title: How well can we identify the high-performing hospital?
abstract: Sharing lessons from high-performing hospitals facilitates quality improvement. High-performing hospitals have usually been identified using a small number of performance measures. The objective was to analyze how well 1,006 hospitals performed across a broader range of measures. Five measures were developed from publicly available data: adherence to processes of care, 30-day readmission rates, in-hospital mortality, efficiency, and patient satisfaction. For a subset of hospitals, the authors included two survey-based assessments of patient care quality, one by chief quality officers and one by frontline clinicians. In general, there was little correlation among the publicly available measures (r ≤ .10), though there was notable correlation between objective measures and survey-based measures (r = .23). Hospitals that performed well on a composite measure calculated from the publicly available measures were often not in the top quintile on most individual measures. This highlights the challenge in identifying high-performing hospitals to learn organizational-level best practices.
authors.affiliation: VA Boston Healthcare System, Boston, MA, USA, Boston University, Boston, MA, USA. mshwartz@bu.edu
authors.forename: Michael
authors.initials: M
authors.lastname: Shwartz
authors.forename: Alan B
authors.initials: AB
authors.lastname: Cohen
authors.forename: Joseph D
authors.initials: JD
authors.lastname: Restuccia
authors.forename: Z Justin
authors.initials: ZJ
authors.lastname: Ren
authors.forename: Alan
authors.initials: A
authors.lastname: Labonte
authors.forename: Carol
authors.initials: C
authors.lastname: Theokary
authors.forename: Raymond
authors.initials: R
authors.lastname: Kang
authors.forename: Jedediah
authors.initials: J
authors.lastname: Horwitt
mesh_terms: D006761:Hospitals / Q000592:standards*; D006801:Humans; D015233:Models, Statistical; D005791:Patient Care / Q000592:standards*; D017060:Patient Satisfaction; D011785:Quality Assurance, Health Care / Q000379:methods* / Q000592:standards; D058996:Quality Improvement; D014481:United States