Reporting the Quality of Care in Hospitals

The Hospital Community Reports

Project Summary

Service, cost, and quality of care vary widely between hospitals. Publically available data can help healthcare consumers choose where to seek care and encourage quality improvement by allowing hospitals and providers to see how they compare to other facilities in the state and the nation.

Vermont law requires hospitals to publish annual reports containing information on a variety of measures which assess quality and costs of care. VPQHC supports the State of Vermont in the annual production of the Hospital Community Reports, also known as the
Hospital Report Card, by compiling data on healthcare associated infections (HAI) and nurse staffing.

Nurse Staffing - We work with hospital staff to compile reports showing total nursing care hours per patient day, broken down between care provided by Registered Nurses and care provided by other nursing staff. These data can help inform potential patients on the amount of care they can expect to receive while in the hospital.

HAI - A surgical site infection (SSI) is a type of HAI that takes place after a patient undergoes surgery. Central line associated blood stream infections (CLABSIs) are another type of HAI that occur in patients who have had a central line within 48-hours prior to the onset of symptoms. VPQHC works extensively with designated Vermont hospital
Infection Preventionists (IPs) to validate reported CLABSI and SSI associated with three types of surgical procedures: hip replacements, knee replacements, and abdominal hysterectomies. High rates of SSIs and CLABSI may reflect poor quality care.

Using the Centers for Disease Control and Prevention National Healthcare Safety Network (NHSN) online reporting platform, VPQHC is able to provide standardized infection ratios (SIRs) for each type of infection. The SIR is a summary measure that enables hospitals to track progress over time and compare their rates with the national baseline.

Both the nurse staffing and HAI reports are publicly accessible on the Vermont Department of Health's website.

Recommendations and Next Steps

VPQHC, along with the State of Vermont, will continue to work with hospitals to ensure the hospital community reports incorporate new metrics of health care reform and provide meaningful and accessible data to the consumer. Beginning in Fall 2016, we will be working with hospitals to validate a new measure – Clostridium difficile infections – that will be included in the 2017 Vermont Hospital Community Reports.