Measuring Value—Our Accountability
Multiple parties measure the value of the care we provide:
Ideally, our patients look to us and say, “You made it easy for me to get the care I needed.” Or, “I thought the cost of care was fair.” Or, “I was treated at multiple Stanford Health Care clinics, and the communication between them was excellent.” The ultimate measure of success at fulfilling our goal of delivering quality care is patient satisfaction. If the end recipients of all our efforts feel positive about their experience, we have succeeded.
A critical measure of patient satisfaction is the “Likelihood to Recommend” ranking in patient surveys. This ranking, benchmarked against some of our most challenging cases such as cancer patients, shows that our Cancer Center continues to demonstrate strong performance year over year. In fact, we’ve maintained top rankings for the past four years, including, most recently, an 88 percent ranking that put us in the 91st percentile of all cancer centers.
Stanford Health Care has seen consistent overall improvement, with primary drivers of inpatient services, primary care, specialty care, emergency department, and cancer care.
In 2017, we achieved:
- 83.6 percent ranking—target: 83 percent
- 78th percentile
- 5-star rating for “Likelihood to Recommend” on the Centers for Medicare & Medicaid Services (CMS) hospital comparison website
LIKELIHOOD TO RECOMMEND
C-I-CARE—our framework for structuring best practice communications and relationship-based care with patients—was a key contributing factor in our past year’s improvement in the “Likelihood to Recommend” ranking.
The many companies that choose Stanford Health Care for their employees’ care rely on us to help keep their workforce healthy and satisfied with the care they receive. Employers also expect to achieve a return on their investment and closely analyze the overall value of the services we provide. And to make our care as convenient as possible, we are leveraging the trend by Silicon Valley’s largest employers to bring health care where employees spend the most of their time. Currently, we have on-site clinics at Cisco, Oath (formerly Yahoo!), and Qualcomm.
We hold ourselves to the highest standard and take pride in being the best partner possible for patients, employers, and payers. U.S. News & World Report once again ranked Stanford Hospital as one of the top 10 hospitals in the nation in 2018. We also measure ourselves against other academic medical centers, using the Vizient™ Quality and Accountability Study—a system that measures real-time patient data.
In 2017, we increased our overall Vizient ranking 69 percent over the previous year. The study assesses key measures including:
Observed vs. Expected Mortality Rate
In 2017, we established a new baseline to measure improvement in mortality rate. Our rankings improved continually and, by the end of the year, we were at levels within our target range.
CAUTI: Catheter-Associated Urinary Tract Infections
Our initiatives in 2017 significantly decreased both the duration of catheterization and number of infections:
- 59 percent reduction year to year
- Average duration of catheterization dropped more than 50 percent
The major drivers of improvement in our programs include:
- Early removal of urinary catheters
- Good handwashing hygiene
- Use of alternative external devices
CLABSI: Central Line-Associated Bloodstream Infections
The majority of CLABSI cases are preventable. To optimize our prevention rate, our hematology and oncology specialists recognized their patients’ vulnerability to infection and worked to eliminate CLABSI in their unit. They created a task force to identify the most effective actions to achieve their goal, including the top three:
- Consistency in following proven standards of care across all cases involving catheters
- A campaign focused on the benefits of handwashing; benefits can include a reduction in CLABSI rates
- “Scrub the Hub” education that involves training all our health care professionals in the safest way to connect, disconnect, and clean the hub at each end of a catheter
The result: Our CLABSI rate has dropped to under 1.0 (meaning less than one occurrence per 1,000 days on a central line catheter) in the most recent measurement.
VALUE FOCUSED: A PATIENT-CENTERED FOUNDATION
The advances we have made in reshaping the health care landscape with innovations that are uniquely Stanford and our successes advancing digitally driven initiatives all converge to deliver value. Value in the quality of our care, value in the reach of our access and network, and value in strong fiscal management. These advances herald a cultural shift at Stanford Medicine. Human-centered and discovery-led, we are making value-based care a reality. Not just for the patient journey but for providers, payers, and the community at large.