If hospitals published a Consumer Reports-style comparison of how often they perform some simple procedures that tend to keep patients from having serious complications, the reports couldn’t be downloaded fast enough, right?

Well, there is a report out there measuring quality indicators of Iowa’s hospitals, but it has been primarily doctors, not the public, who have been sitting up and taking notice.

“What’s most interesting is that when you take these measures and release them to (the doctors), they’re freaked out,” said Dr. Tom Evans, president of the Iowa Healthcare Collaborative. “There isn’t a hospital or a physician that thinks that they’re in the lower 50th percentile. So what happens is that quality clinical measures that are released cause tremendous energy (among physicians).”

Originally formed through a partnership of the Iowa Hospital Association and the Iowa Medical Society, the Iowa Healthcare Collaborative has grabbed the attention of nearly all of the state’s hospitals and resulted in an unprecedented sharing of knowledge, even among competing organizations, Evans said. Working to implement the latest in quality improvement techniques, the group last year released its first Iowa Healthcare Report, and this year is sponsoring a number of forums to move the effort forward.

“Historically in health care, it’s been difficult to compare one health system to another, because everyone has defined quality differently,” he said.

Since 2000, however, there have been a number of successes in standardizing those measures. One of the first efforts came in 2002, when the Hospital Quality Initiative provided a set of 10 measures of clinical quality. In 2004, the National Quality Forum released 30 standardized measures of procedures proven to improve patient safety, known as the 30 Safe Practices.

“We thought (the 30 Safe Practices) was so important, we took the role of promoting it to hospitals,” Evans said. “We did a survey of all the hospitals, asking: are you aware these are out there, how important are they, and where are you with deploying these?”   When 88 percent of the state’s hospitals returned the survey – an overwhelming response rate for any survey – “we knew we had some good pretty good engagement with the providers in the state,” he said. Last year, the Iowa Healthcare Collaborative followed up with a Web-based survey of those 30 safe practices, asking each hospital to complete a detailed self-assessment of how those procedures were being carried out. All but three of the state’s 116 hospitals, or 97 percent, returned the survey.

“Now that we have some measures of what that would be, we have coordinated a discussion among Iowa health-care providers, they’re actually stumbling over each other to help each other improve care,” Evans said.

Reducing the rate at which patients get serious infections while in the hospital is one example of how the Iowa Healthcare Collaborative is making a difference, said Dr. Lisa Veach, an epidemiologist with Iowa Health – Des Moines.

One specific procedure that Iowa Health’s and many other Iowa hospitals have adopted in infection control is to administer an antibiotic just prior to surgery to reduce the rate of post-operative infections.

Because the timing of the antibiotic dose is critical to its effectiveness, “a protocol is put in place to make sure the dose is given when needed, neither too early nor too late,” Veach said.

Preventing just one hospital-borne infection can save $40,000 in additional treatment costs related to lengthier hospitalizations, not to mention the benefits to the patient and family, she said.

“Basically, we’ve seen a nice improvement (in outcomes),” Veach said. “We can definitely say we’ve improved that process, and we know that leads to better outcomes.”

The Collaborative’s primary mission is to use information to improve care, and to create a culture of continual improvement in quality, patient safety and value, Evans said. Along those lines, among the events scheduled later this year by the Collaborative is a forum on introducing lean manufacturing-type concepts into the healthcare environment.

“It’s a flashlight, it isn’t a hammer,” he said. “It illuminates what the opportunities are; it helps us ask the next question. But it still creates the situation where the providers who deliver the care have to conceive of the changes and execute them.”

More information about the Iowa Healthcare Collaborative and the 2005 Iowa Healthcare Report can be accessed at www.ihconline.org.