Web site puts physicians and hospitals under microscope

As health consumers across the country demand better and more detailed information about their physicians and hospitals, Beth Israel Deaconess Medical Center (BIDMC) is stepping up to detail its own performance efforts ranging from the percentage of clinicians who clean their hands to the number of times physicians take the proper steps in treating heart attack patients.

A new section of BIDMC's web site, “The Facts: Putting Ourselves Under A Microscope,” (http://www.bidmc.harvard.edu/thefacts) offers the public a chance to see how BIDMC measures up with hospital-wide programs, such as reducing infections and patient satisfaction, as well as in specific areas of clinical care. Initially, there are measurements for heart, pneumonia, surgical and orthopedic care, although the site will be expanded over time to include a longer list of clinical departments.

The initiative, which has won praise from leading national voices for patient safety and quality, is one of the first in Massachusetts.

“Serious improvement begins with understanding reality. Transparency and honesty are not just assets for better health care, they are preconditions,” says Donald Berwick, MD, MPP, President and CEO of the Institute for Healthcare Improvement, a non-for-profit organization leading the improvement of health care throughout the world. “BIDMC is helping to raise the bar on the standards for such openness and frank conversation, and many patients, communities, and health care leaders will benefit from their example.”

“By this courageous act, BIDMC has set a new standard for openness and transparency that will benefit both patients and their caregivers,” says Lucian Leape, MD, of the Harvard School of Public Health. “I hope other hospitals will be quick to join them.

Among the principal areas of focus, part of BIDMC's commitment to quality improvement, is the reporting of efforts to prevent infections – whether through proper hand hygiene, the placement of central intravenous lines or the use of antibiotics after surgery. In addition, the web site charts pneumonia treatment, including the administration of blood tests and vaccines as well as whether a patient continues to smoke.

For example, in the first quarter of 2007, BIDMC was at or above national performance measures for the treatment and prevention of heart failure and its clinicians did well in preventing ventilator-assisted pneumonia or central line infections.

But the data shows work still needs to be done to provide prompt administration of medication for pneumonia patients – and to increase the percentage of people who cleaned their hands before patient contact. The site describes what is being done at BIDMC to increase these numbers.

The web site also posts patient satisfaction with care in BIDMC's inpatient, outpatient surgery, ambulatory and emergency departments.

“It is our belief that the public deserves timely and accurate information about the quality of care at hospitals. There are other web sites that provide some information; however, most of what is available is not current and is often based on administrative data like insurance claims, rather than on clinical data,” says Paul Levy, BIDMC's President and CEO. “Where national comparisons or benchmarks exist, we compare ourselves to them. Where national standards do not exist or where we think they are not adequate, we show our own goals and how we are reaching them.”

The site includes a section listing areas of improvement targeted for this year – as well as recognition from state and national organizations that tracks quality improvement efforts.

Beth Israel Deaconess Medical Center is a patient care, teaching and research affiliate of Harvard Medical School, and ranks third in National Institutes of Health funding among independent hospitals nationwide. BIDMC is clinically affiliated with the Joslin Diabetes Center and is a research partner of Dana-Farber/Harvard Cancer Center. BIDMC is the official hospital of the Boston Red Sox. For more information, visit