Last week, the Centers for Medicare and Medicaid Services (CMS) released the newest star ratings for all hospitals in the United States on its Hospital Compare website. For those of you who do not follow what this is all about, CMS receives a stream of data from each hospital which treats Medicare and Medicaid patients, and performs multiple analyses with this data, and publishes their analysis for the public.
The maximal number of stars which any facility can earn is 5, and the least is 1. In summary, they evaluate how each hospital performs on:
1. Care delivery. This includes how quickly and appropriately care was given for heart attack, whether colonoscopy results were followed up, and surgical care, to name a few.
2. How patients feel about the care they received. This is accomplished via a survey called HCAHPS, which stands for Hospital Consumer Assessment of Healthcare Providers and Systems. This survey is required, and asks patients things like how quiet was their room at night and if doctors and nurses answered their questions.
3. Complications. This part of the evaluation includes whether you had a serious complication or death after a surgery, and whether you got an infection in the hospital.
4. Readmissions and deaths. Pretty self-explanatory. Most people don’t plan to come back for more care or die.
5. Use of medical imaging. This covers things like whether more than one X-ray or scan was done when one was enough, and whether an imaging procedure should have been done at all.
6. Cost and value of care. This seems fairly clear. Costs of a particular type of care or surgery vary hospital to hospital even though CMS decides how much they are paid for most anything.
But my intent is not to make you quality and safety experts, but to make it clear how and why to use this information.
Please, if you believe you or a loved one will have to go to a hospital, look at the public website hospitalcompare.hhs.gov. There you can select a hospital by name, or county, or state, or ZIP code. If your family lives in New Jersey, not a problem. You can still see their ratings. If the admission is for a heart attack, you may not have a choice. But for a hip replacement you have time to choose.
One other thing I would like to tell you about is that Manatee County has three hospitals: Manatee Memorial, Lakewood Ranch Medical Center, and Blake Medical Center. All three happen to be for-profit hospitals, and two of the three are larger than the average hospital in the U.S. (nearly 50 percent of US hospitals are 100 beds or less). When the Manatee County EMS picks you up, you will be taken to one of these three hospitals.
However, I just reviewed the data released for all three in detail.
Manatee Memorial — 2 stars
Lakewood Ranch — 3 stars
Blake Medical Center — 2 stars
Having worked for hospitals and for other kinds of organizations as a chief medical officer and a quality and safety executive, as well as having practiced for over 20 years, I have heard lots of hospital leadership teams say, “We can’t do better, our patients are so sick” or “so poor” or “so non-compliant” and so on. Without belaboring the issue, I just looked at Sarasota County. They have four hospitals, one of which, Sarasota Memorial, is the county hospital, treats all comers, and has 819 beds. It is a not-for-profit hospital and the other three are for-profit.
Doctors’ Hospital — 3 stars
Englewood Community Hospital — 4 stars
Sarasota Memorial — 5 stars
Venice Regional Bayfront — 3 stars
Only 102 hospitals in the U.S. were awarded 5 stars — it is very difficult to achieve! Congratulations to Sarasota Memorial.
I submit to you that the citizens of Manatee deserve better.
Dr. Linda Christmann of Bradenton has decades of experience in quality and safety of care. She led Kaiser Permanente in Atlanta to earn the coveted 5-star rating for its Medicare plan.