Four hospitals in upstate New York have been given poor grades and put on a "watch list" by a private health care watchdog group.
The Niagara Health Quality Coalition has been ranking New York state’s best and worst hospitals for a decade, and the latest report card released on Sunday shows a mixed bag in upstate New York.
The report card takes millions of data sets from hospitals around the state and calculates how likely patients are to suffer complications or death undergoing various procedures.
Those hospitals with results above the state average go on the honor roll. Those with several areas below the average are relegated to the watch list.
The first report card was released in 2002. Since then Bruce Boissonnault, CEO of the Niagara Health Quality Coalition, says standards have increased around the state. He says mortality rates have decreased substantially, by roughly 50 percent since 2002, and several indicators of patient safety have also improved.
The report card covers more than 200 hospitals across the state and is based on billing data and internal quality data from 2011.
Across the upstate region most hospitals were ranked on par with the state average. But there were a select few that slipped below board in several areas and were named on the 2013 watch list.
Brushing it off
Providers are already responding, saying that the ratings are based on outdated data.
Upstate University Hospital, a state run teaching hospital in Syracuse, is on this year’s watch list. It scored below the state average in four areas, including stroke mortality.
But hospital CEO, Dr. John McCabe, says the report card is based on outdated administrative data. He says they look at the report, but don’t break a sweat over it.
“The bottom line is it’s a rehash of data that’s out there already; it’s old data. It may not be perfect and probably only partly represents the true care that’s being given,” he told the Innovation Trail.
McCabe adds large state-run teaching hospitals like his face a unique set of challenges: they often take on patients other hospitals won’t or can’t.
However, he says that’s a reality of their day to day functioning and it can’t be used as an excuse for higher mortality rates.
“At the end of the day we ought to say, none of those should impact how safe our care is for patients," he said. "So, while we have challenges, I don’t think they can be excuses.”
Privately run Crouse Hospital in Syracuse also scored poorly in several areas, but managed to avoid making the watch list, barely. It also received demerits for six occasions of leaving foreign objects - like a sponge - inside a patient during surgery.
St. Joseph’s Hospital in Syracuse was recognized for its above state average treatment of heart attacks. It was placed on the group's honor roll for the effort.
Good to bad
There were mixed reviews in several cities across the upstate region. Hospitals in Rochester showed a similar narrative.
The city’s Highland Hospital went from being praised as one of "America’s Safest Hospitals" in the 2011 report (using data from 2009), to landing on this year’s watch list.
Associate Medical Director of the Highland facility, Richard Magnussen, also pointed to the outdated data as a reason for their fall from grace.
“We’re being put on the watch list for information that’s somewhat dated, and we do know that we’ve made significant improvements since that time," Magnussen said. "But we certainly take it seriously, we take it as a challenge and as a stimulus to move forward and do better.”
Magnussen says the hospital has its own quality indicators and it has made a lot of positive changes in the past two years. He says since 2011, Highland has created a dedicated heart failure unit, and has acquired new technology to aid physicians.
On the other side of the coin, it was Rochester General Hospital (RGH) that was ranked as an above-average medical center. It was one of 23 hospitals statewide to be named on this year’s "America’s Safest Hospitals" list, along with Albany’s St. Peter’s Hospital.
Most of the accolades for RGH came for its performance in the areas of heart surgery and heart disease treatment.
Dr. Ron Kirshner, chief of cardiothoracic surgery at the hospital, says the facility changed its approach to cardiac care several years ago, determined to become one of the best cardiac centers in the nation.
He says all hospital units are also preparing to be able to deal with any influx of patients that may occur with the introduction of the Affordable Care Act later this year.
And, this commitment to above-average care will serve them well as changes to the system roll in, Kirshner says.
“There have been lots of different attempts at changing health care, but one thing we’ve learned, and that is that if you deliver high quality, high efficient care, then no matter what the model is you’ll be successful,” he said.
None of the hospitals evaluated in Buffalo, Syracuse, Binghamton, or the North Country joined the Rochester and Albany facilities on the 2013 safe hospitals list. The lion's share were downstate and in New York City.
Several hospitals received above average scores in at least one area. However, the Champlain Valley Physician’s Hospital in Plattsburgh and Saratoga Hospital in Saratoga Springs were placed on the watch list.
Buffalo’s Millard Fillmore Hospital, Mercy Hospital, and Sisters of Charity Hospital all received poor marks in more than one area.
Patients can access the report cards for their local hospitals online. Data is collected and analyzed independently, and the report is funded in part by the state Department of Health.
Most hospital officials are giving the same advice, regardless of their grade. They say patients should consult their doctor if they have any concerns about the level of care they’re receiving, and people should keep in mind that the data presented is not from this year.