Hospitals around the country are beginning to share details on the quality and safety of care they provide to patients, aiming to drive transparency to stand out from the competition. But one Texas health system is taking a perhaps unprecedented next step, blowing open the books for anyone who wants to see them, "warts and all."
Starting today, Texas Health Resources is posting all of its quality indicators on its website, uncensored, for everyone from employers to physicians and patients to peruse, using metrics and indicators established by other organizations.
"We believe that transparency drives continuous performance improvement through accountability and, more importantly, it's the right thing to do," Barclay Berdan, chief operating officer and senior executive vice president, said during a Web conference with reporters Tuesday. "We've learned that public reporting helps us document our care more carefully, obtain more valid data, and it drives performance improvement further than we would have without public reporting."
Texas Health Resources is posting some 15 indicators — which are evidence-based, developed by reputable organizations and easy to understand — on its website to start, comprising some 300 metrics. Visitors can view clinical results and complication rates, for instance, and THR includes explanations about each indicator, along with a glossary of terms to help the layman cut through all of the health care industry's "alphabet soup."
The system does plan to scrub the numbers, to make sure they're accurate and valid. But leaders emphasized that a key rule governing the endeavor — besides third-party ownership and indicators — is that they don't hide indicators in which they're performing poorly. Leaders shouldn't hold back such information from stakeholders, sacrificing the greater good for the sake of perfection, said Dan Varga, M.D., chief clinical officer and senior executive vice president.
"Jump in the water; the water is fine," Varga advised other hospital leaders. "We don't think there is a downside around this. It's good for patients, it's good for consumers, and it's great for inciting and really fueling performance improvement. The one thing that we can say the evidence shows is that public reporting and clinical transparency drive performance improvement activity, and so we would welcome everybody to put it out there."
Of course, being open and honest with your hospital's stakeholders is a little easier when you're excelling at this stuff. In other transparency-related news, the Leapfrog Group on Tuesday released the spring update to its Hospital Safety Score, assigning letter grades to more than 2,500 institutions across the country. The 11 hospitals I see on the list with "Texas Health" at the front of their name all earned an A.
All told, Leapfrog, a nonprofit consortium of employers and other health care purchasers, found that hospitals are making "incremental improvements" in preventing errors, injuries and infections. Some one-third of hospitals showed a 10 percent or greater improvement in their performance on safety measures, and there's been a 6.3 percent overall mean improvement of hospital performance since 2012.
Some, including the American Hospital Association, have criticized the Hospital Safety Score in the past, questioning the reliability of some of the measures it uses to compile that information. Nancy Foster, vice president for quality and patient safety at the AHA, said that hospitals are increasingly sharing information on their performance with the outside world, and doing so is a key strategy to better engage patients and the greater community.
"Putting data out the way Texas Health Resources is doing, or other strategies that are similar, is really about more effective engagement with your community," she said Tuesday. "That is enormously important and a goal that all hospitals are striving for, even if they're not employing the same tactics."