07.10.19
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Delivering high-quality and high-value care is the goal of every hospital and health system. Evidence-based medicine with focus on reduced variation — guided by best practices and data-driven improvement processes — has improved patient care and reduced harm in Missouri.
Missouri hospitals’ quality improvement programs are grounded in four dimensions of performance improvement. Based on the Quadruple Aim framework, hospitals’ goals include improving population health, enhancing patient care, reducing the per capita cost of health care, and advancing the patient experience while improving the work life of clinicians and staff.
MHA’s 2019 Annual Quality Report includes performance data on 19 metrics tracked by Missouri hospitals, and summarizes progress and trends on measures related to hospital infections, patient safety and readmissions. The baseline data comparison period is five years for infection and safety measures, and three years for readmissions measures. Participants in these quality initiatives are encouraged to support a culture of shared responsibility that holds organizations accountable for the systems they design, while promoting an open and honest reporting environment.
As quality improvement efforts expand, new programs designed to reduce or prevent costly chronic diseases, maximize outcomes, and improve health across the patient’s life span will emerge. Some of these efforts will reach outside of hospitals’ traditional improvement models, with increasing dependence on partnerships linked to process.
Missouri ranks higher than the national average for maternal and infant mortality. To address this trend, in early 2019, Missouri was accepted into The Alliance for Innovation on Maternal Health collaborative. AIM is a federally funded, data-driven, quality improvement program to reduce maternal mortality and severe maternal morbidity. The AIM goal is to improve maternal safety and outcomes, and eliminate preventable maternal mortality and severe morbidity nationwide. The first AIM focus will engage Missouri birthing hospitals, emergency departments and OBGYN ambulatory services to improve assessment, response and treatment of severe preeclampsia and maternal hypertension.
Despite progress, the rate of opioid-related mortality and morbidity remains high. On average, nearly 190 patients per day were treated at Missouri hospitals in both inpatient and ED settings for opioid-related symptoms in 2017.i When combined with the 1,000 annual opioid-related overdose deaths among Missourians, the daily economic burden attributable to the opioid crisis in the state is $33 million.ii
To address the national opioid crisis, a multifaceted strategy — including research, policy and practice change — is being implemented. Federal funding has served as the catalyst for many initiatives, including integrated pharmacological, psychosocial and recovery-oriented approaches to opioid use disorder treatment.
Workplace violence continues to threaten delivery of care and workforce stability. Missouri’s hospitals support quality programs to reduce and eliminate workplace violence through evidence-based medicine, best practices and regulatory reform to support safe workplaces.
The Missouri Hospital Association provides performance data on 19 metrics, including specific data for hospital infections, readmissions and patient safety, tracked by Missouri hospitals.
