As hospitals plan for a post-COVID healthcare landscape, one of the important factors to consider will be how patients can know it is “safe” to go back to the hospital. It evokes thoughts of the Jaws 2 poster as many remain conflicted about the safety of visiting restaurants, friends, and other places outside of the home. With increasing vaccination rates, though, the trend is leaning toward yet another “new normal” across the country.
Throughout the pandemic, many hospitals experienced a decline in volumes for specialty services, including emergencies like heart attack. The popular conjecture is that this was due to hesitations to seek care, and the eventual passing of symptoms (though certainly not due to spontaneous recovery). As the country reopens, it will be more important than ever to know that critical services in a hospital are being provided with the utmost attention to detail. Demonstrating high quality of care will be a signal to the community that the hospital is prepared to safely care for them and their family members.
Similarly, with COVID-19 having such a systemic impact on patients’ health, clinicians are pushing to understand what this will mean for programs going forward. During the pandemic, some hospitals saw increases of incidents and adverse outcomes in some patient populations. Some of this is very likely due to COVID-19, whether from longer term effects on recovered patients or the significant complications presented by performing emergent procedures on COVID-positive patients. In a specialty as closely monitored as cardiovascular, it is expected that hospitals and program leaders are able to drill down to understand this impact on overall performance.
As healthcare providers have been tasked with responding to surges, new patient care protocols, significant changes to safety measures, and other challenges presented by the pandemic, some areas have been provided some leeway to reallocate focus. Certain accrediting bodies have delayed onsite surveys, and some reporting requirements to data registries have been relaxed due to other priorities, and rightly so. However, as the country moves toward reopening, it is just as important to understand the information presented by trending dashboards and other quality reports. The question has come up whether the complications from COVID-19 could be “masking” other quality or operational issues that must be addressed.
If a program’s reporting mechanisms are illustrating a decline in patient outcomes or a rise in adverse events over the last year, it cannot be attributed to COVID without first validating that information. It is expected that the virus has impacted many programs across the country, but the obligation remains to be aware of all of the other quality measures and best practice benchmarks remain in effect. This is where outside entities, such as accrediting bodies like Corazon, can come into play. The goal of these reviews ought to be the identification of underlying issues, while also supporting the overall quality of the program. The accreditation process and ongoing review should support an organization needing to focus efforts elsewhere, such as during the pandemic, and allow for a broader view of any potential quality fallouts, along with recommendations as to how these should be addressed.
Through the accreditation process, hospitals are able to identify specific areas for improvement and develop action plans to advance quality of care. Corazon provides a customized dashboard each quarter based on these metrics and summarizing the hospital’s performance. These indicators allow program leaders to easily identify opportunities, and afford them the opportunity to collaborate with national experts at Corazon in developing a plan.
Maintaining a proactive approach to quality and program management will continue to be of even greater focus as “long-hauler” COVID patients and other long-term effects of the pandemic are realized, whether from patients choosing to not seek care or other factors. Cardiovascular remains one of the most closely-watched services within a hospital for quality data. If providers exceed just 1% mortality for PCI and 2% for OHS, it can start to make headlines in local news. Proactively seeking oversight from Corazon, whether through accreditation or peer review, can help to maintain a focus on these important measures to ensure they remain a positive attribute for the hospital.
Even during the pandemic, Corazon worked with hospitals to ensure a focus on cardiovascular as a central service. Those who added this level of attention were able to see more stable volumes, and even gain market share. At the same time, these hospitals are pushed to achieve the 75th or 90th percentile in specific quality performance metrics, all of which adds up to supporting the goal of saving patient lives. What safeguards do you have in place to proactively monitor performance and achieve your program’s goals?
