Quality & Patient Safety

Overview

Hospital Quality Institute (HQI)

The Hospital Quality Institute (HQI) directs the statewide strategy and vision for patient safety and quality improvement activities for CHA, Hospital Council, HASC and HASD&IC.  The organization builds reliable and sustainable measures to gauge California’s performance and identifies opportunities for focus and innovation.

HQI oversees and coordinates Patient Safety First as well as the California Hospital Engagement Network (CalHEN), California Hospital Patient Safety Organization (CHPSO), and the Hospital Quality Committee.

For more information, please visit the HQI website.

CHA News Article

CDC Reports Nationwide Reduction in HAI
Highlights need for continued improvement

The Centers for Disease Control and Prevention (CDC) announced that progress has been made in the effort to eliminate infections that commonly threaten hospital patients.

CHA News Article

Bonnie Zell, MD, MPH, Joins HQI

Dr. Bonnie Zell joined the Hospital Quality Institute (HQI) this month as executive director of clinical improvement, as Michele Davenport Lambert completes her contract as director of the California Hospital Engagement Network (CalHEN) at the end of the year.

“We are very excited to have Dr. Zell join the team. She is exceptionally qualified and will contribute greatly to our statewide improvements,” said Julie Morath, CEO of HQI. “The ability to attract a candidate of Dr. Zell’s caliber speaks to the exciting work being accomplished in California.”

CHA News Article

HQI Looks to a Third Year of Funding for CalHEN in 2014

The Hospital Quality Institute (HQI) has announced it expects approval for an additional year of funding for the California Hospital Engagement Network (CalHEN) for 2014. Established through the Centers for Medicare & Medicaid Services as part of the Partnership for Patients national initiative, CalHEN now includes 169 participating hospitals.

“The original two-year funding period is finishing strong, with impressive results that speak to the commitment and resolve of participating hospital leaders and teams to reduce harm to patients and reduce readmissions,” said HQI CEO Julie Morath. “It is because of those results that we will be awarded the third year. This is an exciting opportunity to build infrastructure for those hospitals that need greater support, and organize for sustained results and further improvement.”

Overview

California Hospital Patient Safety Organization
Trusted leadership in patient safety

One of the first and largest PSOs in the nation, the California Hospital Patient Safety Organization (CHPSO) is a trusted leader in the analysis, dissemination and archiving of patient safety information. CHPSO offers unmatched access to the emerging best practices of hundreds of hospitals.

Complimentary membership is available to California Hospital Association and regional hospital association members.

CHA News Article

CHPSO Announces Partnership With Colorado Hospital Association

The California Hospital Patient Safety Organization (CHPSO) has announced that the Colorado Hospital Association will now partner with CHPSO to offer patient safety organization (PSO) services to hospitals and health systems in Colorado.

CHA News Article

CMS Finalizes PSO Reporting Requirements

Yesterday, the Centers for Medicare & Medicaid Services (CMS) issued the attached final rule implementing a number of provisions of the Affordable Care Act (ACA), including the provision that hospitals must satisfy certain patient safety and quality improvement requirements to contract with a qualified health plan (QHP) through Covered California, the state’s health insurance exchange.

The ACA required QHPs to contract with hospitals that have more than 50 beds only if they meet certain patient safety standards, including the use of a patient safety evaluation system (PSES) and a comprehensive hospital discharge program. However, the final rule adopts the CMS proposal to phase in these changes over time. In phase one, CMS adopted its proposal to allow a QHP to contract with hospitals that have more than 50 beds only if they are either Medicare-certified (having a Medicare CCN) or are Medicaid-only and have been issued a Medicaid-only CMS certification number, even if they don’t use a PSES or meet other ACA patient safety standards. Phase one would begin Jan. 1, 2015, and last two years or until CMS issues further regulation. CMS discusses in the final rule its response to input received through comments on next steps in phase two of implementation.

CHA News Article

New Guides Address Safety Assurance Factors for EHR Resilience
Each includes assessment checklist for multidisiplinary team

The newly published Safety Assurance Factors for EHR Resilience (SAFER) Guides are self-assessment booklets designed to help health care organizations optimize the safety and safe use of electronic health records (EHRs). Published by the Office of the National Coordinator for Health Information Technology, each guide begins with a checklist that can be used by a multidisciplinary team for assessing their organization’s level of implementation of each recommended practice. The California Hospital Patient Safety Organization (CHPSO) was among six quality oversight and patient safety organizations to review guidelines and dissemination plans, along with the ECRI Institute, Institute for Safe Medical Practices, The Joint Commission, National Patient Safety Foundation and Pascal Metrics. As part of the roll out, CHPSO plans to ensure that hospitals can share locally developed practices, as there is no set of standard “safest” practices yet identified. Hospitals that have questions about the guides may contact CHPSO.

Additional information and copies of the guides are available on the CHPSO website at www.chpso.org/post/safer-guides-safety-assurance-factors-ehr-resilience.

CHA News Article

CHA and CHPSO Comment on PSO Reporting Requirements Under the ACA

CHA and the California Hospital Patient Safety Organization (CHPSO) have sent a joint comment letter to the Centers for Medicare & Medicaid Services (CMS) regarding a proposed rule that would require certain patient safety and quality improvement activities in order to contract with a qualified health plan (QHP) through the new health insurance exchanges. In the letter, CHA and CHPSO generally agree with CMS’s proposal for implementing the requirements through a delayed two-phased approach. CHA/CHPSO support CMS’s understanding that additional time is needed for hospitals to implement robust patient safety evaluation systems. However, CHA/CHPSO disagree with the assertion that there is a lack of capacity for all hospitals subject to the provision to contract with a PSO at this time. The comment letter points out that CHPSO, in particular, and nationwide PSOs, in general, currently offer adequate capacity to meet the mandate.

CHA News Article

CHPSO Participates in International Standardization of New Connectors

The California Hospital Patient Safety Organization (CHPSO) is taking part in an international effort to create standards for replacing Luer connectors for enteral and neuraxial uses with new connectors to prevent accidental, and sometimes fatal, misconnections with intravenous lines. Meeting California’s Jan. 1, 2016, deadline for implementation of new connectors will be difficult for manufacturers, and CHPSO is working with the FDA, manufacturers and clinicians in other countries to help accelerate standards development and device manufacture in order to meet the deadline.

Overview

Infection Prevention

Health care-associated infections (HAIs) constitute a risk to patients and health care facilities. Estimates indicate that 240,000 patients admitted to California hospitals annually develop HAIs, contributing to the suffering associated with illness and increasing costs to the health care system by approximately $3.1 billion. Literature suggests that a significant proportion of HAIs can be eliminated with intensive surveillance and prevention programs. CHA supports decreasing the number of HAIs through a deliberate and systematic approach that addresses infection-control program infrastructure and oversight. CHA also supports the public reporting of meaningful, scientifically valid information related to HAIs. The most prevalent HAIs (approximately 80 percent) are urinary tract infections, surgical-site infections, ventilator-associated pneumonia and central-line blood stream infections.

The HAI Advisory Committee - created by SB 739 (Chapter 526, Statutes of 2006) — recommends methods for preventing and reporting HAIs to the California Department of Public Health.

CHA News Article

CDC Reports Nationwide Reduction in HAI
Highlights need for continued improvement

The Centers for Disease Control and Prevention (CDC) announced that progress has been made in the effort to eliminate infections that commonly threaten hospital patients.

Overview

Pay for Quality Reporting/Performance

Pay for performance is an emerging movement — in which providers are rewarded for the quality of their health care services — among health plans and insurers (the Centers for Medicare & Medicaid Services and others). Some programs are initially providing financial incentives to participate in quality reporting. However, the overall movement focuses on financially rewarding high quality patient care or financially penalizing poor quality of care. The CHA Board has adopted a partial payment or non-payment policy related to billing for preventable adverse events that are under the control of the hospital. 

CHA News Article

MAP’s Pre-Rulemaking Report Available for Comment
Comments are due Jan. 27

The Measure Application Partnership (MAP) has released its draft pre-rulemaking recommendations on performance measures under consideration for federal quality reporting and payment programs. MAP reviewed 234 measures submitted by the U.S. Department of Health and Human Services (HHS) for 20 federal programs that reimburse providers, including clinicians, hospitals and post-acute care facilities. The attached draft report includes tables that summarize MAP’s recommendations for each federal program. CHA participated in the MAP process and will prepare formal written comments reflecting member discussions held in December and submit the comments by Jan. 27. The comment period is open to the public, but comments can only be submitted by registered users of the National Quality Forum’s (NQF) website. As required by the Affordable Care Act, MAP must release its final report to HHS by Feb. 1.

CHA News Article

CMS Estimates 0.8 Percent Payment Increase in 2014 for Hospital-Based ESRD PPS

Hospital-based dialysis facilities paid under the end-stage renal disease (ESRD) prospective payment system (PPS) will see an estimated 0.8 percent increase in payments for calendar year (CY) 2014 compared to CY 2013, according to a final rule issued by the Centers for Medicare & Medicaid Services (CMS). CMS estimates that independent ESRD facilities will see no increase in payments in CY 2014 as compared to CY 2013. The update reflects the effect of a 3.2 percent ESRD bundled market basket update; the Affordable Care Act-required productivity adjustment of 0.4 percent; the American Taxpayer Relief Act (ATRA)-required drug utilization adjustment of negative 3.3 percent; a 0.4 percent overall estimated increase in outlier payment from the updates to the fixed-dollar loss threshold and Medicare Allowable Payment amounts; and a 0.2 percent overall estimated increase in payments from the change in the blend of payments.

CHA News Article

IRF, LTCH Quality Program Recordings Available

Recordings of recent conference calls held by the Centers for Medicare & Medicaid Services on the quality reporting programs for inpatient rehabilitation facilities (IRFs) and long-term-care hospitals (LTCHs) will be available July 30 through Aug. 1. Facilities may access the calls by dialing (855) 859-2056, and using conference IDs 13189170 for IRFs and 13198135 for LTCHs. As mandated by the Affordable Care Act, IRF and LTCH quality reporting programs will begin Oct. 1. 

Overview

Public Reporting of Quality Data

CHA supports a single, meaningful reporting system of quality data that allows transparency and enhances accuracy. Consumer groups, health plans and payers continue to push for more public disclosure of hospital quality. CHA remains supportive of transparency if the measures are scientifically based, valid and accurate.

Recording

CDPH’s Website on HAI Reporting Webinar CD
Improved website, fresh data on HAI, validation process update

Webinar Recorded Live October 9, 2012

In mid-August, CDPH released their most recent data on HAI reporting through an improved website. This website presents the material in a more user-friendly format and groups the reporting hospitals into like categories for a more balanced analysis and comparison. Learn about changes to the website, recent release and analysis of HAI data, and what it says about the performance of California hospitals to date.

Commands