Measuring Quality at Banner Health

Providing excellent patient care across an organization does not just happen. 

Banner Health has developed a systemwide approach to improve clinical quality and patient safety.  We judge our performance in several different ways, monitoring the following clinical areas:

• Clinical Outcomes: How well are we providing superior medical care?
• Patient Safety: How well are we avoiding causing harm to the patient?
• Evidence-based care: How well are we able to follow practices shown to improve patient care? 

As part of our ongoing quality-improvement efforts, we determined national standards for those selected clinical areas and the best practices used to reach those standards. We collected data at our 24 hospitals to determine how we compared to the national standards. Then, working together we developed programs to improve or maintain our performance.

Goal: To measure clinical outcomes
Measurement: Mortality rates
Banner Health account for deaths of those patients who receive acute care at our facilities (excluding those who are psychiatric, hospice and skilled nursing facility patients).

Overall, Banner Health's mortality rates compare favorably to other institutions across the country.
View our most recent score

Goal: To measure patient safety
Measurement: Preventing infections
Among the patient-safety indicators that Banner reviews carefully is the number of laboratory-confirmed bloodstream infections that occur after a central intravenous (IV) line is placed in a patient in our intensive-care units.
View our most recent scores 

Measurement: Patient Safety Indicators
We also measure safety by monitoring certain patient-safety indicators published by the Agency for Healthcare Quality and Research. These indicators include treatment complications, wound care and mortality rates.
View our most recent scores 

Goal: To measure how well we provide evidence-based care
Measurement: Care of heart-attack patients, heart-failure patients, pneumonia patients and surgical patients.
Banner Health uses four composite indicators to measure our performance in delivering evidence-based care. These indicators are the same ones that are published by Centers for Medicare and Medicaid Services. They are:

1. Heart Attack (Acute myocardial infarction or AMI) treatment: The score is a composite of eight indicators including the following:

• The percentage of acute AMI patients (without aspirin contraindications) who received aspirin within 24 hours before or after hospital arrival
• The percentage of AMI patients (without aspirin contraindications) who are prescribed aspirin at hospital discharge
•  The percentage of AMI patients with left ventricular systolic dysfunction (without both angiotensin converting enzyme inhibitor – ACEI – and angiotensin receptor blocker – ARB – contraindications) who are prescribed an ACEI or ARB at hospital discharge
• The percentage of AMI patients with a history of smoking cigarettes who are given advice during their hospital stay about how to stop smoking
• The percentage of AMI patients (without beta-blocker contraindications) who are prescribed a beta blocker at hospital discharge
• The percentage of AMI patients (without beta blocker contraindications) who received a beta blocker within 24 hours after hospital arrival
• AMI patients with ST-elevations receiving fibrinolytic therapy during the  hospital stay and having a time from hospital arrival to fibrinolysis of 30 minutes or less
• AMI patients with ST elevation receiving percutaneous coronary intervention (PCI) during the hospital stay with a time from hospital arrival to PCI of 90 minutes or less
• View our most recent score in this category

2.  Heart-failure treatment: The score is a composite of four  indicators including the following:

•  The actual percentage of heart failure patients who are discharged home with written instructions or educational materials given to the patient or caregiver that address all of the following: activity level, diet, discharge medications, follow-up appointment, weight monitoring and what to do if symptoms worsen
• The actual percentage of heart failure patients with documentation in the hospital record that left ventricular systolic (LVS) function was evaluated before arrival, during hospitalization or is planned after discharge
• The actual percentage of heart failure patients with left ventricular systolic dysfunction(LVSD) and without both angiotensin converting enzyme inhibitor (ACEI) and angiotensis receptor blocker (ARB) contraindications who are prescribed ACEI or ARB at hospital discharge
• The actual percentage of heart failure patients with a history of smoking cigarettes who are given advice during their hospital stay about how to stop smoking
• View our most recent scores 

3. Pneumonia  The score is calculated on the monthly performance of each facility as well as a Banner overall summary index for each of six indicators:  

• Pneumonia patients who had an assessment of arterial oxygenation by arterial blood gas measurement or pulse oximetry within 24 hours prior to or after arrival at the hospital
• Pneumonia patients over the age of 65 who were screened for pneumonia vaccine status and were administered the vaccine prior to discharge
• Pneumonia patients whose initial emergency room blood culture specimen was collected prior to hospital arrival
• Pneumonia patients with a history of smoking cigarettes who are given advice during their hospital stay about how to stop smoking
• Pneumonia patients who receive their first dose of antibiotics within four hours of arriving at the hospital
• The percentage of pneumonia patients who are given the most appropriate initial antibiotic. Since antibiotics are medicines that treat infection, each one is different.  Hospital caregivers need to choose the antibiotic that can best treat the infection type a pneumonia patient has.
• View our most recent score 

4. Surgical Care Improvement:  This score is based on each facility's performance and how well Banner does as a system:

• The actual percentage of surgical patients who received prophylactic antibiotics within one hour prior to surgical incision
• The actual percentage of surgical patients whose prophylactic antibiotics were discontinued within 24 hours of the surgery end time
• View our most recent score