Report: Hospitals improve care for heart attack, surgery and more

Accredited hospitals in the U.S. are providing higher quality evidence-based care for heart attack, pneumonia, surgical care and children’s asthma care, according to Improving America’s Hospitals: The Joint Commission’s Report on Quality and Safety 2010. The report presents scientific evidence of improvement and how it relates to these common medical conditions and procedures.

This year’s report shows high rates of performance on these critical process measures, according to The Joint Commission, based in Oakbrook Terrace, Ill.

The report shows continual improvement over an eight-year period on accountability measures—quality measures that meet four criteria designed to identify measures that produce the greatest positive impact on patient outcomes. For example, the 2009 heart attack care result is 97.7 percent, up from 88.6 percent in 2002. A 97.7 percent score means that hospitals provided an evidence-based heart attack treatment such as aspirin at arrival and beta-blockers at discharge 977 times for every 1,000 opportunities to do so.

The data, drawn from more than 3,000 accredited hospitals, show:

• Hospitals made consistent progress in using evidence-based treatments. In 2002, hospitals achieved 81.8 percent composite performance on 957,000 opportunities to perform care processes related to accountability measures. In 2009, hospitals achieved 95.4 percent composite performance on 12.5 million opportunities – an improvement of 13.6 percentage points.
• Hospital performance on measures of quality relating to inpatient care for childhood asthma has increased dramatically in the two years since being introduced. The 2009 children’s asthma care result is 88.1 percent, up from 70.7 in 2007.
• The 2009 pneumonia care result is 92.9 percent, up more than 20 percent from 72.4 percent in 2002.
• The surgical care result improved to 95.8 percent in 2009 from 77.4 percent in 2004.

Although hospitals achieved 90 percent or better performance on most individual process of care measures, more improvement is needed, the report contended. For example, hospitals finished 2009 with relatively low performance on two measures introduced in 2005:

• Providing fibrinolytic therapy within 30 minutes of arrival to heart attack patients—only 55.2 percent of hospitals achieved 90 percent compliance or better.
• Providing antibiotics to ICU pneumonia patients within 24 hours of arrival—only 67.5 percent of hospitals achieved 90 percent compliance or better.

The fifth annual report, which focuses on accountability measures for the first time, is an effort to clearly demonstrate the impact that performance measures have on improving patient outcomes. Specific expectations for performance on accountability measures will be included in hospital accreditation standards by 2012, according to The Joint Commission.

Click here to access the report.