Consistency Boosts Quality For Truven's Top 15 Systems

By Christine Kern, contributing writer

Being in a “good rut” can be a good thing for hospital ratings.

Truven Health Analytics recently released its list of the top 15 healthcare systems, and it is clear that concerted attention to consistency and efficiency of healthcare for patients was essential for top rankings.

As Modern Healthcare reports, one system, OhioHealth, has established protocols – called “good ruts” by leaders there – ensuring consistency of care at all of its 12 hospitals. OhioHealth's chief medical officer Dr. Bruce Vanderhoff explained, “The 'rut' liberates the physician and allows them to focus their expertise where it is most needed.”

The system's efforts have paid off. This year marks the fifth year in a row OhioHealth is being recognized as one of Truven's 15 Top Health Systems. The recognition is given for high achievement in clinical performance, efficiency, and patient satisfaction.

Truven’s SVP of performance improvement, Jean Chenoweth, explains, “Consistency across sites of care is terribly important as transparency increases under the Affordable Care Act. It's a major goal of these very high-performing systems.”

Truven's sixth annual list of the 15 Top Health Systems is based on aggregated data for all of a system's hospitals. The 15 systems include the top five each from large, medium, and small health systems across the nation with system size based on total operating expenses.

The study used publicly available government data to assess eight performance measures. The criteria included death rates, complications, 30-day readmission rates, lengths of stay, a patient-safety index, and Hospital Consumer Assessment of Healthcare Providers and Systems score. The data are adjusted for the illness severity of patient populations.

On average, winning systems saw a 10 percent shorter hospital stay than their peers with small systems seeing an even of 16 percent difference in length of stay compared with the benchmark. The top 15 hospital systems also outperformed their peers by 8 percent on the patient-safety index, meaning they had fewer adverse patient-safety events. Safety performance was higher among small and medium-sized systems, which performed 14 percent and 11 percent better, respectively.

Eight health systems were on the list for the second consecutive year: Advocate Health Care, OhioHealth, and Scripps Health for the large health systems; Alegent Creighton Health, Mercy Health Southwest Ohio Region, and Mission Health for the medium systems; and Asante and Roper St. Francis Healthcare for the small systems.

According to Chenoweth, the concept of “systemness,” coordinating efforts across organizations that elevate quality and provide maximum value for the consumer, has caught on since Truven first began publishing its 15 Top Health Systems list six years ago. “When we first published in 2009, we didn't see very much consistency across (a system's hospitals in) the metrics we were measuring, but today these particular systems are showing a great deal of consistency and high performance,” she said. “That is good news.”

As early as next year, Truven is looking at adding new measures on cost and financial performance, including per-patient spending on Medicare beneficiaries and system operating margins. Preliminary analyses show a lot of variation among hospitals in a system on these measures, Chenoweth said.

This year’s leaders expressed that a key to their success was the importance of finding collaborative ways to work with doctors and nurses to identify areas that need improvement. Several systems said they identified staff members who were trusted by other staff and were seen as clinical practice leaders. These individuals, they say, not only helped identify best practices, but also led the way in implementing them.