Published: November 20, 2009 07:35 pm      

IDPH issues Hospitals Report Card

EDITOR’S NOTE: This is the first of a two-part series on information provided by the new Illinois Department of Public Health Hospital Report Card and Consumer Guide to Health Care recently made available to the public.



By TESA CULLI

tesa.culli@register-news.com

MT. VERNON — Consumers now have more information than ever on how local and regional hospitals perform, thanks to a new initiative by the Illinois Department of Public Health — the Hospital Report Card.

“To help Illinoisans make better decisions about their choice of hospital or health care provider, they need information about the quality of care offered by these facilities,” IDPH Director Dr. Damon T. Arnold stated. “The Hospital Report Card and Consumer Guide to Health Care Web site will allow consumers to find average costs for specific medical procedures, nursing staffing levels at hospitals and general quality of care information.”

In Jefferson County, there are two hospitals, and information provided on both is included in the report card. The card provides an overview of the facilities, quality information, safety, satisfaction, services and staffing/beds.

Of the two local hospitals, Crossroads Community Hospital has 52 total beds, while St. Mary’s Good Samaritan Hospital has 134 total beds. Crossroads has 95.63 percent hospital employed nurses and 4.27 percent contract staff nurses. St. Mary’s Good Samaritan has 96.47 percent hospital employed nurses and 3.53 percent contract staff nurses.

Under quality, the IDPH provides information on process of care, in-patient mortality and in-patient utilization.

“These indicators are used to measure how often hospitals use recommended treatments known to get the best results for certain conditions,” information on process of care states. “All reported measures for the conditions ... were included in the composite measure.”

The mortality information is gathered for the report card by IDPH using discharge data provided by hospitals as well as information from the Agency for Healthcare Research and Quality.

“The Centers for Medicare and Medicaid Services publish a set of data every quarter covering several measures each for heart failure, heart attack and pneumonia care,” information from IDPH states. “This data is submitted to CMS by the hospitals using clinical chart data.”

IDPH compiles all data into one composite measure.

“A weighted average is computed by adding up all the numerators and dividing by all the denominators,” IDPH states. “The numerator for the composite score is calculated by summing the number of patients who were both candidates for and received any of the aspects of care. If a patient received all four aspects of heart failure care, the patient would be counted four times. If the patient was a candidate for only three aspects of care, he/she would only be counted three times. ...”

For Crossroads Community Hospital, there were too few cases to create a percentage for overall heart attack care. Overall heart failure care was scored on the report card at 92.45 percent and overall pneumonia care was scored at 92.67 percent.

For St. Mary’s Good Samaritan Hospital, overall heart attack care was listed at 97.04 percent, overall heart failure care at 97.04 percent and overall pneumonia care at 93.63 percent.

In the area of in-patient mortality rate, Crossroads Community Hospital was listed at 1.82 percent for congestive heart failure; 4.55 percent for stroke; 4.35 for hip fracture; .97 for pneumonia; too few cases for a score in heart attack deaths; and 0 percent for hip replacements.

St. Mary’s Good Samaritan was rated at 3.41 percent for congestive heart failure; 12.36 for stroke; 6.78 for hip fracture; 5.28 for pneumonia; 7.11 for heart attack deaths and 0 percent for hip replacement.

Inpatient utilization is another area covered under quality on the report card, and utilization indicators examine procedures whose use varies significantly across hospitals and for which questions have been raised about overuse or misuse, according to IDPH.

Four measures are listed on the report card in the inpatient utilization area: Incidental appendectomy in the elderly, bi-lateral cardiac catheterization, cesarean section delivery and laparoscopic cholecystemomy, which is also known as minimally invasive gallbladder removal.

At Crossroads, of the four measures, only the minimally invasive gallbladder removal is applicable, and scored at 89.66 percent.

At St. Mary’s Good Samaritan, there are too few cases of incidental appendectomy in the elderly to score; bi-lateral cardiac catheterization is scored at 1.21 percent; cesarean section delivery at 31.7 percent; and minimally invasive gallbladder removal at 94.44 percent.

Safety is one of the major items covered in the hospital report card, with specific measures of surgical care improvement, health care associated infections and patient safety as sub-groups.

“Hospitals can reduce the risk of infection after surgery by making sure patients get the right medicine at the right time as indicated for their surgery,” information on the report card states. “These measures tell you what percentage of surgical patients received the recommended treatments.”

Pre-surgical antibiotic given at the right time, overall rate for Crossroads was 98.85 percent; surgical patients given the right kind of antibiotic, overall rate was at 98.85; and preventative antibiotics stopped at right time, overall rate was at 86.85 percent. Pre-surgical antibiotic given at the right time for knee arthroplasty was listed at 97.62 percent, and surgical patients given the right kind of antibiotic for knee arthroplasty was at 100 percent for Crossroads.

For St. Mary’s Good Samaritan, pre-surgical antibiotic given at the right time, overall rate was 91.54 percent; surgical patients given the right kind of antibiotic, overall rate was 98.32 percent; and preventative antiobiotics stopped at right time, overall rate was listed at 88.42 percent. Pre-surgical antibiotics given at the right time for knee arthroplasty was at 97.64 percent; surgical patients given the right kind of antibiotic for knee arthroplasty was 99.21 percent; and preventative antibiotics stopped at the right time for other cardiac surgery was listed at 50 percent.

Also discussed as part of the patient safety information is potential inhospital complications and adverse events following surgeries and procedures.

For Crossroads, unexpected deaths were at 1.22 percent; there were no accidental puncture and lacerations; no health care associated collapsed lung; no foreign body left during procedures; or postoperative hip fractures.

For St. Mary’s Good Samaritan, unexpected deaths were at .11 percent; accidental puncture and lacerations at .09 percent; health care associated collapsed lung at .02 percent; no foreign body left during procedure; and postoperative hip fracture at .07 percent.

The next installment of this series will include information about the satisfaction ratings, median prices of services offered and staffing.