​Quality and patient safety

Ongoing measurement through a quality dashboard

Using robust data from various external and internal sources, information is leveraged across Cancer Treatment Centers of America® (CTCA) hospitals to drive performance. Although not an exact match to publicly reported data, more timely internal data create transparency at all organizational levels and support real-time improvement. Through a dashboard approach, CTCA® continuously monitors and assesses a variety of metrics related to the IOM aims with respect to care outcomes, processes and structures. The list of metrics changes as CTCA views the metrics of interest from multiple angles, including those of our patients, clinicians, the board of directors of the CTCA hospitals and the employer and payer communities. The following measures are examples of our current focus areas.

Infection prevention

The prevention of hospital-acquired infections is a national priority. CTCA conducts Central Line Associated Bloodstream Infection (CLABSI) and Catheter Associated Urinary Tract Infection (CAUTI) surveillance in all inpatient care areas utilizing surveillance definitions from the Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN). CTCA has implemented a number of CLABSI and CAUTI prevention efforts to reduce the number of infections and sustain evidence-based practices for central line and urinary catheter insertion and maintenance as evidenced by our performance. In addition, recognizing that proper hand washing is a simple yet effective way to prevent infections, CTCA monitors compliance with CDC guidelines for hand hygiene.

patient safety quality CLABSI 2019

patient safety quality CAUTI 2019

patient safety quality hand hygiene compliance 2019

Inpatient complications, length of stay and adverse events

CTCA hospitals utilize Crimson Continuum of Care (CCC) software, an industry-leading solution, to aggregate our source system data to produce meaningful metrics, providing visibility into our coded data for purposes of benchmarking and supporting improvement. The CCC database has over 1,000 hospital members and represents approximately one-third of all inpatient admissions in the U.S. The tool uses a severity-adjusted methodology based on the 3M™ All Patient Refined Diagnosis Related Groups (APR DRG) grouper to compare only clinically-relevant cases.

The inpatient complications of care rate depicts the percentage of inpatient cases with a complication code, excluding complications that were already present on admission (POA) or related to pre-existing conditions upon admission to the hospital. By excluding complications that were POA, this measure provides results that more directly reflect quality of care. These codes are useful for screening for adverse events that patients experience as a result of exposure to the health care system, which are likely amenable to prevention by changes at the system or provider level. CTCA continues to take appropriate action to ensure our patients are provided safe and high quality care at all times.

inpatient complications psq 2019

inpatient length of stay psq 2019

Patient safety and adverse events composite

The Patient Safety and Adverse Events Composite, known as PSI 90, is a composite score that provides an overview of hospital-level quality as it relates to a set of potentially preventable hospital-related events associated with harmful outcomes for patients. Included in this measure are events such as developing a stage 3-4 pressure ulcer, postoperative hemorrhage and postoperative sepsis. Our commitment to safety and eliminating patient harm has led to an overall reduction in our composite score.

patient safety indicator psq 2019

Nursing-sensitive indicators

CTCA utilizes numerous nursing-sensitive indicators to assess patient safety and quality. Two measures monitored include patient falls and hospital-acquired pressure ulcers (HAPU).

CTCA assesses the risk of falling continuously and puts into place prevention efforts to keep each patient safe. The pressure ulcer metric explores the relationship between nursing assessments performed, interventions used and pressure ulcer development. The development of a HAPU places the patient at risk for other adverse events and increases resource consumption and health care costs. In most at-risk patients, interventions to reduce pressure and shear, and to mitigate other patient risk factors (immobility, incontinence, impaired nutrition, etc.) will decrease development. CTCA targets a rate of “0” for both metrics—striving for no pressure ulcers or falls occurring in our facilities.

nursing sensitive falls 2019

nursing sensitive hospital acquired pressure ulcer 2019