1. Quality Health Indicators
Brought to you by…
Quality Health Indicators
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2. Menu About QHi Defining your facility Selecting Measures Entering Data
Dashboards
Reports
How we use the data
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3. Quality Health Indicators
The Quality Health Indicator (QHi) web site was developed through KHA and KRHOP to facilitate a benchmarking project for rural Kansas hospitals.
The goal of QHi is to provide hospitals an economical instrument to evaluate internal processes of care and to seek ways to improve those practices by comparing specific measures of quality with like hospitals.
Using QHi as a tool, regional networks of hospitals and individual facilities can select from a library of quality indicators to determine which measures meet their unique needs.

4. Quality Health Indicators
Critical Access Hospitals in Kansas, Michigan, Nebraska, Oklahoma, South Dakota, Alaska, Wyoming and Missouri use QHi as a data collection tool.
Through this multi-state project, QHi is well positioned to serve as a significant repository of information on quality of care and performance in Critical Access Hospitals nationwide.

5. Quality Health Indicators
Four Pillars Of Measurement
Clinical
Quality
Financial
Operational
Employee
Contribution
Patient
Satisfaction

6. QHi Core Measure Set Clinical Quality
All participating hospitals are asked to collect and report the 8 QHi Core Measures
Clinical Quality
Healthcare Acquired Infections per Patient Day
Pneumonia Patients Given Antibiotics within 6 hours of admission (CMS PN-5c)
Pneumonia Patients Receiving Pneumonia Immunization (CMS PN-2 )
Unassisted Patient Falls
Employee Contribution
Benefits as a Percentage of Salary
Staff Turnover
Financial Operational
Gross Days in AR
Days Cash on Hand

7. Clinical Quality Measures
Additionally, facilities select from over 50 measures
in the QHi library of indicators
Clinical Quality Measures
Healthcare Acquired Infections per Patient Day
Unassisted Patient Falls
Inpatients Screened for Pneumonia
Medication Omissions Resulting in Medication Error
Medication Errors Resulting from Transcription Errors
ER Provider Response Times
Return ER Visits within 72 hours with same diagnosis
Readmits Within 30 Days with Same or Similar Diagnosis
CMS Pneumonia Measures
Inpatients Receiving O2 Assessment within 24 hours of admission - CMS Pn-1
Inpatients Receiving Pneumonia Immunization - CMS Pn-2
Pneumonia Given Antibiotics within 4 hours of admission - CMS Pn-5b
Pneumonia Given Antibiotics within 6 hours of admission - CMS Pn-5c
CMS OP Transfer Measures
Percentage of eligible patients who received thrombolytic therapy - CMS OP-1 and OP-2
Median Time from Emergency Dept Arrival to Time of Transfer to another Facility for Acute Coronary Intervention -compare to CMS OP-3
Number of AMI patients without aspirin contraindications who received aspirin within 24 hrs -CMS OP-4
Percentage of AMI or Chest Pain pts receiving ECG within 10 min. of arrival (prior to transfer) CMS OP-5

8. The following measures exist for each pillar:
Financial/Operational
Bad Debt Expense
Charity Care
Cost per Patient Day
Current Ratio
Days Cash on Hand *
Gross Days in AR *
Labor Hours per Patient Day
Net Patient Revenue per Patient Days
Newest Financial/Operational Measures
Physical Therapy Labor Hours per Unit of Service
Laboratory Labor Hours per Unit of Service
X-Ray Labor Hours per Unit of Service
Mammogram Labor Hours per Unit of Service
Ultrasound Labor Hours per Unit of Service
CT Labor Hours per Unit of Service
MRI Labor Hours per Unit of Service
Pharmacy Labor Hours per Unit of Service
Nursing Hours per Patient Day
Rural Health Clinic Encounters per FTE
Long Term Care Hours per LTC Patient Day
Laboratory Hours per Billed Service
Operating Profit Margin (percent)
Payer Mix - Commercial
Payer Mix - Medicaid
Payer Mix - Medicare
Payer Mix - Other
Payer Mix - Other Government
Payer Mix - Self/Private Pay
*QHi Core Measure Set

9. The following measures exist for each pillar:
Employees
Average Time to Hire (All Staff)
Average Time to Hire (Non-Nursing)
Average Time to Hire (Nursing)
Benefits as a Percentage of Salary*
Non-Nursing Staff Turnover
Nursing Staff Turnover
Salary to Operating Expenses Comparison
Staff Turnover *
Patient Satisfaction
How well staff worked together to care for the patient
How well the patients pain was controlled
Likelihood of recommending this hospital to others
Overall rating of care given to hospital
The extent to which the patient felt ready for discharge
*QHi Core Measure Set

10. QHi users log directly in to the site at www. qualityhealthindicators
QHi users log directly in to the site at

11. Quality Health Indicators
A user name ( address) and password is required to enter this secure web site. The password must be 8 characters that include upper and lower case letters and at least one number. For example: myQhi789
The level of access is determined by the user type.
System Administrator – maintains the site (KHA)
State Administrator –provides support to Hospital Contacts in their State
Network Administrator – maintains Network profiles & provides support
Hospital Contact – maintains Hospital profiles , adds users & enters data
Hospital User – enters data and runs reports
View Only – views data and runs reports

12. Select Announcements & Calendar to view the portal home page.
The HQRA (Healthcare Quality in Rural America) portal, introduced in 2008, provides access to multiple resources with just one log in.
Users navigate from resource to resource by selecting the appropriate tab.

13. Click QHi tab to return to QHi
The Event Calendar provides a monthly view of upcoming QHi training sessions and advisory committee meetings
… as well as Webinars related to the overall Quality Project.

14. Defining
Your
Hospital
Return to Main Menu

15. Click Administration to view Hospital Profile Page

16. Hospital Characteristics define each facility for the creation of peer groups when running reports.
Question marks provide pop-up definitions throughout the QHI site. 16

17. 17 Entire Enterprise or CAH only.
Select Entire Enterprise, if other entities are included in your financial reporting, i.e. Long Term Care Unit or Rural Health Clinics.
Select Hospital only for CAH or 25 beds or less or Hospital only for non-CAH, greater than 25 beds, if you will report financial information for your Hospital only.
Note: This applies only to Financial/Operational measures. Clinical Quality measures should be reported only for your acute care hospital. 17

18. Selecting
Measures
Return to Main Menu

19. In Part E of the Hospital Profile, users can select the default measures predetermined by their State or Network. 19

20. Part G lists the measures within the measure sets currently collected by the hospital.20

21. The show elements link displays the elements required to calculate the measure.
Question marks provide further definition of the elements. 21

22. The number of hospitals collecting the measure.
Additional measures can be selected in Part H.
The number of hospitals collecting the measure.
Individual hospitals can select any/all measures that meet their needs. 22

23. Entering
Data
Return to Main Menu

24. The prior months entry displays for guidance.
Data elements populate the data entry screen based on measures selected in the Hospital Profile.
The prior months entry displays for guidance.
Calculate Measures provides instant feedback by automatically calculating measures and immediately displaying results. 24

25. Users Save data by clicking “Save All and Stay”
In addition, new enhancements provide instant validation for most elements, displaying error messages if potential ‘outliers’ are entered.
Entered information is not pulled into the database for display on the dashboard or in reports until the Activate Data for Reporting box is checked.

26. The
Dashboard
Return to Main Menu

27. The Core Measures Dashboard provides comparison data for the 8 QHi Core measures.
All data is calculated using a consecutive three month summing average.
State Avg values pertain to data from hospitals that reside in the same state as hospital being viewed and are reporting in the same time interval.
QHi Avg values pertain to all hospitals in QHi that are reporting same measure and are reporting in the same time interval.

28. Financial measures on the dashboard default to peer groups based on the hospitals level of reporting, either CAH Only or Entire Enterprise.
Hospitals must have activated data for at least one of the three months displayed to view the dashboard measure.
Hospital specific data for pneumonia measures will not display for hospitals with no occurrences during the reporting period.

29. The Dashboard can be viewed as a table

30. Table View

31. Change the 3 months viewed by selecting a different start month.

32. Click to view as a PDF
The Dashboard can be printed in graph or table view. Excellent for board and committee meetings.

33. The PDF format allows the user to save, print or email the document.

34. …or choose another recipient
Or users can simply the report in PDF to themselves by clicking “To Myself”
…or choose another recipient

35. Users select from existing registered users
…or add a new recipient

36. …Enter the Name and Email address of the new recipient
…and click Add New

37. Create Schedule

38. Select a run date
Select the frequency
Select Recipients
Save Schedule
Report is sent through as a PDF attachment.

39. Create a customized dashboard by clicking View My Dashboard

40. Click the drop down to select measures to display.
Only those measures collected by the hospital are visible.
Selected measures are retained and user specific.

41. Reports
Return to Main Menu

42. Reports are available for all measures in QHi.
Hospitals view reports only for those measures and data elements they collect.
There are 6 categories of reports
Clinical Quality
Employees
Financial Operational
Hospital Characteristics
Patient Satisfaction
System 42

43. 43 Step 2: Select a date range and grouping interval
Step 1: Select from these 4 default peer groups.
State
All QHi
My Network
My Medicare Region 43

44. In Step 3, hospitals define a customized peer group based on a list of hospital characteristics.
Multiple values can be selected to better define the peer group. 44

45. Step 4 lists available values for the criteria in Step 3.45

46. Step 5 holds the selected criteria.
The results can be displayed in 4 formats by clicking:
View Line Graph
View Bar Graph
View Table or
View Text Detail Measure
Step 5 holds the selected criteria. 46

47. The Graph View 47

48. The Bar Graph View 48

49. The Table View 49

50. 50 Click Export to export report data to Excel.
The users facility is identified by ‘Hospital’
The Text Detail View
Please note: Hospitals are not identified by name. 50

51. From Excel users can create customized graphical displays to meet their needs.

52. Hospitals can be contacted for benchmarking by clicking the envelope icon.
The Text Detail View 52

53. The hospital contact at the selected facility receives an email message.
Hello,
Hospital 2 is interested in discussing some benchmarking opportunities with your facility.
You may contact me at
Thank you, Sally 53

54. Educational materials and worksheets to facilitate data collection are available for download on the Help page. 54

55. How we use the data
Return to Main Menu

56. Quality Health Indicators
What do we do with the data?
A few comments from our hospitals…
I print a copy of the graphs and take it to the board for discussion. They appreciate seeing in color how we compare to other CAHs in KS as well as others in the USA.
On a quarterly basis I am giving a copy of the bar graphs to our Board Members at their meeting.
I give the Quality Committee a copy of the quality reports on a quarterly basis.
We track and present our indicators monthly and are usually above the norm. On the occasions when we fall below, it prompts us to review processes to seek improvements.
If we fall below expectations, we look for ways to improve and then report back to the board in the next quarter.
We like the Days in AR report. This is our only source for comparative information on this measure.

57. Thank you for viewing this demonstration.
If you have any questions or would like additional information on the QHi project, please contact
Sally Perkins, QHi System Administrator
Director of Data Services
at the Kansas Hospital Association