2007-09-21 / Columnists

It's My Turn

Understanding Your Public Hospitals Safety, Quality Record
By Dr. Alan D. Aviles President NYC Health And Hospitals Corporation

Dr. Alan D. Aviles Dr. Alan D. Aviles At the New York City Health and Hospitals Corporation (HHC), New York City's public hospital system, we believe the public - and especially our patients and their families-deserve access to objective information that truly reflects the quality of care provided by our hospitals and other facilities.

That is why we recently have posted on our public website, (www.nyc.gov/hhc) a new section, HHC in Focus. For the first time, we are giving the public access to certain quality and performance data that hospitals generally do not share with the communities that they serve. The goal of HHC in Focus is to help patients better understand what our public hospitals are doing to deliver more reliable, effective care and to keep patients safe. Ultimately, we hope this type of transparency also will help patients make better-informed healthcare decisions for themselves and their family.

In the last few years, both the federal government and a few states have compelled hospitals to make important patient safety data transparent to the public. The states of Florida, Missouri and Pennsylvania now mandate public reporting of hospital acquired infections, such as ventilator-associated pneumonias and catheter-related bloodstream infections. More states, including New York, have plans for requiring the public reporting of hospitalacquired infection rates in the not-too-distant future.

But we have decided that information related to the incidence of these potentially deadly, hospitalacquired infections is too important to wait for a mandate or law requiring us to disclose it. We are posting this information now, voluntarily, because we feel that it is in the public's interest and the right thing to do.

According to the national Centers for Disease Control, nearly 99,000 patients die each year in hospitals across the nation as a result of hospital-acquired infections. This makes these infections more lethal than car accidents, breast cancer and AIDS combined. Studies have shown that most such hospital acquired infections are preventable through well-understood, but too infrequently practiced, procedures as simple as better hand hygiene.

On our website, we will share our hospital-specific rates related to ventilator-associated pneumonia and catheter-related bloodstream infections, as well as other data that shows whether we are providing effective and safe care at our 11 hospitals and four long term care facilities/nursing homes. This is some of the same data that we monitor internally to measure if the care we provide meets the standards we would want for our own family members.

The specific quality and safety-related data now available on our website includes mortality and hospital acquired infection rates; our rates of adherence to best clinical practices in treating heart attacks, heart failure pneumonia and in preventing surgical infections; and performance measures that reflect how well our nursing homes are doing in providing quality care. Where possible, we also provide information that shows how our hospitals and nursing homes compare to state and national benchmarks in the performance areas covered.

Not all of our results are as good as we want them to be; but there is plenty of evidence of excellent care across our entire system. Going forward, we realize that by publishing this sensitive information we will be held publicly accountable for doing our best to provide high quality healthcare and to keep our patients safe. And that is fine with us.

I feel strongly that open and honest transparency - especially about the measures that matter most - has the power to accelerate performance improvement, even as it helps to deepen the trust that is essential between a hospital and its community. I am confident that in time others will agree and will venture to do the same. In the meantime, I am proud that HHC is leading the way.

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