HOW TO CHOOSE MORE RELIABLE ORTHOPEDIC CARE
Choosing one healthcare provider over another may get you a very different result. That’s why it’s important to ask for reliability data for your specific surgery or treatment so that you can make an informed decision.
At HSS, improving the outcomes we achieve for patients is one of our most important goals. While some very good measures of hospital safety and efficiency can be found at the CMS Care Compare website, they do not cover all procedures or all the outcomes that are important to patients. That means it can be difficult for patients contemplating a
1. SUCCESS RATE
“Success rate” refers to the
percentage of patients reporting improvement in their condition after
having a procedure. HSS is one of the only hospitals in the country to collect success rate information as a standard of care. Because not all
hospitals track such information, it can be difficult to compare success rates between hospitals.
How We Measure
At HSS, we measure success rates according to how much better
patients report feeling one year after treatment. HSS patients complete Patient-Reported Outcome Measures (PROMs)
at every visit so our clinicians can develop a patient-centered care plan based on their quality of life, general health, ability to complete various activities, and
level of fatigue and/or pain – and so clinicians can determine if therapies are working. We also
measure whether patients perceive an improvement one year after any
procedure. Although all patients are asked about improvement, for the purposes of public reporting we
draw a random sample of patients to complete PROMs by email,
phone or mail. This randomized selection ensures that we quantify our success rates with as little bias
as possible.
2. PATIENT EXPERIENCE
“Patient experience” data focuses on key aspects of care that
patients themselves say are important to them and for which
patients are the best and/or only source of information. Patient experience data looks at how
patients experienced critical aspects of healthcare, including communication with their doctors,
understanding their medication instructions, and the coordination of their healthcare needs. It does not
include things like amenities.
How We Measure
All U.S. hospitals measure patient experience using a national survey called the Hospital Consumer Assessment of Healthcare
Providers and Systems (HCAHPS). This data is reported to the Centers
for Medicare & Medicaid Services (CMS), a branch of the U.S.
Department of Health and Human Services, and is available on the
CMS Care Compare website (www.medicare.gov/care-compare).
Of the 10 important data points that
are collected through the HCAHPS survey, HSS focuses on the metric that tracks patients’ willingness to
recommend the hospital to others. “Likelihood to recommend” is used to create a “net promoter score,” a metric that is broadly recognized across industries as the best way to measure customer experience.
3. COMPLICATIONS
“Complications” shows how often patients experience a medical problem after their procedure. It is one of several important data
points that measure patient safety.
How We Measure
CMS collects safety data from all U.S. hospitals. CMS complications
data measures how often patients with Original Medicare experienced serious medical problems during a
hospital stay or after having certain inpatient surgical procedures. It also factors in the mortality rate of
patients who have been admitted to the hospital with certain conditions. This is the only publicly available source of patient safety data except
hospitals’ independent reports.
For hip and knee replacements,
HSS uses a CMS measure that tracks the percentage of hip and knee replacement patients who have a complication up to 90 days after their initial surgery. Procedure-specific data is not certain procedure to compare hospitals, since the measures that matter to them for that procedure may not be readily available.
So with the aim of creating a better system of measurement to quantify hospital quality, HSS sought input from patients, families and caregivers to hear what mattered most to them. The Five Factors of Reliability, which build on the CMS Care Compare measures, are based in part on that feedback as well as our own research into what matters most, with the goal of helping patients make better-informed decisions about their hospital needs.
available for other HSS procedures. So for such procedures, HSS uses
a metric, available on the CMS Care Compare website, called the Patient Safety Indicators 90 (PSI-90), which tracks a hospital’s overall
ratio of serious complications.
4. AVOIDABLE HOSPITAL VISITS
Like “complications,” this is another
data set that measures patient safety. It shows whether a hospital
is doing what’s needed to reduce the risk of harmful events such as
healthcare-associated infections and other serious problems that
require rehospitalization. Avoidable return hospital visits
are sometimes referred to as “hospital readmissions.”
How We Measure
CMS collects data from all
U.S. hospitals on how often a patient with Original Medicare is rehospitalized for an avoidable reason within 30 days of being discharged from the hospital.
For hip and knee replacements, CMS tracks the percentage of patients who have an unplanned readmission up to 30 days after their initial hip or knee replacement surgery. Procedure-specific data is not available for other HSS
procedures, so for such procedures, HSS uses a metric available on the CMS Care Compare website that tracks a hospital’s overall rate of
unplanned readmissions 30 days after a patient’s initial surgery.
As with the “complications” measure, other than the CMS data, there is no source of safety data for U.S. hospitals except hospitals’ independent reports.
5. PROCEDURE VOLUME
This data shows how many
procedures a hospital performs in a given period of time.
How We Measure
HSS uses different measures for tracking our volume for
specific procedures:
Regional Data Source: The New York State Department of Health (NYSDOH) publishes data annually about certain common procedures and conditions that New York hospitals treat, along with the number of patients discharged. This data covers all patients, regardless of the type of insurance they have.
National Data Source: The NYSDOH does not report hospital volume data for rarer procedures such as hip and knee revisions. For these procedures, HSS uses the most recently available data from CMS.
Internal Data Source: Procedures that do not require an overnight stay (e.g., hip and knee arthroscopy) are not captured by the NYSDOH, and many times such data is not available from CMS either. In the absence of a publicly available source to provide comparisons with other centers, HSS shares its own
internally reported volume data.
The Hospital Reliability Scorecard
is a free tool to help anyone having surgery, no matter where they seek care.
Download and personalize your Hospital Reliability Scorecard at HSS.edu/Scorecard