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States Move To More Transparency Regarding Medical Malpractice & Hospital Errors

Picture-1161When a family member is hurt, injured, or sick, you want to know that their hospital has a good reputation with few serious medical errors.

You expect doctors and nurses to treat your loved ones with the respect, care, and caution that is owed to them to ensure that they get better, not worse.

The frequency and prevalence of medical malpractice and medical errors, especially those medical errors leading to serious injury or even death, are significant factors when choosing a hospital. Illinois has made it easier for patients to know how frequently medical errors occur at hospitals with the Illinois Hospital Report Card and Consumer Guide to Health Care.

In 2009, Illinois launched the Illinois Hospital Report Card and Consumer Guide to Health Care website in an effort to increase transparency about the quality of health care provided in Illinois hospitals. This website, driven by the Hospital Report Card Act (Public Act 93-0563), which was passed in 2004, gives consumers the information necessary to make more informed healthcare choices. The website provides the following information:

  • Volume and cost of services in hospitals and ambulatory surgery treatment centers
  • Quality and safety data
  • Nurse staffing data
  • Patient satisfaction surveys
  • Summaries and links to Illinois laws that ensure consumer protection

Information Contained on Report Card

The Hospital Report Card Act requires that all Illinois hospitals compile, maintain, and report the following information to the Illinois Department of Public Health (IDPH):

  • Nurse staffing
  • Infection prevention measures
  • Hospital acquired infections
  • A typical Hospital Report Card includes the following information:

Overview

  • Name
  • License Number
  • Address
  • Phone Number
  • State Designations

Process of Care and Inpatient Quality

  • Process of Care (indicators are used to measure how often hospitals use recommended treatments known to get the best results for certain conditions)
    • Overall Heart Attack Care
    • Overall Heart Failure Care
    • Overall Pneumonia Care
    • Inpatient Mortality
      • Mortality Rate: Congestive heart failure
      • Mortality Rate: Stroke
      • Mortality Rate: Hip Fracture
      • Mortality Rate: Pneumonia
      • Mortality Rate: Inpatient Heart Attack Deaths
      • Mortality Rate: Hip Replacement
    • Inpatient Utilization (examines procedures whose use varies significantly across hospitals and for which questions have been raised about overuse, underuse, or misuse)
      • Incidental Appendectomy in the Elderly
      • Bi-Lateral Cardiac Catheterization
      • Cesarean Section Delivery
      • Laparoscopic Cholecystectomy (minimally invasive gallbladder removal)

Safety Measures

  • Surgical Care Improvement
  • Pre-Surgical Antibiotic Given at the Right Time – Overall Rate
  • Surgical Patients Given the Right Kind of Antibiotic – Overall Rate
  • Preventative Antibiotics Stopped at Right Time – Overall Rate
  • Pre-Surgical Antibiotic Given at the Right Time – Knee Arthroplasty
  • Surgical Patients Given the Right Kind of Antibiotic – Knee Arthroplasty
  • Preventative Antibiotics Stopped at Right Time – Other Cardiac Surgery
  • Health Care-Associated Infections
    • Central Line Associated Bloodstream Infections in Medical/Surgical ICU
    • Central Line Associated Blood Stream Infection Rate in the Surgical ICU
    • Central Line Associated Bloodstream Infections in Medical ICU
    • Central Line Associated Blood Stream (CLABSI) Infection Rates – Detailed Report
    • Patient Safety
    • Unexpected Deaths
    • Accidental Puncture and Laceration
      • Latrogenic Pneumothorax (health care-associated collapsed lung)
      • Foreign Body Left During Procedure
      • Postoperative Hip Fracture

Satisfaction Survey Responses

  • Percent of Patients Highly Satisfied
  • Doctors Always Communicated Well
  • Nurses Always Communicated Well
  • Patient Always Received Help As Soon As They Wanted
  • Staff Always Explained About Medicine
  • Pain Was Always Well Controlled
  • Patient’s Room Always Kept Quiet At Night
  • Patient’s Room and Bathroom Always Kept Clean
  • Patients Given Information About Recovery At Home
  • Patients Would Definitely Recommend This Hospital to Friends and Family

Services

  • Patients, Median Length of Stay, and Median Change
    • Appendectomy
    • Asthma
    • C-section
    • Chest Pain
    • Chronic Obstructive Pulmonary Disease
    • Diabetes
    • Gallbladder Removal
    • Heart Failure
    • Normal Newborn
    • Pneumonia
    • Vaginal Delivery

Beds – Nursing Staffing

  • Nurse Staffing
    • Hospital-Employed Nurses
    • Contract Staff Nurses
    • Percent RN Nursing Staff Hours
    • Percent LPN Nursing Staff Hours
    • Percent Nursing Assistant Staff Hours
  • Authorized Beds
    • Bed Type
      • Medical-Surgical Beds
      • Intensive Care Beds
      • Pediatric Beds
      • OB/Gynecology Beds
      • Long-Term Care Beds
      • Neonatal ICU Beds
      • Acute mental Illness Beds
      • Long-Term Care Acute Care Beds
      • Total Beds

The Consumer Guide to Health Care uses discharge data from hospitals and ambulatory surgical treatment centers to report “the conditions and procedures demonstrating the widest variation in changes and quality of care.” The website will also include “inpatient and outpatient data with current comparison information related to volume of cases, average charges, mortality rates, complications and hospital associated infections.”

The methodology used by IDPH to produce the Hospital Report Cards includes using the following data sources to create composite measures and rates to assess the main information set, including: quality, surgical care improvement, infection rates, patient safety, satisfaction, services, and staffing. The data sources for the Hospital Report Card are as follows:

Quality-Recommended Care (how well a hospital cares for patients with specific conditions) – data comes from the U.S. Department of Health and Human Services Centers for Medicare & Medicaid Services

Surgical Care Improvement Project – data comes from data submitted by Illinois hospitals to the Illinois Department of Public Health

Patient Satisfaction – data comes from the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys

Administrative Data (information on hospital stays) – data comes from the Illinois Department of Public Health’s Discharge Data Set

Volume (number of times a procedure was performed) – data comes from the Department of Public Health Hospital Discharge Data Set

Infection Data – data comes from the Centers for Disease Control and Prevention’s National Healthcare Safety Network (NHSN)

Facility Information – data comes from the Annual Hospital Profile and the Annual Ambulatory Surgical Treatment Center Profile

Nurse Staffing Data – data comes from hospital reports submitted to the Office of Policy, pursuant to the Illinois hospital Report Act

Revenue – data comes from the Illinois Department of Public Health

Methicillin-Resistant Staphylococcus aureaus (MRSA) Data – data comes from data submitted by hospitals to the Illinois Department of Health

Clostridium Difficile Data – data comes from data submitted by hospitals to the Illinois Department of Health

What does this mean for consumers?

The hope is that with better transparency into medical errors, hospitals will improve care, and these unfortunate situations where patients are actually injured by medical error can be avoided. The Hospital Report Cards provide one tool to ensure that you or your family member receives quality care in hospitals.

However, be aware that medical errors can still occur even at hospitals with good report cards. Also, the Illinois Department of Health (IDPH) posts a disclaimer noting that while IDPH attempts to make efforts to ensure that the website provides accurate and reliable information, it does not guarantee that the information on the site is complete, accurate, or up-to-date. Therefore, it is still important that you question the doctors and nurses who are treating your family member to ensure that they receive quality care. So, remember, the Hospital Report Cards are just one tool you can use to guarantee that hospitals are safe and effective.

I applaud this push towards transparency in the field of medicine.  For too long consumers have steering blindly when attempting to locate a hospital.  Hopefully, this tool will prove valuable not just in the selection process, but also in encouraging poorly performing facilities to improve care.

Thanks to Heather Keil, J.D. for her assistance with this Nursing Homes Abuse Blog Entry

Resources:

Illinois Department of Public Health: State Public Health Director Announces Launch of Hospital Report Card and Consumer Guide to Health Care Web Site

IDPH: Division of Patient Safety and Quality

ILGA: Hospital Report Card Act

Illinois Hospital Report Card

Illinois Hospital Report Card: Data Sources

Illinois Hospital Report Card: Disclaimer

The report card contains information on popular Chicagoland hospitals such as:

  • Adventist Hinsdale Hospital (Hinsdale Hospital)
  • Adventist La Grange Memorial Hospital (La Grange Memorial Hospital)
  • Advocate Christ Medical Center
  • Advocate Good Samaritan Hospital
  • Downers Grove
  • Advocate Illinois Masonic Medical Center
  • Advocate Lutheran General Hospital (Advocate Lutheran General Hospital)
  • Advocate Trinity Hospital
  • Alexian Brothers Medical Center
  • Children’s Memorial Hospital
  • Elmhurst Memorial Hospital
  • Gottlieb Memorial Hospital
  • Holy Cross Hospital
  • Jackson Park Hosp & Med Ctr. (Jackson Park Hospital)
  • John H. Stroger Jr. Hospital
  • La Rabida Children’s Hospital
  • Little Company Of Mary Hosp (Little Company Of Mary Hospital)
  • Loretto Hospital
  • Louis A Weiss Memorial Hospital
  • Loyola Univ Medical Center (Loyola University Medical Center)
  • MacNeal Hospital (Mac Neal Hospital)
  • Mercy Hospital And Med Center (Mercy Hospital And Medical Center)
  • Methodist Hospital Of Chicago
  • Metro South Medical Center
  • Mount Sinai Hospital (Mount Sinai Hospital Medical Center)
  • Neurologic And Orthopedic Institute of Chicago (Neurologic And Orthopedic Inst Of Chgo)
  • NorthShore University HealthSystem
  • Evanston NorthShore University HealthSystem Skokie Hospital
  • Northwest Community Hospital
  • Northwestern Memorial Hospital
  • Norwegian American Hospital (Norwegian-American Hospital)
  • Our Lady Of Resurrection Center (Our Lady Of The Resurrection Med Ctr)
  • Palos Community Hospital
  • Provident Hospital Of Cook County (Provident Hospital Of Chicago)
  • Resurrection Medical Center
  • Roseland Community Hospital
  • Rush Oak Park Hospital
  • Rush University Medical Center
  • Sacred Heart Hospital
  • Saint Anthony Hospital
  • Saint Francis Hospital (Rhc St Francis Hospital)
  • Saint Joseph Hospital
  • Shriners Hosps For Children
  • South Shore Hospital
  • St Bernard Hospital
  • St Mary and Elizabeth Med Center (St Mary and Elizabeth Med Ctr-Claremont Campus)
  • St Mary and Elizabeth Med Center (St Mary and Elizabeth Med Ctr-Division Campus)
  • Swedish Covenant Hospital
  • Thorek Memorial Hospital
  • University Of Chicago Medical Center (University Of Chicago Hospitals)
  • University Of Illinois Medical Center – Chicago (University Of Illinois Hospital)
  • West Suburban Medical Center
  • Westlake Hospital (Westlake Community Hospital)

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