Get­ting Rank­ings Right

In this in­ter­view, Ekta Pun­wani of IBM Wat­son Health dis­cusses the im­por­tance of award pro­grams in driv­ing per­for­mance at U.S. hospi­tals and ex­plains how hospi­tal rank­ings have evolved with in­dus­try changes.

Modern Healthcare - - The Week Ahead - By Adam Ruben­fire, Mod­ern Health­care Cus­tom Me­dia


Ms. Pun­wani is a trusted ad­vi­sor to client ex­ec­u­tives on per­for­mance im­prove­ment op­por­tu­ni­ties and strate­gies based on the 100 Top Pro­gram stud­ies. She pro­vides lead­er­ship, di­rec­tion, and guid­ance to health­care or­ga­ni­za­tions to drive best prac­tice im­ple­men­ta­tion.

There are a va­ri­ety of pro­grams that rank hospi­tals based on a wide va­ri­ety of met­rics. Why is it im­por­tant to use pub­licly avail­able data?

EP: There’s so much data col­lected in health­care from a wide va­ri­ety of sources. Pub­lic data is a par­tic­u­larly re­li­able source be­cause the data is de­rived from stan­dard op­er­a­tional def­i­ni­tions that the in­dus­try has agreed upon. We can all agree that the data is ac­cu­rate and valid. Medi­care is one of the big­gest sources of data and it’s been widely used so I view it as re­li­able — as a former hospi­tal qual­ity leader,

I know there are checks and bal­ances at Medi­care to en­sure in­for­ma­tion is mea­sured on com­mon ground.

How do rank­ings and award pro­grams en­cour­age hospi­tals to im­prove qual­ity of care?

EP: We’re all com­pet­i­tive. When you see some­one in your area is do­ing bet­ter than you, the ques­tion im­me­di­ately be­comes, “What are they do­ing that’s dif­fer­ent?” Rank­ings and award pro­grams ac­ti­vate the com­pet­i­tive na­ture of lead­ers and can spark con­ver­sa­tions about best prac­tices. It makes a lead­er­ship team think, “What can we do to im­prove our­selves?” When I was a hospi­tal ex­ec­u­tive, we used to take data from pro­grams like 100 Top Hospi­tals and in­te­grate it into our op­er­a­tional plan. You must be a top per­former if you want to thrive in a com­pet­i­tive mar­ket.

Why is it im­por­tant for or­ga­ni­za­tions to be trans­par­ent about their rank­ing method­ol­ogy?

EP: It is crit­i­cal for these or­ga­ni­za­tions to be trans­par­ent. If the pur­pose of an awards pro­gram is to change the health­care in­dus­try and to in­spire lead­er­ship to make that change, they need to know what levers to pull to ac­com­plish that. Pro­vid­ing trans­parency in method­ol­ogy helps lead­ers fig­ure out how they should start craft­ing a per­for­mance im­prove­ment pro­gram and where they need to be mea­sur­ing per­for­mance. When ex­ec­u­tives un­der­stand the method­ol­ogy be­hind how award-win­ning hospi­tals are ranked, they can take that in­for­ma­tion back to their or­ga­ni­za­tion to pin­point ex­actly where they need to im­prove to reach the same sta­tus.

How do you see hospi­tal rank­ings evolv­ing? More specif­i­cally, how has the 100 Top Hospi­tals pro­gram evolved?

EP: Pro­grams are evolv­ing by ac­knowl­edg­ing that health sys­tems are pro­vid­ing much more than just in­pa­tient care. As the in­dus­try has evolved, providers are not only de­liv­er­ing care in more phys­i­cal lo­ca­tions, but they’re also pro­vid­ing more telemedicine and home health vis­its. Whether a visit is vir­tual or in-per­son, health sys­tems are tasked with pro­vid­ing high-qual­ity, re­li­able care at all touch­points. Or­ga­ni­za­tions that mea­sure per­for­mance need to start think­ing about mea­sures that more ac­cu­rately de­pict our in­dus­try and the emerg­ing ways in which we serve pa­tients. Rank­ings should not only judge whether a hospi­tal is per­form­ing well, but also whether that per­for­mance is be­ing sus­tained through­out an or­ga­ni­za­tion. The met­rics of the 100 Top Hospi­tals pro­gram have his­tor­i­cally fo­cused on the in­pa­tient side, so we’re con­tin­u­ing to im­prove our study by ex­plor­ing other met­rics that will en­sure the study stays rel­e­vant.

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