First in NY State to voluntarily post mortality rates,
infection control efforts and other performance indicators

New York City – The New York City Health and Hospitals Corporation (HHC) today released details of its record on certain key performance measures, including mortality and hospital-acquired infection rates, in response to consumer demands for better and more detailed information about hospital quality and safety, and in an effort to drive further performance improvements. The data is available on the HHC website, www.nyc.gov/hhc. HHC also posted how often NYC public hospitals are following best clinical practices in treating certain serious conditions like heart attacks and pneumonia, and how well public nursing homes are doing in reducing falls, bed sores and managing pain.

"While hospitals almost universally market themselves with slogans that tout the quality of their care, very few have actually been willing to share the data that might support those claims." said HHC President Alan D. Aviles. "By posting quality and safety information that is objective, understandable and timely, we are showing our willingness to be held publicly accountable for doing all that we can to provide reliable, effective health care and to keep our patients safe."

In a new website section, HHC in Focus on www.nyc.gov/hhc, the public will be able to review how HHC and its 11 hospitals and 4 long term care facilities compare to state and national benchmarks on a number of quality indicators. The section will feature graphs and charts to make it easy to track performance trends at various HHC facilities over time. The city’s public hospitals are the first in the state of New York to voluntarily disclose detailed mortality and hospital-acquired infection information to the public. The rest of the data has been available through the Centers for Medicaid and Medicare Services (CMS).

"Measurable progress begins with understanding the true story of current performance. Transparency and honesty are not only essential for moving toward better health care, they are the first crucial steps," said Donald Berwick, MD, MPP, President and CEO of the Institute for Healthcare Improvement, a non-profit organization helping to catalyze improvement in healthcare in the U.S. and globally. "New York City's public hospital system is making a bold move by being so open with their patients and community. The courage to share information in this way can, and I think will, build trust and confidence in that system's commitment to the continual improvement of care. I hope that many other leaders and organizations in health care will follow their lead."

• Annual mortality rates for the entire system and for each of its hospitals;
• Adherence to best practice treatment for patients with heart attack, heart failure and pneumonia;
• 30-day mortality rates for heart attack and heart failure;
• Adherence to best practice treatment for prevention of surgical infection;
• Rates of ventilator-associated pneumonia and central line-associated bloodstream infection for critically ill patients;
• Rates of falls, pressure ulcers and effective pain management for long term care patients.

"While our results are not uniformly the best they can be, our data reflect vast improvements across our system compared to years past," said Aviles. "We are convinced that measuring what matters and honestly and openly reporting it can only help us drive further improvement. The patients and the communities we serve deserve no less."

Mortality
Over the last four years, overall mortality at the city’s 11 public hospitals steadily decreased from 1.7% of all hospital discharges in 2003 to 1.45% in 2006.

"The relatively steep and continuing decline in mortality rates from 2003 -- even as the relative complexity of our patient admissions increased --effectively means that roughly 300 preventable patient deaths were averted in 2006. We credit this success in great part to our patient safety efforts, including our consistent evidence-based treatment for heart attack patients, more effective infection control measures and our implementation of "rapid response teams" to bring critical care resources to the bedside of patients who exhibit early signs of developing possible cardiovascular distress," added Aviles.

Infections
HHC has focused on reducing hospital-acquired infections in critical care units as part of a larger patient safety program to reduce preventable deaths. Central line-associated infections and ventilator-associated pneumonia can be life-threatening, especially for critical ill patients. After an aggressive corporate wide infection reduction program over a two-year period, HHC achieved a 30% reduction in the rate of central line infections and a 68% reduction in the rate of ventilator-associated pneumonia among adult patients receiving care in its intensive care units.

Long-term Care/Nursing Homes
HHC in Focus, on www.nyc.gov/hhc, also presents data on falls, pressure ulcers and pain management efforts for the system’s four nursing homes. The prevalence of falls among longterm care patients for July 2005-June 2006 was 6.75%. The state average for the same period was 15.4%. Some 10% of HHC long-term care patients at high risk developed bed sores during July – Dec 2006 compared to the national average of 13% and a state average of 14%.

All national, state and other comparative data referenced on HHC in Focus are from the Centers for Medicare and Medicaid Services (CMS) or from the Agency for Healthcare Research and Quality, both federal agencies.

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The New York City Health and Hospitals Corporation (HHC), the largest municipal hospital and health care system in the country, is a $5.4 billion public benefit corporation that serves 1.3 million New Yorkers and nearly 400,000 who are uninsured. HHC provides medical, mental health and substance abuse services through its 11 acute care hospitals, four skilled nursing facilities, six large diagnostic and treatment centers and more than 80 community based health centers. For more information about HHC, visit nyc.gov/hhc.