PHCQA provides data that emphasizes continuous evaluation and improvement of work processes by hospital teams, and empowers them to make decisions based on data. Doctors, nurses and hospital staff need to know how they are performing and where there is room for improvement. The PHCQA provides this high-level data, aggregated from different sources so that health care professionals can better benchmark themselves, and in turn, pass on that knowledge to their patients.
Measurement is key to helping hospitals identify opportunities for improvement, track the progress of their changes, and compare their performance against other hospitals to guide data-driven decision-making and action. Reporting allows for data transparency that is critical to hospitals for benchmarking, as well as to consumers for making informed decisions about their health care options. In 2001, the Institute of Medicine (IOM) published Crossing the Quality Chasm, in which it identified six aims for improving our healthcare system. It called upon all healthcare organizations to commit to a shared vision of reform, so that together, we can transform our healthcare system to be patient-centered, effective, safe, timely, efficient and equitable.
Striving For Better
The Pennsylvania Health Care Quality Alliance (PHCQA) has been working to align and standardize measure sets that best represent a fair and valid approach to hospital quality accountability. Accordingly, physician leaders from Pennsylvania's hospitals, the Pennsylvania Medical Society, six of the state's largest insurance organizations, and state and regional hospital associations assembled several workgroups to facilitate efforts towards creating a consensus-driven approach to quality measurement:
Measures and Methods Workgroup
The Measures and Methods Workgroup is a group of physicians, biostatisticians, hospital quality staff members, and health plan representatives who are responsible for evaluating hospital measures, recommending the panel of measures, reviewing specifications and definitions, determining data sources, and collecting and analyzing methods for measures.
Physician Advisory Committee
The Reporting and Marketing Workgroup consists of hospital and health plan IT personnel, quality reporting staff members, health care marketing professionals, and web design/development staff responsible for creating and/or selecting the reporting platform, format, tools, output, and the website, as well as supporting communication and marketing strategies.
Ad Hoc Workgroups
A variety of ad hoc groups have been created to support the work of the PHCQA. To date, these have included a Data Management Advisory Group to assist with the selection of a data management and reporting vendor; a Reporting and Marketing Workgroup designed to create and select the reporting platform and to develop communication and marketing strategies; and a PR Task Force to make recommendations on public relations matters and external communications.
What process is being used to develop the overall approach?
The Measures and Methods Workgroup conducts its work by gathering and reviewing a comprehensive collection of existing hospital quality measures that are already being collected by Pennsylvania hospitals. More specifically, measures need to meet the following requirements to be considered for selection:
- Measures should be already reported and preferably available through public data sources — PHCQA has primarily focused on measures that already exist or can be derived from existing data sources. We do not do any raw data collection or extraction.
- Measures should be endorsed by national organizations (e.g. NQF) and already recognized as being valid measures of hospital quality — To maintain broad participation and acceptance , only measures that have already been established individually as being good indicators of quality will be considered for inclusion on the website.
- Measures should be evidence-based - The measures should be ones supported by clinical studies and existing literature, and combined together, should reflect as many of the dimensions of quality (e.g. Donabedian Model, IOM) as possible.
The PHCQA’s efforts to date have primarily focused on hospital metrics/measures, largely because of the long history of public reporting on hospital care in Pennsylvania. However, we believe that this initiative must evolve over time to include measures covering the whole episode of care, across a variety of settings. A key overall goal of the PHCQA is to continue to build on the strong physician-hospital partnership to improve care and patient outcomes, particularly for individuals with chronic conditions.
How can you get involved?
If you are interested in getting involved or contributing to this effort, please contact one of the following individuals:
General PHCQA Inquiries:
Frank Trembulak, Chair, PHCQA
(570) 271-6467 or firstname.lastname@example.org
Erik Muther, Executive Director, PHCQA
(215) 241-3097 or Erik.Muther@phcqa.org
Measures and Methods Workgroup:
Patrick (P.J.) Brennan, MD, Chief Medical Officer & Senior Vice President, University of Pennsylvania Health System
Richard Snyder, Senior Vice President and Chief Medical Officer, Independence Blue Cross
Physician Advisory Committee:
John Bulger, MD., Chair, Geisinger Health System
Cardiac Surgery Advisory Group:
Pierantonio Russo, MD., Chair, Medical Director, Independence Blue Cross
For More Information
- Hospital Compare
- Hospital Quality Alliance
- CMS Value Based Purchasing Hospital Initiative
- CMS Value Based Purchasing Physician Initiative
- National Quality Forum
- The Agency for Healthcare Research and Quality