Peer Review May Help to reduce Mortality at Poorly Performing Hospitals


Thumbs Up for Medical Quality Assurance

Medical quality assurance stands at the forefront of Germany’s Helios Hospital Group’s expansion plans. Becker’s Hospital Review writes that 18 acute-care German hospitals recently purchased by the group experienced high mortality rates. According to a study in Health Affairs, Helios initiated a medical quality assurance program that significantly reduced these mortality rates.

Emphasizing Medical Quality Assurance

According to the Helios Hospital Group’s website, they rank among the largest and most medically advanced hospital groups in Europe. Since their inception in 1994, the Helios Group placed a strong emphasis on medical quality assurance.

Studying these 18 hospitals between 2004 and 2009, researchers found that each hospital implemented the Helios medical quality assurance management system, which was based on measurement, analysis and improvement by employing these five steps:

1. Hospitals measure outcome, volume and other indicators.

2. The Helios Medical Advisory Board evaluates the indicators and schedules peer review for sub-par hospitals that demonstrate high in-hospital mortality rates.

3. During peer review, the hospital conducts a self-assessment of selected cases and a team of peers analyzes patient records with local head physicians to identify problems.

4. Based on the peer review the hospital recommends changes to treatment and care processes.

5. Managers monitor the progress. If there is no improvement, they repeat the peer review process.

Experiencing Substantial Improvement

Results showed considerable improvement, demonstrating medical quality assurance through peer review to be highly effective. Three years after the intervention, in-hospital mortality rates for myocardial infarction, heart failure, ischemic stroke and pneumonia at the initially sub-par hospitals were significantly reduced from rates measured one year before the intervention.

Since more emphasis is placed on medical quality assurance and quality measures in the U.S. thanks to the Joint Commission, steep challenges still lie ahead for radiology departments to make certain that some core quality assurance processes are in place.

Based on the promising results noted above, it’s clear that all radiologists must be engaged in the quality assurance process.

What quality assurance challenges is your organization facing?

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