Raymond Kang

Publications (2)2.96 Total impact

• Article: Reporting information on emergency department crowding to the hospital board and delivery of time-sensitive care.

  Megan McHugh, Raymond Kang, Alan B Cohen, Joseph D Restuccia, Romana Hasnain-Wynia
  [show abstract] [hide abstract]
  ABSTRACT: Hospital governing boards influence the quality of care that hospitals provide by holding senior leaders and managers accountable. A study was conducted to determine whether reporting data on emergency department (ED) crowding to hospital boards was associated with better performance on a time-sensitive quality measure for patients with acute myocardial infarction (AMI): Primary PCI [percutaneous intervention] Within 90 Minutes of Hospital Arrival. In a survey, hospital chief quality officers were asked whether the following data were reported to the hospital governing board: ED wait times, the percentage of ED patients who left without being seen (LWBS), and the percentage of admitted ED patients who are boarded in the ED. Responses were paired with Centers for Medicare & Medicaid Services (CMS) data on the percentage of eligible AMI patients who received PCI within 90 minutes of arrival, which served as the hospitals' PCI score. In the sample of 261 hospitals, 133 (51%) of hospital governing boards received data on wait times, 125 (48%) received data on LWBS, and 63 (24%) received data on ED boarding. After hospital characteristics were controlled for, hospitals that reported data on ED boarding to the governing board had PCI scores that were 5.5 percentage points higher (that is, better); p < .05. There was no association between reporting wait times or LWBS to the board and PCI scores. Reporting data on the incidence of ED boarding to hospital governing boards was associated with better performance for PCI. More research is needed to explore the direction of this relationship, but the results suggest that hospitals should consider reporting data on ED boarding to their boards as a low/no-cost quality improvement activity.
  Joint Commission journal on quality and patient safety / Joint Commission Resources 05/2012; 38(5):229-34.
• Article: How well can we identify the high-performing hospital?

  Michael Shwartz, Alan B Cohen, Joseph D Restuccia, Z Justin Ren, Alan Labonte, Carol Theokary, Raymond Kang, Jedediah Horwitt
  [show abstract] [hide abstract]
  ABSTRACT: Sharing lessons from high-performing hospitals facilitates quality improvement. High-performing hospitals have usually been identified using a small number of performance measures. The objective was to analyze how well 1,006 hospitals performed across a broader range of measures. Five measures were developed from publicly available data: adherence to processes of care, 30-day readmission rates, in-hospital mortality, efficiency, and patient satisfaction. For a subset of hospitals, the authors included two survey-based assessments of patient care quality, one by chief quality officers and one by frontline clinicians. In general, there was little correlation among the publicly available measures (r ≤ .10), though there was notable correlation between objective measures and survey-based measures (r = .23). Hospitals that performed well on a composite measure calculated from the publicly available measures were often not in the top quintile on most individual measures. This highlights the challenge in identifying high-performing hospitals to learn organizational-level best practices.
  Medical Care Research and Review 12/2010; 68(3):290-310. · 2.96 Impact Factor