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Most Hospitals in Collaborative Gain on Quality Measures

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The Robert Wood Johnson Foundation in Princeton, New Jersey says its Aligning Forces for Quality initiative improved the quality of care for patients in measurable ways at hospitals in 16 communities in the U.S. The foundation released results from an evaluation of the program that aims to improve the quality of health care, reduce disparities, and provide models of reform.

The project was funded by the foundation and supported by health care experts at George Washington University in Washington, D.C. Participating hospitals filed quantitative reports each month, with quarterly narrative progress reports, to the George Washington University program office. The findings reflect 4,000 of these reports filed over an 18 month period.

Hospitals participating in Aligning Forces effort were part of a network where the institutions developed, shared, and implemented quality improvement tools, strategies, and lessons learned. The foundation says 90 percent of the nearly 150 hospital teams participating in the collaborative reported tangible results related to the quality of health care, such as hundreds of avoided readmissions, improved patient safety, standardized data collection on patients race/ethnicity and language preferences — a critical part of tracking and meeting diverse patient needs — and improved emergency department care.

Hospital readmissions. National data show about one in four Medicare patients admitted to the hospital for chronic diseases return to the hospital within 30 days of being discharged. Of the hospitals in the Aligning Forces program, 60 percent improved their 30-day readmission rates for heart failure patients. Teams at the hospitals that reduced their readmissions rate avoided some 486 readmissions.

Improving language services for non-English-speaking patients. Previous studies show that communication in a language the patient can understand is fundamental for receiving and providing safe, high-quality health care. Of the participating hospital teams in the Aligning Forces program, 95 percent improved their screening rates to determine a patient’s preferred spoken language for health care. As a result, some 1.5 million patients were screened for preferred spoken language, more than half a million were screened for preferred written language, and more than 4,500 patients had qualified interpreters at both initial assessment and discharge.

On the related issue of race/ethnicity and language preference, nearly all (95%) participating teams standardized the way they collect these self-reported data from patients, which gives hospitals the ability to look for disparities within any subgroup or any condition.

Emergency department crowding. Crowding and poor patient flow can cause patients to remain in the emergency room longer than necessary, and also cause some patients to leave before being seen by a clinician. In the Aligning Forces participating hospitals, more than half (55%) of the teams reduced the time patients spent in their emergency departments by an average of 30 minutes, and some 10,000 patients avoided leaving before care was provided.

Robert Graham, director of the Aligning Forces for Quality initiative calls the results a good start, but just the beginning of the effort. “We hope these hospitals and teams will continue to test and evaluate their results,” says Graham, “making adjustments wherever needed to build upon the gains from this unique initiative and to ensure on-going progress and sustainability of this important work.”

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