In cardiology, not all quality labels are created equal. In a previous edition, we took a look at how a 2018 report found patient outcomes were no better in Joint Commission-Accredited Hospitals than in peers. Our review of the latest news in cardiovascular care turned up two more articles concerned with quality labels and whether they reflect the best cardiology outcomes: ‘Center of Excellence’ designations from payors might not mean much, but process of care scores from public hospital performance reports may.
And speaking of labels, we also found insights on quality from Phoenix Children’s Hospital which owns a rarefied three-star rating from the Society of Thoracic Surgeons.
Several health insurers have created “Centers of Excellence (COE)” designations to steer patients towards providers who provide higher quality care at a lower cost—but do these designations actually correlate to better outcomes? A new study says no—on endpoints of mortality and readmissions. Across three insurers’ designations, researchers found no meaningful difference in mortality rates for heart attacks when compared to non-COE-designated peers. In fact, 30-day mortality rates were worse for Aetna’s COE-designated hospitals than for their non-designated peers. “Insurers likely make these determinations primarily based on cost to them,” said Dr. Deepak Bhatt of Brigham and Women’s Heart & Vascular Center in Boston, who was not involved in the study. Read more »
That’s not to say quality measures are all bad. A new study examined quality of care measures established in 2004 by the Centers for Medicare and Medicaid Services for acute myocardial infarction and found the process of care scores to correlate with outcomes in New Jersey hospitals, as measured by mortality rates and readmissions. Previous studies on quality scores and outcomes have found mixed results, but these studies were more limited, said the study’s authors. The study also found that patients admitted to a teaching hospital had a 25 percent lower chance of being readmitted after a month and their chances of cardiovascular death after one year were ten percent lower.
“It is the education that makes the biggest difference, especially with cardiac patients,” said Sheryl Mount, a cardiac nurse asked for comment. “I believe that in these teaching hospitals and hospitals with high care scores, they have made education a priority.” Read more »
‘Everyone is Expected to Speak Up’: How Phoenix Children’s Cardiac Program Maintains High Surgical Quality – Becker’s Hospital Review
Some quality designations are directly dependent on outcomes measures like mortality rates. Phoenix Children’s Hopsital, which has a three-star rating from the Society of Thoracic Surgeons’ Congenital Heart Surgery Database, “has achieved lower-than-expected mortality rates across all levels of complex heart surgeries for the past six years,” according to an interview with Becker’s Hospital Review. What’s key to their success? “It’s about building a culture of trust among all the stakeholders in our heart center,” says Daniel Velez, MD, division chief of cardiothoracic surgery. “Everybody here understands that they can speak up… All team members need to be able to communicate the good, the bad and the ugly, and everyone must be ready to do what is best for [the] patient.” Read more »
Accreditation for Cardiovascular Excellence is a Quality Quality Label – Directly Connected to the Best Cardiology Outcomes
Accreditation through ACE captures insight into the quality of cardiac care at a provider organization via both process of care measures validated to impact outcomes as well as direct outcomes measures. Accreditation is a quality quality label that communicates excellence in cardiovascular care delivery. ACE continues to invest in science to validate our accreditation processes, keep our standards at the cutting-edge of quality care, and provide the most value to organizations seeking to provide the highest quality cardiovascular care to patients. Learn more about ACE accreditation »