Quality can be measured in many different ways. While there is no universal agreement about which method should be used, the following are often cited as the best indicators to determine whether or not you receive quality care for your medical condition.
Consider these questions:
Is the hospital accredited by the Joint Commission?
The Joint Commission is an independent, nonprofit organization that evaluates and accredits nearly 18,000 healthcare organizations and programs in the United States. Joint Commission accreditation is recognized nationwide as a symbol of quality that reflects an organization’s commitment to meeting certain performance standards.
To earn and maintain accreditation, an organization must undergo an on-site survey by a Joint Commission survey team at least every three years.
Is the hospital rated highly by state or consumer groups?
One important way to learn about hospital quality is to look at hospital report cards developed by state and consumer groups. A recent study about such reports found that besides helping consumers make informed choices, they also encourage hospitals to improve their quality of care.
Does the hospital have experience and success with your condition?
Consumer groups publish guides to hospitals and other healthcare choices in various cities. You can call your state department of health, healthcare council, or hospital association to find more information. Also, you can ask your doctor what he or she thinks about the hospital.
In addition, the Centers for Medicare and Medicaid Services (CMS) and The Joint Commission require all hospitals to report their performance measures by submitting data on processes of care:
While performance measures are important, they only reflect certain process measures such as whether a patient received an aspirin when he or she reported to the emergency department with chest pain.
Patients and consumers are also encouraged to ask about clinical outcomes data such as survival statistics, infection rates and functional outcomes to get a broader picture of care:
A review of clinical and treatment outcomes data should also provide important information about experience and case complexity. In general, the more experience the better the outcome. And hospitals with high case complexity tend to care for patients with the most complex problems.
Is the hospital one where your doctor has privileges?
Is your physician permitted to admit patients? If not, you would need to be under the care of another physician.
Is the hospital covered by your health plan?
Check to make sure that your insurance will cover payment of services provided to you.
Does the hospital review and continuously improve its own quality of care?
Patient satisfaction often reflects the personal side of care, such as how willing doctors and nurses are to listen, answer questions and explain treatments; how much time the doctor spends with the patient; and how comfortable patients find the hospital in terms of cleanliness and the quality of food served. You can use patient satisfaction data to predict what your experience is likely to be.
Although it is impossible to eliminate all risks of death and complications, especially for seriously ill patients, risks can be reduced by choosing a hospital with a lower mortality rate and/or a higher long-term survival or success rate. Risks generally will be higher for patients over age 65 who have other medical conditions such as diabetes, who are having a repeat coronary procedure or who are undergoing multiple procedures such as bypass surgery with a valve repair.
Ask the doctor and the hospital for their mortality rates and try to compare rates for patients most like yourself. If a doctor or hospital is reluctant to give information, look at alternatives.