QUALIS HEALTH

Hospital Outpatient Quality Reporting

Hospital Performance Report for Emergency Department Measures

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

Community: Washington StateIncludes Data Through: Q2 2015 - Q1 2016Report Created: April 20, 2017

Purpose of the ReportThis 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 HealthQualis 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.

1

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.

2

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.

4 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

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6

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.

98

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ED Arrival to ED Departure for Discharged Patients Median Time (minutes), Q2 2015 - Q1 2016

7

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.

0 0

1 1 1 1 1 1 1 1 1 1 1 1 1 1

2 2 2 2 2 2 2 2 2 2 2 2 2 2

3 3 3 3 3 3 3 3

4 4 4

5 5 5 5 5

National Median, 2

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Percent of ED Patients Left without Being Seen, CY 2015

8

100 96

93 92 88 87 86

82 79 79 77 76 76 75 73 73 71 69 69

60 57

46 44 44

27

National Median, 69

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