from staff reports



Rush Foundation Hospital has been named a top performer in a Centers for Medicare & Medicaid Services (CMS), Premier healthcare alliance value-based purchasing (VBP) project that rewards hospitals for delivering high quality care in five clinical areas.

Based on fourth-year results from the Hospital Quality Incentive Demonstration (HQID) project, Rush Foundation Hospital received top performer awards in clinical areas of heart failure and hip/knee replacement and recognition attainment in the areas of heart attack, CABG, and pneumonia.



About the HQID project



The HQID is the first national project of its kind, designed to determine if economic incentives to hospitals are effective at improving the quality of inpatient care.

Through the project, which has been extended by CMS for an additional three years, Premier collects a set of more than 30 evidence-based clinical quality measures from almost 250 hospitals across the country. The quality measures were developed by government and private organizations (for more information on the indicators, visit: www,qualitydemo.com).

HQID tracks process and outcome measures in five clinical areas – acute myocardial infarction (AMI), heart failure, coronary artery bypass graft (CABG), pneumonia, and hip and knee replacement.

Improvements in quality of care saved an estimated 4,700 acute myocardial infarction (AMI/heart attack) patients across the first four years of the project, according to an analysis of mortality rates at hospitals participating in the project. In addition, patients received approximately 500,000 additional recommended evidence-based clinical quality measures, such as smoking cessation, discharge instructions and pneumococcal vaccination, during that same time frame.

For hospitals participating in the HQID project, the average Composite Quality Score (CQS), an aggregate of all quality measures within each clinical area, improved by 2.2 percent between the project’s third and fourth year for total gains of 17.2 percent over the project’s first four years.

Additional research by Premier using the Hospital Compare dataset showed that, by March 2008, HQID participants scored on average 6.9 percentage points higher (94.64 percent to 87.36 percent) than non-participants when evaluating 19 common Hospital Compare measures.



Outstanding patient care



Rush is a 215-bed acute care medical/surgical hospital and is affiliated with Rush Health Systems, which also has a long term acute care facility, three critical access hospitals, and physician clinics/practices in the East Mississippi and West Alabama area.

“Providing outstanding patient care has always been our primary mission,” said Cathy Robinson, vice president of RHS.

“Our successes in this project are a testament to our ongoing efforts to provide excellent quality of care to our patients. We strive to continually raise the bar on quality and patient safety in our community.”

Robinson said the clinical area of heart failure is just one example of the project's impact in Rush's patient care.

"That is, the importance of educating patients who have heart failure how to take care of themselves after they are discharged from the hospital to avoid being readmitted right away," she said.

By educating patients about their activities – what they can and cannot do – their diet, follow-up care with the doctor, the medications they should take, how to recognize signs that their heart failure is worsening and weight control, Rush has reduced heart failure patient readmissions within 30 days by 87 percent.

“The successes of the hospitals – small and large, urban and rural, teaching and non-teaching – in the HQID project have led to its consideration as the basis for key national health reforms,” said Susan DeVore, Premier president and CEO.

“As the proposal of a national value-based purchasing program becomes a reality, hospitals participating in HQID will have six years experience with such a model.”

For their participation in the project, Rush Health Systems received national recognition by being posted on the CMS Web site.

"The recognition that Rush in Meridian, Mississippi, is among the top performers in the nation is the biggest reward we could have received from this," Robinson said.