Public reporting measures don’t indicate hospital safety

Editor's Note

Common measures used to rate hospital safety, such as the Agency for Healthcare Research and Quality (AHRQ) Patient Safety Indicators and the Centers for Medicare & Medicaid Services (CMS) Hospital-acquired Conditions, do not accurately capture the quality of care provided, this study finds.

Only one measure out of 21 met the scientific criteria for being considered a true indicator of hospital safety. That measure was PSI 15, accidental punctures or lacerations obtained during surgery.

The use of these measures for public reporting and pay-for-performance should be reevaluated in light of these findings, the authors say.

Background: AHRQ Patient Safety Indicators (PSIs) and CMS Hospital-acquired Conditions (HACs) are increasingly being used for pay-for-performance and public reporting despite concerns over their validity. Given the potential for these measures to misinform patients, misclassify hospitals, and misapply financial and reputational harm to hospitals, these need to be rigorously evaluated.