November 26, 2010

State rises in ranking of health care quality

Its dedication to collecting hospital data and keeping it in the public eye encourages improvements, experts say.

By John Richardson
Staff Writer

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The Maine Health data Organizations’s quality ratings can be seen at

The federal Agency for Healthcare Research and Quality posts its state ratings at

The growing use of quality ratings has created some tension between consumers who want more information and hospitals who fear the data will be misused or misunderstood.

Much of the data is self-reported and reports can be subjective or based on limited observations, said Doug Salvador, associate chief medical officer and patient safety officer for Maine Medical Center in Portland, Maine's largest hospital.

"The more we can engage patients in their health care, the better patients are going to do," Salvador said.

And, he agreed, transparency can help drive quality improvements. The hospital used the tool itself, posting each department's progress on meeting hand-washing standards where patients could see the information.

"We definitely made (hygiene) better. I think the transparency is part of that," he said.

What worries Salvador, however, is that the quality measures may not always have high-quality data behind them, he said.

"We're in the infancy of measuring health care quality," he said. "The danger is the public wants data. They want it now. They want more of it and if we put numbers up on a website that show a difference between two hospitals, two doctors or two practices when there really isn't one, that's the danger. That's happening."

Salvador said the numbers that show Maine as one of the top states, on the other hand, are credible because they are based on large samples and audited data.

"We do really well as a state compared to the rest of the country," he said.

Salvador said that is reflection of a strong quality ethic and a "culture of collaboration" between hospitals and private and public agencies that doesn't exist in other states.

Mitchell agreed that there is more work to do and that making the data both meaningful and accurate "is technically challenging."

But, she said, the information is clearly helping to improve care in Maine.

"We do not have a comprehensive review of quality, but we have more than anyone else," Mitchell said.

Staff Writer John Richardson can be contacted at 791-6324 or at:

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