For the past several years, Ellis Hospital in Schenectady has focused on improving its mortality rate — the percentage of deaths associated with a procedure or condition — for congestive heart failure.
That effort has paid off.
This year, Ellis received a three-star rating — the highest awarded — on a hospital report card measure of congestive heart failure mortality rate. Last year, the hospital received two stars, an indication of average performance. The three-star rating also placed Ellis on the report card’s honor roll, which acknowledges hospitals with above-average performance.
“We’re very pleased we made the honor roll,” said Mary Ellen Crittenden, vice president of quality at Ellis Hospital. “This validates the staff’s hard work. This has been a work in progress over many years.”
Today, the Niagara Health Quality Coalition released its seventh annual hospital report card, which provides information for 42 procedures and conditions, including mortality rates, error rates and surgical infection rates. Overall, these measures have improved steadily since the 2002, when the nonprofit organization released its first hospital report card. This year’s report added two new categories, pain management and overall patient satisfaction with clinical care, areas where New York’s hospitals perform below the national average.
“That’s why we added these measures,” said Bruce Boissonnault, president of the Niagara Health Quality Coalition. “New York has work to do.”
Every hospital in the Capital Region received two stars for pain management.
Overall, the state’s hospitals perform well.
“There are plenty of areas where New York has a lot to brag about,” Boissonnault said. “In New York, quality of care is pretty darn good.”
Other categories measured by the report card include morality rates for conditions such as hip fracture, pneumonia, stroke and gastrointestinal hemorrhage and mortality rates for procedures such as hip replacement, coronary artery bypass graft and pancreatic resection. The report also measures the volume of procedures, patient safety indicators and hospital-level procedure utilization rates.
Top honors
In the Capital Region, most hospitals scored at or above average.
A few, like Ellis, made the honor roll.
St. Peter’s Hospital in Albany made the honor roll for heart attack, congestive heart failure, acute stroke mortality, post-operative sepsis and post-operative wound reopening in abdominopelvic patients. Albany Memorial Hospital received a three-star rating for post-operative pulmonary embolism or deep vein thrombosis, as did Ellis. St. Mary’s Hospital at Amsterdam received a three-star rating for post-operative respiratory failure, and Sunnyview Hospital and Rehabilitation Center in Schenectady received three stars for acute stroke mortality.
“The honor roll is a big deal,” Boissonnault said. “Those hospitals are statistically significantly better. They’ve genuinely accomplished something.”
The hospital report card is a relatively new tool for assessing quality of care.
Boissonnault said that when hospitals know that the public will be looking at reports assessing their performance, they make an effort to improve the quality of patient outcomes.
“We now have among the most comprehensive set of patient safety measures and error rates for any large state,” he said.
The report card gives hospitals star ratings in each category: one star indicates the hospital performed worse than the state average, two stars indicates an average performance and three stars indicates a performance that is significantly better than average.
In the Capital Region, hospitals mostly received two-star ratings, while a few also received one- and three-star ratings.
Helpful information
Hospitals caution against relying too heavily on a single hospital report card. But that doesn’t mean they aren’t pleased when they receive high ratings.
“We generally do very well on hospital report cards,” said Elmer Streeter, a spokesman for St. Peter’s Hospital.
But he said patients should consult a wide range of sources — friends, family, doctors and hospital report cards — when making care decisions.
“Most report cards are difficult to use as a single source,” he said.
Streeter said St. Peter’s takes hospital report cards seriously, and if it performs below average, it likes to know why and take steps to improve.
“We say, ‘Wait a second, we want to do better,’ ” he said.
The report card ratings are based on billing and discharge information reported by all New York state hospitals to the New York State Department of Health for every patient in 2007.
Further improvement
In improving its congestive heart failure mortality rate, Ellis focused on management of patient care, making sure patients had received the appropriate discharge instructions and understood how to take their medicine. They implemented real-time chart review, requiring staff to monitor patient charts and make sure guidelines were being followed.
Crittenden said Ellis decided to focus on congestive heart failure for several reasons: the hospital is seeing more patients with congestive heart failure, treating the condition is expensive and the readmittance rate is high.
Ellis is also working to improve performance in a number of other high-volume categories, including pneumonia, heart attack care, postoperative pulmonary embolism and deep vein thrombosis.
“Surgical care is another area we’re looking at, preventing infection and complications by providing timely antibiotics,” Crittenden said.
The 2009 New York State Hospital Report card can be found at www.myhealthfinder.com. Hospital readmission rates will be added in 60 days.
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