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Chat about hospital quality with Terry Rusconi, senior director for operational improvement at the University of Kansas Hospital

July 3, 2007

This chat has already taken place. Read the transcript below.

Terry Rusconi, senior director for operational improvement at the University of Kansas Hospital, will take questions about hospital quality.

Moderator:

Hi I'm Christine Metz and today I am here with Terry Rusconi, senior director of operational improvement at the University of Kansas hospital. He is here today to chat about hospital quality. Thanks for chatting with us today Terry.

Terry Rusconi:

Happy to be here.

Moderator:

To get started, we have a great question from yme.

yme:

How can a consumer make sense of the all of the lists and report cards about hospitals that are out there?

Terry Rusconi:

There are a variety of ways. The best way is to ask a trusted healthcare professional such as your family physician. Or, you can ask the hospital itself how to make sense of all of the variety of data that is out there. You might also ask the hospital how many of this particular diagnosis or procedure do you treat each year. Some additional questions might be: where does the data come from, how current is it and is it adjusted for the complexity of the patients you care for. Unfortunately, right now, it is such a confusing maze of data that it is up to the consumer to find the data that best meets their needs. Your hospital and family physician should be more than willing to help.

thinkks:

I've seen KU Hospital claim it is a national leader in quality, yet these CMS stats don't support that. What is the basis for your claim?

Terry Rusconi:

There are a number of foundations for this claim. We belong to the largest group of teaching hospitals in the country, University HealthSystem Consortium. Last year, KU Hospital ranked 11 out of all UHC hospitals in quality and safety. For the most current year, our mortality rate places us in the top 25 percent of all UHC hospitals. We have also been recognized for our stroke care by the American Heart Association/American Stroke Association, rank among the best hospitals in the country for the time it takes to get from the emergency room door to actual intervention for heart attack patients, are a nationally accredited Level 1 Trauma Center through the American College of Surgeons and just became the first hospital in Kansas to receive Magnet Accreditation (recognizing overall nursing care and quality) through the American Nurses Credentialing Center. We've also received an exceptional performer award through the American Cancer Society. These are just a number of indicators that allow us to claim we are a national leader in quality. Also, as our quality programs continue to focus on patient outcomes and the use of evidence-based medicine, we expect to receive additional recognition in the years to come.

Moderator:

You answer brings up an interesting point. What set of data should patients look at when they start to compare hospitals? As your answer demonstrated - there are many different organizations and groups that look at this information and publish it.

Terry Rusconi:

I think the first thing is how current the data is. Many of the "for profit" sites or those that advertise heavily are using the Medicare cost report that is over two years old. This data is both out of date and only reflects one component of that hospital's patient population. I think the best places to look based on the fact they are consistent across all hospitals and are based on the most current data are the CMS Hospital Compare website and the Focus on Hospitals website. These two websites detail how fully the hospital applies evidence-based medicine for certain diagnoses/procedures. The Joint Commission website will also detail these same quality measures, the hospital mortality rate for heart attack and the accreditation status of the hospital. Beginning in early 2008, the CMS website will also provide some comparisons on patient satisfaction for hospitals.

Moderator:

First, we have time for more questions, so if you have any get them.
Now I have a question. In the past few years there has been a bigger push for more data on the quality that patients receive at hospitals and what they will have to pay. From your experience, has it benefited the consumer? Do patients use it? And what other impacts has this new information had on the health care industry. And, what difference has it made at your hospital?

Terry Rusconi:

Let me answer the last question first. I think the publicly reported data has truly helped healthcare get better. Prior to the posting of that data, it was not easy for hospitals to get comparative data that allowed them to see how good they were. The sharing of this data, especially since it is based on evidence, provided hospitals with the visibility to areas for improvement. We have taken the data to heart and worked to improve the systems that ensure this evidence-based care is provided to every patient. Sometimes, this was just making sure that our documentation detailed the care we provided. Other times, we "hard wired" certain initiatives into our workflows to ensure they took place. Just this activity alone has benefited the consumer. As for whether patients are really using this information, it's hard to tell. The difficulty of trying to pull all of this information together and to be sure that the data being used is timely and accurate makes it a real challenge for most folks. We do find a large number of patients, however, who do a great deal of research on the internet on their particular condition and come prepared to discuss options with their physician. This is always welcome in the healthcare process and makes the patient a partner in their care.

coach08:

Does the KU hospital have a reputable labor & delivery department?

Terry Rusconi:

Yes we do. As a teaching institution, we are often the place that other hospitals and physicians refer their highest-risk patients. I can tell you that our physicians and clinical staff are well trained in the latest evidence-based medicine, generate exceptional outcomes and receive very high marks for patient satisfaction. We are in the process of implementing a new piece of equipment that will allow care providers to simulate the amount of pressure they are placing on the baby as it is delivered. This is one of the highest risk components of a delivery and staff will be able to practice their technique in a safe environment that provides immediate feedback. We will be the first in the nation to have this equipment.

Moderator:

Well, those are all the questions we have. Terry thanks so much for taking the time to chat with us and talk about the information that is out there on hospital quality.

Terry Rusconi:

Thank you Christine. It's been fun talking about the great things that we are doing at KU Hospital and hopefully helping consumers make the best decision about their care.

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