Sustainers: Hospitals with sustained superior performance

Al‐Amin, Mona; Hefner, Jennifer L; Hogan, Tory H.; Li, Kate

doi:10.1097/hmr.0000000000000269

Cited by 8 publications

(10 citation statements)

References 45 publications

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“…This is consistent with the literature that states smaller and not-for-profit hospitals outperformed other hospitals over time. [26][27][28][29][30] Another finding was rural hospitals were more likely to have better performance on three domains (person and community engagement, safety and efficiency and cost reduction) and TPS, which is in line with previous literature. 26 This result could be explained by patients' lower expectations, which could be related to the patient and community engagement domain, as well as lower complexity of healthcare needs, with patients in rural settings with complex health issues potentially travelling to urban hospitals.…”

Section: Discussionsupporting

confidence: 89%

Telehealth and hospital performance: Does it matter?

Zhao

Hamadi

et al. 2020

J Telemed Telecare

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Introduction Previous studies indicated that telehealth services may improve hospital performance. However, the extent to which these telehealth provisions would improve hospital total performance score under the hospital value-based purchasing (HVBP) programme is not clear. The aim of this study is to examine the association between telehealth provision and hospital performance. Methods We performed a retrospective analysis of the association between the provision of telehealth services and 2699 hospital’s total performance score (TPS) on the 2018 HVBP programme and its four domains. Multivariate regression models were used to analyse TPS and hospital performance on each domain. Telehealth services offered by a hospital was categorically operationalized as hospitals with no telehealth services, with one to two telehealth services, and with three or more telehealth services. Results Hospitals with one to two telehealth services have TPS (ß coefficient = 1.50; 95% confident intervals (CI): 0.28, 2.73; p < 0.05) and hospitals with three or more telehealth services have higher efficiency and cost reduction (ß = 1.10; 95% CI: 0.32, 1.87; p < 0.01) domain scores. However, the impact of telehealth on clinical care, person and community engagement, and safety domain scores was not significant. Discussion The expansion of hospital telehealth service provision can improve not only the efficiency of care, but also the total performance of the hospital. Since total performance is directly associated with hospital payments from the government, these findings have significant practice and policy implications. In addition, the effect of telehealth on other quality measures such as clinical care and safety needs further investigation.

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Section: Discussionsupporting

confidence: 89%

Telehealth and hospital performance: Does it matter?

Zhao

Hamadi

et al. 2020

J Telemed Telecare

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“…The program evaluates hospitals’ quality of care and incentivizes hospitals to improve targeted measures. These incentives are determined based on hospitals’ total performance scores (TPS) (2,3). The TPS is an indicator for the quality of care, and it measures four domains (clinical care processes, patient safety outcomes, patient satisfaction, and efficiency).…”

Section: Introductionmentioning

confidence: 99%

“…Prior research documents that patient-and hospital-level characteristics and four hospital service domains (nursing care, physician care, staff performance, and hospital environment) act as determinants of patient satisfaction. There is evidence that age (11), race/ethnicity (12)(13)(14), and gender (15) are related to patient ratings on inpatient stay (2,(16)(17)(18)(19). Previous studies investigated the association between the four hospital service domains and patient ratings on inpatient stay.…”

Section: Introductionmentioning

confidence: 99%

Factors Impacting Patients’ Willingness to Recommend: A Structural Equation Modeling Approach

Park

et al. 2022

Journal of Patient Experience

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Patient ratings of inpatient stay have been the focus of prior research since better patient satisfaction results in a financial benefit to hospitals and are associated with better patient health care outcomes. However, studies that simultaneously account for within- and between-hospital effects are uncommon. We constructed a multilevel structural equation model to identify predictors of patients’ willingness to recommend a hospital at both within-hospital and between-hospital levels. We used data from 60 U.S. general medical and surgical hospitals and 12,115 patients. Multilevel structural equation modeling reported that patient ratings on the overall quality of care significantly affect the willingness to recommend within hospitals. Also, patients’ perspectives on the hospital environment and nursing are the significant factors that predict the patient ratings on the overall quality of care. Overall patient satisfaction significantly predicts the willingness to recommend at the between-hospital level, whereas hospital size and location have marginal impacts.

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“…They relied on the Hospital Consumer Assessment of Healthcare Providers and System, which captures the person and community engagement domain of TPS, to assess performance. Al-Amin et al (2021) later relied on HVBP-TPS, a more comprehensive measure of performance than the Hospital Consumer Assessment of Healthcare Providers and System, and classified hospitals as sustainers if they have maintained high HVBP-TPS over the years despite the changes in how TPS scores were measured. More specifically, sustainers are “hospitals that were among the top 25th percentile on TPS for four consecutive years” (Al-Amin et al, 2021).…”

mentioning

confidence: 99%

“…Al-Amin et al (2021) later relied on HVBP-TPS, a more comprehensive measure of performance than the Hospital Consumer Assessment of Healthcare Providers and System, and classified hospitals as sustainers if they have maintained high HVBP-TPS over the years despite the changes in how TPS scores were measured. More specifically, sustainers are “hospitals that were among the top 25th percentile on TPS for four consecutive years” (Al-Amin et al, 2021). Previous research indicates that sustainers account for less than 10% of hospitals in the United States and tend to be small not-for-profit hospitals with higher registered nurse staffing levels (Al-Amin et al, 2021).…”

mentioning

confidence: 99%

Were hospitals with sustained high performance more successful at reducing mortality during the pandemic’s second wave?

Al‐Amin

Hefner

et al. 2023

Health Care Manage Rev

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BackgroundIn 2019, the COVID-19 pandemic emerged. Variation in COVID-19 patient outcomes between hospitals was later reported.PurposeThis study aims to determine whether sustainers—hospitals with sustained high performance on Hospital Value-Based Purchasing Total Performance Score (HVBP-TPS)—more effectively responded to the pandemic and therefore had better patient outcomes.MethodologyWe calculated hospital-specific risk-standardized event rates using deidentified patient-level data from the UnitedHealth Group Clinical Discovery Database. HVBP-TPS from 2016 to 2019 were obtained from Centers for Medicare & Medicaid Services. Hospital characteristics were obtained from the American Hospital Association Annual Survey Database (2019), and county-level predictors were obtained from the Area Health Resource File. We use a repeated-measures regression model assuming an AR(1) type correlation structure to test whether sustainers had lower mortality rates than nonsustainers during the first wave (spring 2020) and the second wave (October to December 2020) of the pandemic.ResultsSustainers did not have significantly lower COVID-19 mortality rates during the first wave of the pandemic, but they had lower COVID-19 mortality rates during the second wave compared to nonsustainers. Larger hospitals, teaching hospitals, and hospitals with higher occupancy rates had higher mortality rates.ConclusionDuring the first wave of the pandemic, mortality rates did not differ between sustainers and nonsustainers. However, sustainers had lower mortality rates than nonsustainers in the second wave, most likely because of their knowledge management capabilities and existing structures and resources that enable them to develop new processes and routines to care for patients in times of crisis. Therefore, a consistently high level of performance over the years on HVBP-TPS is associated with high levels of performance on COVID-19 patient outcomes.Practice ImplicationsInvesting in identifying the knowledge, processes, and resources that foster the dynamic capabilities needed to achieve superior performance in HVBP might enable hospitals to utilize these capabilities to adapt more effectively to future changes and uncertainty.

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Sustainers: Hospitals with sustained superior performance

Cited by 8 publications

References 45 publications

Telehealth and hospital performance: Does it matter?

Telehealth and hospital performance: Does it matter?

Factors Impacting Patients’ Willingness to Recommend: A Structural Equation Modeling Approach

Were hospitals with sustained high performance more successful at reducing mortality during the pandemic’s second wave?

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