal Centers for Medicare and Medicaid Services. There was one major reaction to a blood transfusion (for a rate of zero events per 1,000 discharges) and 63 instances of a foreign object accidentally left in a patient during a surgical or other procedure (for a rate of 0.1 events per 1,000 patients having that procedure).
Potentially preventable trauma cases were less rare, according to the report. These include maternal injuries during a vaginal birth requiring the use of forceps or other instrument assistance (907 cases or 173.6 per 1,000 instrument-assisted vaginal deliveries). New Jersey’s rate for this indicator was better than the U.S. rate.
In the quality-of-care section of the Hospital Performance Report, hospitals are scored on 25 measures of quality health care. The measures represent nationally recognized best care practices – such as giving aspirin to a heart attack patient upon arrival, or giving heart failure patients written care instructions upon discharge – that give patients the best chance for full recovery.
Hospitals continued to improve in 2008. Statewide, hospitals exceeded national averages on 15 measures of quality care, tied the nation on nine, and fell below on one. Many New Jersey scores were at or close to 100 percent. The difference between high- and low-performing hospitals in the state continues to decrease, which means better care for all patients.
This year, two new measures were added to the report -- controlled blood sugar for heart surgery patients and safe hair removal for those undergoing surgery. High blood pressure after surgery increases infection risk. Using a razor to remove hair from the surgical area before surgery also increases infection risk, and clippers and hair removal cream are safer.
New Jersey has undertaken several major initiatives over the years to improve patient safety and health care quality.
Governor Corzine signed legislation in 2007 that required hospitals to report to DHSS cases of patients developing infections related to their health care. Hospitals began reporting in January 2009, and that data will be included in next year’s performance report.
In addition, under the state’s Patient Safety Reporting Initiative, hospitals and licensed surgery centers are required to engage in a confidential process of review and analysis under State supervision for every “never event” that takes place. This mandatory root cause analysis leads to system changes to prevent the problem from recurring. In the past, the Department has also worked with the industry on programs to reduce patient falls and to improve congestive heart failure treatment.
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