At Hospital for Special Surgery, quality in all aspects of health care delivery is of the utmost importance. Our team works together to continuously improve our standards of care and our clinical outcomes. Understanding quality measures gives potential patients the confidence in their choices in healthcare. Michelle Horvath, Vice President of Quality Management, answers questions on safety and quality at HSS.
What is Quality?
There are many definitions of quality. One that I like is doing the right thing, for the right person, at the right time. In healthcare, “right” depends on knowing the scientific evidence for which treatment option is best for which patient. It is important to recognize that care has to be individualized based on each patient’s health status (e.g. other illnesses). It sounds simple, but it isn’t. What is “right” can also depend on any other care or therapies that a person has already tried. “Right” might also be influenced by a person’s culture or beliefs. At its heart, quality is about constantly improving at what we do every day.
How is Quality measured?
Measuring clinical quality involves measuring the “how” of how we do things. For instance, do patients get appointments for physical therapy within a reasonable time frame? Are medications given in a timely manner? For example, patients on a certain type of heart medication at home (called a “Beta Blocker”) need to have the medication restarted very soon after surgery. Many, but not all, patients having orthopedic surgery require medications to prevent clots that can form in the legs or lungs after surgery. We measure if patients receive these medications on time. Other quality measures include how compliant staff is with hand-washing and whether antibiotics are given timely in an effort to prevent infection.
Quality also involves measuring outcomes of care, for instance the development of blood clots after surgery (as mentioned above), infection rates and improvement in mobility. These can occur even when all efforts are made to prevent them. We even measure the things that we successfully prevented to remain successful in the future. Analyzing this information helps keep patients safe through prevention.
In addition to clinical quality, it is also important to measure our patients’ satisfaction with the care they receive, because achieving the best outcomes goes hand-in-hand with providing the best patient experience possible. We have teams of staff always working to improve how we create an excellent patient experience in all of our services -inpatient and outpatient.
How does HSS ensure quality practices across all service areas?
The processes and outcomes mentioned above (as well as many others) are measured across all of our services. We call this information “data.” Teams and clinical committees in every area of the hospital meet together to review data and surveys that tell us more about the care we provide. These teams include physicians, staff and managers. Our service excellence program reviews patient satisfaction surveys in detail and develops plans in areas that need improvement. Senior leaders in the hospital regularly “round” in all areas to ask our patients and our staff directly what we can do better. Because most patients are highly satisfied with their care at HSS, we pay special attention to comments or letters where the experience wasn’t as expected. To be the best, we always want to improve, and never be satisfied that we are “good enough.”
For more information on Quality and Safety at HSS, please visit: https://hss.edu/quality.asp.
Michelle Horvath is the Vice President of Quality Management at Hospital for Special Surgery.