Background

In California, as in other states, the quality of inpatient care varies considerably from hospital to hospital and even from one department to another within the same institution. A facility known for its top-notch cardiac care, for instance, may perform poorly in preventing hospital-acquired infections.

To create a standardized "report card" on hospital quality that would better meet the needs of all stakeholders, the California Hospital Assessment and Reporting Taskforce (CHART) was convened in 2004 with funding from the California HealthCare Foundation. The broad-based initiative involved active participation from all stakeholder groups: hospitals, government entities, insurers and health plans, clinicians, employers and the business community, labor unions, and consumers.

Performance measures. Working on a consensus basis, the taskforce adopted 50 hospital performance measures that they agreed were indicative of quality and aligned with national initiatives like the Agency for Health Quality and Research and the National Quality Forum. The California Office of Statewide Health Planning and Development and the Joint Commission are among the regulatory and accrediting agencies that support CHART.

Participation. More than 240 hospitals, representing 86% of the average daily hospital census in California, participate in the voluntary reporting effort, which is currently funded by health plans and hospitals. The team agreed on processes for data collection, aggregation, and auditing, and evaluated means to translate complex data into consumer-friendly decision-support tools.

CHART Public Report Card

The CHART public report card, which is updated quarterly, was introduced on March 7, 2007, at CalHospitalCompare.org, which is maintained by the California HealthCare Foundation. The CHART measures include cardiac care, maternity care, pneumonia treatment, intensive care unit (ICU), pressure-ulcer rates, patient safety, surgical infection prevention, and patient experience.

Across these categories, 71 performance measures are further stratified and reported on the website. Five performance ratings — superior, above average, average, below average, and poor — are displayed for each measure in color codes that facilitate easy comparison. Consumers can compare up to five hospitals simultaneously on various measures. Site visitors can also see the percentage of patients who would recommend a particular hospital to friends and family members.

Data collection and analysis for the project was designed and is managed by the University of California at San Francisco Phillip R. Lee Institute for Health Policy Studies, with assistance from experts at other California universities and the RAND Corporation.

For more information about the CHART project and related materials, see the links below.