Hospital Quality Improvement Platform Updates

Quality Quarterly Article

Use of HQI’s Hospital Quality Improvement Platform — a quality analytics system that consolidates disparate data sources into a single, statewide platform — continues to increase as more hospitals complete their contract reviews. The platform is free to all California Hospital Association members.  

The secure, web-based platform provides risk-adjusted quality measures for conditions most affected by hospital quality initiatives. Through the platform, hospitals gain access to clinically rich, timely reports to help easily identify opportunities for improvement and areas for focus. The free platform is web-based, does not connect to your electronic health records system, and uses data hospitals already report to the Office of Statewide Health Planning and Development (OSHPD) and the National Healthcare Safety Network (NHSN). We work for you, so please let us know what reports you would like to see in this platform. The HQI team may be able to create and customize reporting to meet your hospital’s needs.

Since launching in October 2019:

  • 297 of 472 hospitals have seen a demo of the platform 
  • 125 hospitals have executed agreements 
  • 160 hospitals have participation agreements under legal review 

WHAT’S IN THE UPDATE 

Reports in the queue

  • Severe Maternal Morbidity: Report showing the 21 CDC SMM Indicators
  • Pediatric Quality Indicators: Reports based on the new AHRQ PDI Indicators and composites. 
  • Mental Health and Substance Abuse: Reports based on the SAMHSA Mental Health Substance Use Diagnosis Codes.  
  • Community Health Needs Assessment: Comprehensive report covering community health needs based on the County of San Diego Health and Human Services Agency Public Health Services Data Guide and Codebook
  • Substance Use Disorders, Dependencies, and Abuse: Detailed reports showing abuses and dependencies of many potentially harmful drugs with a special focus on opioids based on the California Department of Health Care Services’ Substance Use Analysis Codes
  • All-Cause Mortality: Report re-creating Centers for Medicare & Medicaid Services’ 30-day all-cause acute myocardial infarction, chronic obstructive pulmonary disease, heart failure, pneumonia, stroke, coronary artery bypass graft surgery, and hospital-wide mortality rates
  • Pressure Ulcers: Report showing the severity and location of the Agency for Healthcare Research and Quality’s (AHRQ’s) PSI 03 Pressure Ulcers
  • Communicable Diseases: Report of incidence and mortality rates for communicable diseases, including COVID-19, sexually transmitted diseases, and other viral or bacterial infections. 
  • Obstinate/Difficult Patients: A report showing the prevalence of tough to manage patients because of AMA, wandering, refusal of care, non-compliance, and restraint use. 

New functionalities

  • The reports on social determinants of health have been optimized and condensed into one report with the additional filtering to view cases between the three encounter types (inpatient, emergency department, ambulatory surgery).   
  • Added comparison groups for:  
    • HSA x System/Non-System comparison 
    • HSA x Private/Public 
    • HSA x Private/Public x System/Non-System 
  • Added filter for Local Health Plans 

Reporting updates

  • NHSN healthcare-associated infection (HAI) reports have been refreshed with the latest data (last updated August 25th, 2021). 
  • Two chronic conditions reports based on the CCW categories are now available on the platform.  
  • AHRQ IQI and PSI benchmark code sets are being updated. 
  • Adverse Drug Events report code set is being updated. 
  • Sepsis benchmark code set is being updated.  

ABOUT THE PLATFORM

Features include:

  • Web-based, completely free, and uses data you already report to OSHPD and NHSN.  
  • Access to hospital performance data from various sources, integrated into a centralized platform.   
  • Tools to understand your hospital’s quality performance and compare standardized measures to statewide benchmarks and peers.   
  • The ability to explore same-year quality performance for your hospital, rather than waiting eight to 20 months for statewide files to be released.   
  • An intuitive interface that provides a window into inpatient and emergency quality indicators.     
  • Secure data within HIPAA-qualified encrypted data systems.   

Quality measures include:

  • Inpatient episode quality and efficiency  
  • Readmissions (3, 7, 14, 30 day)  
  • HAIs 
  • Case mix demographics, comorbidities, index  
  • Centers for Medicare & Medicaid Services hospital-acquired conditions (DRA HAC and HACRP)  
  • Cancer surgery volumes  
  • Emergency department (ED) discharge analytics (comorbidities, volume, demographics, revisits)  
  • Adverse drug events (anticoagulants, glycemic control, and opioids)  
  • Hospital-acquired conditions (HACs)  
  • AHRQ patient safety indicators  
  • AHRQ inpatient quality indicators   
  • Sepsis incidence and mortality  
  • Maternity measures  
  • Mortality/serious complications/reoperations/length of stay/discharge disposition  
  • Recent (MIRCal/SIERA) discharge volume by source (inpatient, ED, ambulatory surgery) 
  • Social determinants of health 
  • Chronic physical and behavioral conditions 

There are 15 options for benchmarking your hospital’s performance: 

  • All CHA member hospitals  
  • Other critical access hospitals  
  • Other rural hospitals 
  • Other children’s hospitals  
  • Other teaching hospitals 
  • Your hospital’s past performance  
  • Other CHA member hospitals:  
    • In the same health system  
    • In the same general region 
    • In the same health service area (HSA) 
    • In the same metropolitan statistical area (MSA) 
    • With similar bed size 
    • With the same type of control (e.g., non-profit) 
    • With the same license type 
    • With similar Medicare payer mix 
    • With similar Medi-Cal payer mix 
    • With the same adult/children’s trauma level designation  
    • With similar inpatient discharge volume 
    • With same ED service level (e.g., basic, standby) 
    • With similar outpatient visit volume 

For hospitals interested in participating, it can be done in three easy steps:  

  1. Execute the cost-free Business Associated Agreement & Master Service Agreement.   
  2. Securely submit copies of recent MIRCal/OSHPD emergency department, ambulatory surgery, and inpatient patient-level administrative discharge data files.   
  3. Join HQI’s NHSN group. 

For more information about the Hospital Quality Improvement Platform or to schedule a 30-minute demo, visit the HQI website or email HQIAnalytics@HQInstitute.org.