QUALIS HEALTH Hospital Outpatient Quality Reporting Hospital Performance Report for Emergency Department Measures Community: Washington State Includes Data Through: Q2 2015 - Q1 2016 Report Created: April 20, 2017 Purpose of the Report This report shows performance on emergency department (ED) throughput. The source of the data is Hospital Compare. It is intended to help hospitals focus specifically on ways to improve efficiencies and care in their emergency departments. About Qualis Health Qualis Health is one of the nation s leading population health management organizations, working with clients throughout the public and private sector to advance the quality, efficiency, and value of healthcare for millions of Americans every day. As the Medicare Quality Improvement Network - Quality Improvement Organization for Idaho and Washington, our team of quality improvement consultants and clinical leaders works with healthcare providers, consumers, and community partners to redesign processes, build sustainable change, and deliver care with improved value, quality, and safety for patients. This material was prepared by Qualis Health, the Medicare Quality Innovation Network - Quality Improvement Organization (QIN-QIO) for Idaho and Washington, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy. WA-D1-QH-2890-04-17
Qualis Health Report In an effort to help hospitals focus specifically on ways to improve efficiencies and care in their emergency departments, Qualis Health provides the following hospital performance report for select outpatient quality measures. Time periods of performance, unless otherwise indicated, are from second quarter, 2015 to the end of first quarter, 2016. The source of the data is Hospital Compare. Bar charts are used to compare hospitals performance to each other and to national benchmarks. Bars in green meet or exceed the national benchmark; bars in yellow are above the national benchmark; and bars in red are more than 1.5 times higher than the national benchmark. Emergency Department Throughput The report shows performance on the three measures for emergency department (ED) throughput: Median Time from Door to Diagnostic Evaluation; Median Time from Arrival to Departure for Discharged Patients; Percent of Patients that Left without Being Seen. Overcrowding and heavy emergency department resource demand leads to ambulance diversion, prolonged patient waiting times, increased suffering for those who wait, rushed and unpleasant episodes of care, and potentially poor patient outcomes. Reducing the time patients remain in the emergency department (ED) potentially improves access to care. Pain Management The report also shows performance on Median Time to Pain Management for Long-Bone Fractures. Pain management in patients with long bone fractures remains undertreated in emergency departments for all patients, but especially for minorities and other patients of color, including children. 1 2 3 4 Improving the time from ED arrival to administration of analgesics for all patients presenting with confirmed and potential long-bone fractures improves satisfaction with care, improves outcomes, and potentially improves ED efficiency and throughput. 5 1 Ritsema TS, Kelen GD, Pronovost RJ, and Pham JC. The national trend in quality of emergency department pain management of long bone fractures. Acad Emerg Med. 2007 Feb 14; 14(2):163-9. 2 Epps CD, Ware LJ, and Packard A. Ethnic wait time differences in analgesic administration in the emergency department. Pain Manag Nurs. 2008 Mar;9(1):26-32. 3 Todd KH, Samaroo N, and Hoffman JR. Ethnicity as a risk factor for inadequate emergency department analgesia. JAMA. 1993 Mar 24-31;29(12):1537-9. 4 Friedland LR and Kulick RM. Emergency department analgesic use in pediatric trauma victims with fractures. Ann Emerg Med. 1994 Feb;23(2):203-7. 5 Brown JC, Klein EJ, Lewis CW, Johnston BD, and Cummings P. Emergency department analgesia for fracture pain. Ann Emerg Med. 2003 Aug;42(2):197-205. 1
Door to Diagnostic Evaluation by Qualified Medical Personnel Measure Definition The process measure is defined as the median time, in minutes, from the patient s earliest documented arrival time at the ED to the first direct, personal exchange between an ambulatory patient and a physician or institutionally credentialed provider to initiate the medical screening examination in the emergency department. National Median, 22 4 Door to Diagnostic Evaluation Median Time (minutes), Q2 2015 - Q1 2016 10 11 12 13 14 14 16 16 17 18 19 19 19 20 21 22 23 24 25 26 27 28 28 29 29 30 30 30 31 31 31 34 34 35 35 36 37 38 38 40 42 46 50 55 58 68 / CHERRY HILL UNIVERSITY OF WASHINGTON MEDICAL CASCADE SKAGIT YAKIMA REGIONAL MEDICAL AND PROVIDENCE REGIONAL MEDICAL PEACEHEALTH ST JOSEPH MEDICAL PROVIDENCE SACRED HEART MEDICAL PEACEHEALTH SOUTHWEST MEDICAL MULTICARE GOOD 2
National Median, 52 27 32 36 37 38 38 Median Time to Pain Management for Long Bone Fractures in the ED Q2 2015 - Q1 2016 40 40 42 44 45 45 46 47 48 49 50 50 52 52 54 54 55 58 58 58 59 59 60 61 62 62 64 65 66 66 68 68 68 68 69 70 72 73 78 80 85 / CHERRY HILL PROVIDENCE SACRED HEART MEDICAL CENTER CASCADE SKAGIT YAKIMA REGIONAL MEDICAL AND CARDIAC CENTER UNIVERSITY OF WASHINGTON MEDICAL CTR PEACEHEALTH PROVIDENCE REGIONAL MEDICAL CENTER EVERETT PEACEHEALTH SOUTHWEST MEDICAL CENTER MULTICARE GOOD 3
Median Time from ED Arrival to ED Departure for Patients Admitted to the Facility from the ED, Q2 2015 - Q1 2016 National Median, 279 195 196 201 201 202 222 224 231 233 234 240 246 247 254 255 261 267 272 278 280 282 282 284 285 285 286 292 298 299 300 306 313 315 322 328 328 329 341 344 348 351 354 370 400 440 454 488 / CHERRY HILL CASCADE PEACEHEALTH PROVIDENCE SACRED HEART MEDICAL CENTER PEACEHEALTH SOUTHWEST MEDICAL CENTER SKAGIT YAKIMA REGIONAL MEDICAL AND CARDIAC CENTER PROVIDENCE REGIONAL MEDICAL CENTER EVERETT MULTICARE GOOD UNIVERSITY OF WASHINGTON MEDICAL CTR 4
Median Time from Admit Decision Time to Time of Departure from the ED for Patients Admitted to the Facility, Q2 2015 - Q1 2016 306 National Median, 99 59 60 69 72 73 75 76 76 80 85 86 92 94 97 98 100 102 104 104 104 106 108 108 108 110 118 120 123 125 129 129 130 130 130 131 132 136 138 138 142 149 152 171 185 217 229 CASCADE PEACEHEALTH SOUTHWEST MEDICAL CENTER / CHERRY HILL PROVIDENCE SACRED HEART MEDICAL CENTER PROVIDENCE REGIONAL MEDICAL CENTER EVERETT SKAGIT PEACEHEALTH YAKIMA REGIONAL MEDICAL AND CARDIAC CENTER MULTICARE GOOD UNIVERSITY OF WASHINGTON MEDICAL CTR 5
Median Time from Emergency Department Arrival to Emergency Department Departure for Discharged Patients Measure Definition The process measure is defined as the median time, in minutes, from the patient s earliest documented arrival time at the ED to the documented time at which the patient departed from the emergency department. ED Arrival to ED Departure for Discharged Patients Median Time (minutes), Q2 2015 - Q1 2016 National Median, 140 98 102 106 109 110 112 123 126 126 128 128 131 132 135 138 142 146 146 147 150 150 152 156 158 164 164 167 170 171 172 174 178 180 181 183 188 189 190 195 195 196 202 202 214 237 242 247 CASCADE PROVIDENCE ST MARY MEDICAL YAKIMA REGIONAL MEDICAL AND / CHERRY PEACEHEALTH ST JOSEPH MEDICAL LEGACY SALMON CREEK MEDICAL TACOMA GENERAL ALLENMORE SKAGIT PEACEHEALTH SOUTHWEST MEDICAL MULTICARE GOOD SAMARITAN PROVIDENCE REGIONAL MEDICAL PROVIDENCE SACRED HEART MEDICAL UNIVERSITY OF WASHINGTON 6
Left Emergency Department without Being Seen Measure Definition This measure is defined as the percent of patients who presented to the emergency department and signed-in to be evaluated for emergency service, but left without being evaluated by a qualified healthcare provider. Percent of ED Patients Left without Being Seen, CY 2015 3 3 3 3 3 3 3 3 4 4 4 5 5 5 5 5 National Median, 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 0 UNIVERSITY OF WASHINGTON MEDICAL / CHERRY HILL CASCADE SKAGIT YAKIMA REGIONAL MEDICAL AND PEACEHEALTH ST JOSEPH MEDICAL MULTICARE GOOD PEACEHEALTH SOUTHWEST MEDICAL PROVIDENCE REGIONAL MEDICAL PROVIDENCE SACRED HEART MEDICAL 7
100 Percent of Results for Stroke Patients Who Received Head CT or MRI Scan* Who Received Interpretation within 45 Minutes of ED Arrival, Q2 2015 - Q1 2016 96 93 92 88 87 86 82 79 79 77 76 National Median, 69 76 75 73 73 71 69 69 60 57 46 44 44 27 *Only patients who are not admitted to the hospital are included. 8