Quality

Priority 5: Quality

Focus group participants raised potential benefits of the merger related to quality, including through better communication and coordinated care among providers and hospitals. At the same time, both the focus groups and community conversations highlighted overall concerns that any focus on quality improvements by the IAHS might be secondary to other objectives.

Improvements in the quality of care need to be measurable and a primary focus of the IAHS. As of now, the Lifespan and Care New England systems have patient experience scores that are average or slightly below average national levels. Lifting quality performance is vital to creating a better healthcare system and will also encourage more Rhode Islanders to seek care with the IAHS.

There are important equity issues that must be addressed. As part of the broader approach to improving quality there needs to be a concerted focus on reducing disparities in patient experience and other quality measures. Particularly for historically marginalized communities, customer service, compassion, and empathy were emphasized as what was currently missing in the overall health care system. Multiple community conversation participants felt that, when accessing the health care system, a person received better care when they shared an ethnic or cultural identity with their providers.

Recommendations for approval of the merged health system

• The merged system will commit to ensuring patient experience scores are in the top 10% of hospitals in New England within five years of the merger, as well as meeting nationally recognized quality benchmarks that focus on both outcomes and achievement.

• The merged system and state government will provide sufficient resources to allow for a more active focus on quality within the broader oversight entity.

• The merged system will identify key quality gaps with important equity implications (e.g., disparities in maternal and child health outcomes, disparities in access to behavioral health services) and identify specific action plans to address those gaps, as well as a process to identify and address future gaps. › The plan must also include how the merged system will build transparency (both internally and externally) around quality improvement work, ensuring that there is accountability moving forward.