2009-08-14 / Top Stories

PHC And SJEH Graded On Patient Care: Report Cards Differ On Care In Local Hospitals

By Miriam Rosenberg

New report cards on patient care and mortality rates give our local facilities differing reviews as residents now have two new surveys, to help them choose where to go for medical care.

Last month The Wave published the results of consumer surveys from the Center for Medicare and Medicaid Services' Hospital Compare website and the Niagara Health Quality Coalition (NHQC) as they examined patients' satisfaction with Peninsula Hospital Center and St. John's Episcopal Hospital. This week we examine how the two documents rate these hospitals in terms of patient care - including mortality and 30-day readmission rates.

Medicare now uses three years of claim data, July 1, 2005 - June 30, 2008 - for its report.

"More data gives a clearer picture of the quality of care delivered at different hospitals over time, which ultimately increases the value of our mortality information to hospital patients, health care payers, employers, policymakers, and other health care stakeholders," said Barry M. Straube, M.D., CMS Chief Medical Officer and Director of the Agency's Office of Clinical Standards & Quality in a press release.

St. Johns averaged better ratings than PHC in the government report.

In the seven areas for heart attack care measures, St. John's was rated in five of the areas. Its lowest score was achieving a measure 89 percent of the time. In four other indicators it rated 100 percent. PHC had one 50 percent rating, two in the 80 percent range and three 100 percent rankings. In the indicators that measured the level of care for cases of pneumonia, heart failure and in surgical care SJEH had scored higher than PHC.

In cases where a patient died within 30 days of being admitted to the hospital for cases of heart attacks, heart failure or pneumonia, both facilities met the national average. For patients who had to be readmitted into the hospital within 30 days after their discharge for heart attack and heart failure, both hospitals came in at the national average. PHC was also at the national average for pneumonia cases, but SJEH came in worse that the national average.

"St. John's is deeply committed to patient safety and quality improvement and is always pursuing ways to improve it," said Penny Chin, of SJEH. "St. John's has rigorous internal quality improvement systems to ensure the very highest quality of care and to reduce the potential for adverse incidents.

"It should be noted that the quality of care ratings for St. John's are overall excellent to good and on many indicators the hospital exceeds national or New York State averages. For example, on most pneumonia and heart failure measures, we meet or exceed the New York State average and even the national average."

In an email to the newspaper, Liz Sulik of External Affairs for PHC said, "The hospital continues to improve the care we provide and see these survey results as confirmation that we are making good progress."

She added that, "The focus of our Quality Management team and clinical staff is to provide the best possible care experience and outcomes for our patients."

The NHQC's report card showed some differences from the national data, with a slight edge to PHC.

Peninsula was ranked worse than the state average in three of the seven mortality indicators for inpatient conditions, compared with 2007 when the hospital was rated worse than state average in six of seven indicators. St. John's was ranked average in three of its four indicators and worse in only one.

Both hospitals were at the state average in acute stroke and gastrointestinal hemorrhage mortalities. PHC also rated at the state average in congestive heart failure and hip fracture mortalities. As in 2007, it is still rated worse than state average in heart attacks, pneumonia and heart attacks excluding transfers mortalities.

SJEH's pneumonia mortality rates went from worse than average to average, and the rates for congestive heart failure went from state average in 2007 to worse than average in the new report.

In the majority of categories under Patient Safety Indicators both hospitals were at the state average in preventing infections due to medical care. PHC ranked at the state average in seven of its eight indicators; with only one area worse than state average. St. John's had nine out of 10 areas rated at state average, and one at worse than state average. According to our May 2007 article, at that time, both hospitals were rated better than state average in several of these areas.

"It should be pointed out that, as with all surveys, numbers may be skewed by many factors including sample size, the number of patients treated and the number of responses," said Chin. "There are numerous hospital report cards, each often using a slightly different methodology. None of these report cards should, alone, be used as a definitive source for choosing a hospital."

The government agrees. In its July 9 press release announcing the new data, CMS urges consumers to "gather information from multiple sources when choosing a hospital" yet it added "in an emergency situation, patients should always go to the nearest, most easily accessible facility."

To see more of the report, readers can log onto www.hospitalcompare. hhs.gov or www.myhealth finder. com.

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