The Ontario government is considering a provincewide ranking system for hospitals that would provide information that would allow patients to compare hospitals, reward hospitals for good performance and identify poor performers.
The “ name-and-shame” scheme, designed to give patients a clearer picture of service quality, would be modelled after a short-lived one in Britain, which was shown to have improved hospital standards, according to documents obtained by the Ottawa Citizen.
No such scheme is under consideration in B. C., according to Ministry of Health spokeswoman Michelle Stewart.
“ In short,rift gold the Ministry of Health is not actively developing or contemplating a hospital report card,” Stewart said. “ Health authorities do an annual report on their service plans and provide a variety of other performance indicators on their public websites.”
Under the proposed Ontario system, hospitals would be given a rating of up to three stars for their performance in areas such as treating patients safely and effectively, reducing surgical and emergencyroom waits and improving cleanliness.
Another system under consideration would simply rate hospitals “ excellent,” “ good,” “ fair” or “ weak,” according to documents released under freedomofinformation laws.
The merits and pitfalls of a star-rating system were discussed in 2009 by a panel of 13 experts advising the Health Ministry. However, it’s not clear if the government has adopted the idea.
In recent years, Ontario hospitals have gradually adopted ways of measuring their own quality and making their leaders responsible for improving patient care. Last month, new rules kicked in that linked a portion of executive pay to how well hospitals took care of patients.
The new rules require the province’s 154 hospitals to publicly post annual reports detailing their progress in meeting a long list of “ quality indicators,” ranging from getting more staff to wash their hands when dealing with patients to reducing rates of inhospital infections.
The Ontario government sees the new accountability rules as a way not only to improve care and rein in executive salaries, but also to provide taxpayers with a standardized way to compare hospitals and the care they deliver.
A ranking system would appear to be the next logical step.
It could also lay the groundwork for more sweeping changes to how hospitals are funded, with the goal of rewarding those that are more efficient and treat patients safely and effectively.
After Britain introduced a star-rating system in 2001, hospitals showed a noticeable improvement in how well they cared for patients.
High-performing hospitals were rewarded with more funding and financial freedom from the government, allowing them the right to borrow money and organize services to meet local needs.
At facilities with few or no stars, corporate decisions were scrutinized more closely, and executives were told they could lose their jobs if they didn’t do better.
A major downside was that the star-rating system did not take into account the key measure of whether a hospital’s finances were being managed well.
As a result, the system encouraged low-performing hospitals to spend their way out of trouble, resulting in massive deficits.
The reports released to the Ottawa Citizen also indicated that some British hospitals manipulated their data to look like they had improved standards when they actually hadn’t.
For example,rift gold to meet the target of a maximum four-hour wait for treatment in emergency departments, some hospitals made patients wait in ambulances outside the hospital until staff were confident they could be treated.
The reports concluded that services excluded from the ranking system tended to be neglected by hospitals.
As a result, “ a low rating in itself will not necessarily encourage organizations to improve on areas where improvement may be needed if there is no measurement in place for those areas.”
In 2005, amid political and union opposition to the starrating system, the British government scrapped the scheme in favour of a two-tiered system that measured quality of patient care and use of resources.
Instead of stars, hospitals were given a rating on a fourpoint scale ranging from excellent to weak.
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