Measuring Performance

Patient-Centered Measures = Patient-Centered Results 

Let’s face it. Nobody wants to be in a hospital. The lost sense of independence and control is… at best, unpleasant. A winner of NQF’s National Quality Healthcare Award, North Shore-Long Island Jewish Health System (LIJ) shifts power back to patients through extraordinary performance measurement of patient care and satisfaction and public reporting of results. Not surprisingly, the practice of continuous measurement and public reporting creates a feedback loop that improves patient care.

“At North Shore-Long Island Jewish we believe that we must earn patients’ trust by reporting our outcomes and errors and enabling them to make informed decisions about which provider to choose.” 

Kenneth Abrams, MD, Senior Vice President of Clinical Operations at North Shore-LIJ 

What You Say Matters

What patients say about care really matters at North Shore-LIJ. Patients, families, and community members are actively engaged in improving quality by reporting errors, near misses in their care, and complaints. North Shore routinely includes patients in advisory positions when a major decision about patient care is on the table. A database tracks all patient feedback, which system leaders then use to identify trends and determine priorities for improvement. Areas of concern are boldly reported across the system from the boardroom to doctors, nurses, and support staff.

The results are impressive. Using a video-monitoring program that displays progress on priorities throughout the hospital, North Shore-LIJ increased hand-washing compliance by 81 percent. The hand-hygiene vigilance undoubtedly contributed to a 60-percent drop in infections associated with central lines, a 45-percent reduction in Clostridium difficile infection rates (from 1.74 to 0.95 percent), and an 80-percent decrease in Methicillin-resistant Staphylococcus aureus infection rates (0.35 percent to 0.07 percent).

Better communication with patients is also helping to ensure that patients who are discharged from North Shore-LIJ get and stay better. After implementing a process of weekly, post-discharge phone calls to heart-failure patients, one North Shore-LIJ hospital reduced its readmission rate from 32 percent to 9 percent — saving money and giving more patients precious time at home. Medicare reports that unplanned return visits to hospitals generate $17 billion in unnecessary costs each year.

Quality, Front and Center

North Shore-LIJ’s commitment to measurement, transparency, and patient-centered care is front and center for all 38,000 employees, from the parking valets to surgeons. CEO and President Michael Dowling meets with every new employee to present the system’s quality improvement dashboard, which lays out the organization’s quality measures, performance targets, and results.

“Quality is not a department. It’s not just one process,” said Dowling. “It is everyone’s business. You want it to be part of the DNA of the organization.”

Investing in EHRs

Dowling is working to spread performance measurement and quality improvement beyond the walls of North Shore-LIJ through a $400 million investment in an electronic health record (EHR) system for inpatient and outpatient settings. The healthcare system is subsidizing community physicians’ purchase of EHRs with the condition that their performance on quality measures be shared. It’s another extraordinary display of the system’s commitment to transparency and improvement. Under the new integrated program, North Shore-LIJ will provide physicians with feedback that shows where their performance falls in comparison to doctors nationwide and in their community.

Learn what NQF endorsement means.