Becker's Clinical Quality & Infection Control

32 QUALITY IMPROVEMENT & MEASUREMENT Viewpoint: Healthcare needs a 'quintuple aim' By Mackenzie Bean T he healthcare industry should expand the "quadruple aim" to include a fifth key focus: advancing health equity, three physician leaders wrote in a Jan. 21 op-ed published in JAMA. e article's authors are: • Shantanu Nundy, MD, CMO of Accolade and a health policy lecturer at George Washington University Milken Institute School of Public Health in Washington, D.C. • Lisa Cooper, MD, Bloomberg Distinguished Professor at Johns Hopkins University School of Medicine and Bloomberg School of Public Health in Baltimore. • Kedar Mate, MD, president and CEO at the Institute for Healthcare Improvement, pres- ident of the IHI Lucian Leape Institute and a faculty member at Weill Cornell Medical College in New York City. Quality and safety experts at the Institute for Healthcare Improvement first penned the term "triple aim," in 2006 to address a joint focus on improving population health, enhancing patient experience and lowering costs. is term evolved into the "quadruple aim" in 2014 to include a focus on addressing worker burnout. e op-ed's authors said the triple aim was expanded aer experts realized that quality improvement work would be unsustainable if healthcare facilities did not address burnout. "e reasoning for adding equity as a fih aim is similar: Quality improvement without equity is a hollow victory," they wrote. "Quality improve- ment efforts without a focus on disparity reduc- tion may have limited effects on health dispari- ties and in fact unintentionally worsen them." Addressing the "fifth aim" requires healthcare leaders to identify health disparities, imple- ment evidence-based interventions to address them, measure progress and incentivize achievement of equity. "Quality improvement efforts should be explicitly designed to improve health equity," they wrote. Policymakers should also set health equity standards and provide effective economic support to help healthcare organizations achieve this work. n Children's health measures worsening: 4 study findings By Erical Carbajal T he number of children diagnosed with anxiety and depression increased significantly between 2016 and 2020, according to a study examining measures of children's well-being published March 14 in JAMA Pediatrics. Researchers used annual data from the National Survey of Children's Health to examine trends in children's health-related measures, in- cluding changes between 2019 and 2020 that might be linked to the COVID-19 pandemic. Findings are based on analysis of surveys cover- ing more than 174,000 children. Four findings: 1. During the five-year period, anxiety levels among children increased 29 percent and depression 27 percent. 2. Researchers found an 18 percent drop in physical activity over the five-year period, and a 9 percent drop in visits for preventive care be- tween 2019-20. 3. Findings also showed the mental health of parents or caregivers declined 5 percent over the five-year period. 4. From 2019-20, behavioral problems increased 21 percent. "This study adds to the growing literature pointing to an exacerbation of challenges brought on by the COVID-19 pandemic, highlighting the urgent need to ensure children's access to timely healthcare services, promote healthy behaviors and support parents to strengthen family well-being," researchers said. n CMS delays star ratings update until July: 4 things to know By Mackenzie Bean C MS is postponing its next Overall Hospital Quality Star Ratings update from April to July to fix a calculation error, the agency said Feb. 11, according to the American Hospital Association. Four things to know: 1. The error involved calculations using 2021 hospital data for the OP-10 outpatient imaging efficiency measure. 2. Hospitals do not need to submit any new data or complete additional actions for the recalculation, and CMS said it doesn't expect the recalcu- lation to affect 2022 payment determinations. 3. Hospitals will be able to preview their updated ratings this spring in their facility-specific reports, CMS said. 4. The agency is also delaying the public reporting of 2022 OP-10 mea- sure results alongside the star ratings. "These measure results are for [calendar year] 2023 payment determina- tion and were initially scheduled for preview release in spring 2022," the agency said. "CMS intends for the calculation error to be corrected in this and in future reporting of results for the OP-10 measure." n

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