In an international context, the United States carries a long-standing reputation for boasting some of the highest quality health care and medical services available anywhere in the world. Despite appearances, however, health care in the United States remains imperfect. Not all medical services and hospital organizations attain the highest quality, despite what many think. The concern of this paper, therefore, is firmly grasp the core elements of quality and to assess their presence or lack thereof by analyzing two United States hospitals. Using available data via the Hospital Compare site from Centers for Medicare & Medicaid Services(CMS), two hospitals with high-low quality rankings are assessed and analyzed for differences. Consideration is given to understanding available criteria that determines hospital quality and what these findings imply for strategic human resource management.
The two hospitals chosen for this study are Detroit Receiving Hospital (DRH) and the University of Michigan Medical Center. Both reside within an approximately 65 mile radius of one another yet a significant quality spread exists between the Detroit center and Ann Arbor. a 320-bed facility that is also a Level I Trauma Center.(“Detroit Receiving Hospital” 2015) Located in Detroit, Michigan, the hospital's ER services over 100,000 patients per year.(“Detroit Receiving Hospital” 2015) DRH has a storied past with the city of Detroit, having opened in 1915 as initially a city-owned hospital with a commitment towards serving the needs of Detroit's public health no matter financial status or ability to pay.(“Detroit Receiving Hospital” 2015) Today, Detroit Receiving Center exists as a primary site for Emergency Room physician residency training; it boasts a historical average of training over 60% of the state's ER doctors.(“Detroit Receiving Hospital” 2015)
Our second chosen hospital is the Medical Center at the University of Michigan Arbor. Ranked among the top medical facilities in the country and world, according to U.S. News and World Report in 2013, University of Michigan Ann Arbor Medical Center (UMich) has received accolades and national recognition for not only its top tier performance in US News' well read and comprehensive ranking publication, but also for its breadth in quality as well.(“University of Michigan hospitals” 2015) Compared to national standards, University of Michigan Ann Arbor Medical Center outperforms many of the best hospitals across the nation: out of 5,000 high performing hospitals across the nation in 2015, only 2.7 (or 137) achieved honorable mention in rank in even one medical specialty while University of Michigan Ann Arbor Medical Center received notice for a total of 11 specialties.(“University of Michigan hospitals” 2015) Detroit Receiving Hospital thus becomes our benchmark standard of an example of a low to low-moderate performing hospital based on the extensive quality assessments, surveys and batteries aggregated and made available on line at Hospital Compare through Centers for Medicare and Medicaid. University of Michigan Ann Arbor Medical Center is our benchmark standard of an example of a high performing hospital.
In this seciton we compare quality ratings between Detroit Receiving Center and University of Michigan Ann Arbor Medical Center hospitals based on our findings from the Centers for Medicare and Medicaid Services' Hospital Compare data set and graphical user interface available on their website. Hospital Care enables for side by side comparison of quality measures based on two major criteria. Multiple categories of data exist and are arranged by topic to include Patient Survey Results, Timely and Effective Care, Readmissions, Complications, and Deaths, Use of Medical Imaging, Linking Quality to Payment, Medicare (“Hospital Compare 2015). Aggregating these totals, Detroit Receiving Center Hospital received an overall quality rating of 1.5 stars, while University of Michigan Ann Arbor Medical Center received the maximum of 4 stars. In each category of rating, University of Michigan Ann Arbor Medical Center scored well above a 60% point spread higher than Detroit Receiving Center hospital. Here, we limit our discussion to a quick summary of results from Patient Feedback Results. Patient Feedback Results includes a list of questions regarding satisfaction with medical staff care, service delivery, condition of facilities, and more. When placing our two hospitals in a side by side comparison, the star rating point spread (UMICH 4/4, (DRH 1.5/4) appears consistent and discernible from the percentile ranks answers from reported survey response feedback about service delivery. Survey of patients’ hospital experiences included various questions, such as percent of patients who reported that their nurses “always” communicated well, percent of patients who reported that their pain was “always” well controlled, or percent of patients who reported that their room and bathroom were “always” clean.(“Hospital Compare” 2015) Umich patients consistently answered above the 80th percentile in these types of questions. Further prompts inquired about perceived staff attentiveness when pressing a “help” button from bed, perceived timeliness of nurses' attention and or doctor's visitation, if patients felt their doctor/nurse respected them and treated them kindly; whether the bathroom and or hospital room/bed was prepared properly before arrival, how well nurses, doctors and other staff communicated and explained instructions for self care after discharge (“Hosptal Comparison” 2015). To these same questoins, Detroit Receiving Hospital survey responders responded with greater range and tending beneath the 50% medium line, indicating less than half perceived service delivery as satisfactory.
References
“DMC Detroit Receivng Hospital.” (2015). Detroit Receiving Hospital. Retreieved from
http://www.dmc.org/DetroitReceiving.
“Calculating the survey of patients' experiences (HCAHPS) star ratings”(.nd.) Center for
Medicare & Medicaid Services. Retrieved from
https://www.medicare.gov/hospitalcompare/about/HCAHPS-Star-Ratings.html
“HCAHPS Fact Sheet.” (2015). Centers for Medicare & Medicaid Services. Retrieved from
http://www.hcahpsonline.org/Facts.aspx.
“Hospital Compare.”(2015). Centers for Medicare & Medicaid Services. Retrieved from
https://www.cms.gov/medicare/quality-initiatives-patient-assessment-
instruments/hospitalqualityinits/hospitalcompare.html
“University of Michigan Hospitals: Among the best nationally, and the best in Michigan &
metro Detroit” (2015). University of Michigan Health System. Retrieved from
http://www.uofmhealth.org/about-umhs/best-hospitals
National Academy of Sciences (2013). Crossing the quality chasm: the IOM health care quality
initiative. Institute of Medicine. Retrieved from
http://iom.nationalacademies.org/Global/News%20Announcements/Crossing-the- Quality-Chasm-The-IOM-Health-Care-Quality-Initiative.aspx#sthash.mUjywSMl.dpuf
