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H PRO TOP 1201 10606 15 Top Health System Abstract.Indd 15 TOP HEALTH SYSTEMS: STUDY OVERVIEW AND RESEARCH FINDINGS 4TH EDITION JANUARY 16, 2012 Thomson Reuters 777 E. Eisenhower Parkway Ann Arbor, MI 48108 +1 800 366 7526 Thomson Reuters 15 Top Health Systems, 2012 Study Thomson Reuters 100 Top Hospitals is a registered trademark of Thomson Reuters. ©2012 Thomson Reuters All rights reserved. Printed and bound in the United States of America. The information contained in this publication is intended to serve as a guide for general comparisons and evaluations, but not as the sole basis upon which any specific conduct is to be recommended or undertaken. The reader bears sole risk and responsibility for any analysis, interpretation, or conclusion based on the information contained in this publication, and Thomson Reuters shall not be responsible for any errors, misstatements, inaccuracies, or omissions contained herein. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without permission in writing from Thomson Reuters. ISBN 978-1-57372-457-9 contents INTRODUCTION 1–2 Identifying Improvement Opportunities for the Entire Industry ...................... 1 The 15 Top Health Systems ................................................................................ 1 The 100 Top Hospitals® Program ......................................................................2 About Thomson Reuters ...................................................................................2 FINDINGS 3-9 Beginning the Performance Improvement Process .........................................3 30-Day Post-Discharge Mortality Rates Increasing — But Hospitals at Winning Health Systems Have Better Results ..................3 Winner Versus Peer Results ..............................................................................4 Winning Health System Results .......................................................................7 Top and Bottom Quintile Results .....................................................................9 METHODOLOGY 11-20 Overview ..........................................................................................................11 Building the Database of Health Systems ......................................................11 Identifying Health Systems ............................................................................. 12 Classifying Health Systems Into Comparison Groups .................................... 13 Scoring Health Systems on Weighted Performance Measures ..................... 13 Performance Measures Used in the Study ..................................................... 15 Determining the 15 Top Health Systems......................................................... 20 WINNERS THROUGH THE YEARS 21 APPENDIX A. HEALTH SYSTEM WINNERS AND THEIR MEMBER HOSPITALS 23-25 APPENDIX B. THE TOP QUINTILE: BEST-PERFORMING SYSTEMS 27-28 APPENDIX C. METHODOLOGY DETAILS 29-36 Methods for Identifying Complications of Care ............................................. 29 Core Measures ................................................................................................33 30-Day Risk-Adjusted Mortality Rates and Readmission Rates ...................34 HCAHPS Overall Hospital Rating ...................................................................34 Length of Stay Methodologies .......................................................................35 Why We Have Not Calculated Percent Change in Specific Instances ............36 Protecting Patient Privacy ..............................................................................36 APPENDIX D. ALL HEALTH SYSTEMS IN STUDY 37-44 REFERENCES 45-46 INTRODUCTION IDENTIFYING IMPROVEMENT OPPORTUNITIES FOR THE ENTIRE INDUSTRY Although hospitals have been using facility-wide Large Health Systems Location performance improvement programs for quite (>$1.5 billion) some time, many health systems do not have Banner Health Phoenix, AZ such a program in place. One of the roadblocks Ca reGroup Healthcare Boston, MA is the lack of reliable and consistent performance System measure data across the nation’s healthcare Jefferson Health System Radnor, PA systems. Memorial Hermann Houston, TX Healthcare System Thomson Reuters 15 Top Health Systems is the St. Vincent Health Indianapolis, IN only study that aggregates individual hospital performance into system-level data. Building Medium Health Systems Location on the 100 Top Hospitals® National Balanced ($750 million – $1.5 Scorecard concept,1 this research allows health billion) system leaders to understand how they measure Baystate Health Springfield, MA up in terms of clinical quality and efficiency. By Geisinger Health System Danville, PA objectively measuring health system quality and HCA Central and West Austin, TX revealing a group of top performers, the study Texas Division provides health system leaders with useful data for Mission Health System Asheville, NC performance benchmarking. Prime Healthcare Ontario, CA Services This year’s study contained more than 300 organizations — almost every U.S. system with two Small Health Systems Location or more acute-care member hospitals, including (<$750 million) critical access hospitals. Like all 100 Top Hospitals Baptist Health Montgomery, AL studies, the research uses publicly available data Maury Regional Columbia, TN and objective statistical analysis developed and Healthcare System carried out by a well-rounded team of researchers Poudre Valley Health Fort Collins, CO that includes epidemiologists, statisticians, System physicians, and former hospital executives. Saint Joseph Regional Mishawaka, IN Health System THE 15 TOP HEALTH SYSTEMS Tanner Health System Carrollton, GA To survive in an industry challenged by a slow-to- The winners of the 15 Top Health Systems award improve national economy, increased competition, outperformed their peers in a number of ways. They: and a new set of rules imposed by healthcare reform, providers must deliver ever-higher quality • Saved more lives and caused fewer patient and become more efficient — doing more with complications potentially lower reimbursements. • Followed industry-recommended standards of care more closely To show health system leaders what the highest • Made fewer patient safety errors performers have achieved, we selected the 15 • Released patients half a day sooner highest-performing health systems in the study • Scored better on overall patient satisfaction population, based on a composite score of eight surveys measures of quality and efficiency. This year’s Thomson Reuters 15 Top Health Systems, placed into size categories by total operating expense, are: Thomson Reuters 15 Top Health Systems 1 And despite the long-heralded and widely known • The 100 Top Hospitals Everest Award, identifying statistics on decreasing mortality rates at U.S. a unique group of hospitals with both the best hospitals, new research from Thomson Reuters current performance and the best performance finds that the rate of patients dying after they leave improvement over five years the hospital is increasing for U.S. hospitals overall. • The 50 Top Cardiovascular Hospitals study, Hospitals that are part of the 15 Top Health Systems identifying hospitals that demonstrate the are bucking this trend. highest performance in hospital cardiovascular services Understanding the similarities and differences • A variety of custom benchmark reports designed between high and low performers provides to help executives understand how their benchmarks for the entire industry. Each year, performance compares with their peers the relevant benchmarks and robust findings we assemble for the 100 Top Hospitals® studies provide You can read more about these studies, and see numerous examples of excellence, as evidenced in a lists of all winners, by visiting 100tophospitals.com. number of published studies.2–18 To read more about the differences between this year’s health systems ABOUT THOMSON REUTERS study winners and their peers, see the Findings section. Thomson Reuters is the world’s leading source of intelligent information for businesses and THE 100 TOP HOSPITALS PROGRAM professionals. We combine industry expertise with innovative technology to deliver critical information For 19 years, the 100 Top Hospitals program has to leading decision makers in the financial, legal, used independent and objective research to guide tax and accounting, healthcare, science, and media hospitals and health systems to improve their markets, powered by the world’s most trusted news performance. Hospitals and health systems do not organization. With headquarters in New York and apply, and winners do not pay to market this honor. major operations in London and Eagan, Minnesota, To increase understanding of trends in specific Thomson Reuters employs 55,000 people and areas of the industry, the program includes a range operates in over 100 countries. of studies and reports in addition to the 15 Top Health Systems study, including: • 100 Top Hospitals, our flagship study, identifying the top U.S. acute-care hospitals, using a set of measures that evaluate performance excellence in clinical care, patient perception of care, operational efficiency, and financial stability 2 Thomson Reuters 15 Top Health Systems FINDINGS BEGINNING THE PERFORMANCE IMPROVEMENT that do not meet certain standards for 30-day PROCESS mortality rates for heart failure, heart attack, and pneumonia patients are financially
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