Press-Republican

September 29, 2013

CVPH on Niagara Health watch list

JEFF MEYERS
Press-Republican

PLATTSBURGH — CVPH Medical Center has been placed on a “watch list” after receiving below-average grades in some patient-care categories.

Officials at the hospital say they were aware long ago of the issues of concern named in a recently released Niagara Health Quality Coalition report. And they say they have taken steps to correct the less-than-favorable areas.

The coalition released its 10th-annual New York State Hospital Report Card earlier this summer, focusing on such issues as mortality, error and surgical-infection rates; pain management; and overall patient satisfaction.

CVPH scored average in most areas when compared to other hospitals across the state.

“Average is at the standard of care,” Bruce Boissonnault, chief executive officer for Niagara, said, “which in New York state is pretty good.”

‘OLD DATA’

Both Alice Hyde Medical Center in Malone and Adirondack Medical Center in Saranac Lake scored average on almost all areas measured.

“When we receive data of this type (as published in the Report Card), there are no big surprises for us,” said Wouter Rietsema, vice president and chief quality and information officer at CVPH.

“We already know about these areas where we’ve had a problem, and we’ve already taken steps to address those problems.

“This data is old,” he said of the 2011 statistics used in compiling this year’s Report Card. “If we relied on this data (for correcting problems), we’d be way behind the eight ball.”

‘ONGOING PROCESS’

For instance, one area where the hospital received a below-average grade was in the death rate for patients following a stroke.

The North Country did not have a full-time neurologist until Dr. Boris Chulpayev came on board earlier this summer, Rietsema explained, but CVPH had taken steps to address the mortality rate by initiating a telemedicine program in the Emergency Department to effectively connect neurologists with stroke patients.

Statistics used for the 2013 Report Card were obtained through billing records that hospitals are required to submit to the state. 

Those records include detailed information on the patient’s care while in the hospital, including complications that may have arisen and whether they lived or died.

“For anybody to look at this type of report and make a decision on whether they want to go to a certain hospital for care, you have to remember that this data is old and has in many cases been fixed (by the facility in question),” Rietsema said.

“We have our own ways of looking at data,” he added. “We’re continually looking at infection rates, mortality rates. Wherever we see trends, whenever numbers are going up or look too high, we are always looking for ways to improve. 

“Quality is a day-to-day, ongoing process.”

OTHER ISSUES

Other areas under the headings of mortality and patient-safety indicators where the hospital failed to earn the blue stars that indicate average care are: pneumonia mortality, collapsed lungs and post-operative hemorrhage or hematoma.

The report shows the hospital had somewhere between one and four instances that year of a foreign body left in after surgery and also had between one and four deaths in low-mortality, diagnosis-related groups. Boissonnault says that from his organization’s perspective no incidences are acceptable in those areas. 

In 15 other categories, CVPH rated average, among them abdominal aortic aneurysm repair, hip replacement, congestive heart failure, heart attack and post-operative sepsis.

‘WAKEUP CALL’

Boissonnault said the report is not meant to single out specific hospitals that received less-than-acceptable grades, but the measurements used can help consumers — and the media — focus on areas where each hospital needs improvement.

“I like to think that when a hospital does poorly on a measure, it’s meant as a wakeup call that something is structurally wrong,” he said from his western New York office. 

“Perhaps, it means the hospital needs more help in terms of financial support.”

The report uses risk-adjusted statistics from every patient in every hospital across the state. Patient records are “de-identified” to protect the privacy of patients.

Niagara identifies a wide range of medical services on its Report Card website, which also lists the “Honor Roll” of top-notch hospitals across the state. However, it does not publish the “watch list” of hospitals on the site, choosing rather to release that information to media outlets.

‘DO HOMEWORK’

The 2013 watch list includes 17 hospitals, with CVPH the only facility listed from this region.

“We urge patients and their families to do their homework in selecting a hospital and to discuss this information with their family physician before an emergency arises,” Boissonnault said.

The Niagara report is representative of many health-care analyses available to the public, which Rietsema believes is not a bad thing for hospitals.

“One way to look at public reporting is that it shines a light on how an organization is doing,” he said. “Much of it (the public reports) is incomprehensible to the general public, but when an organization knows the information is public, that organization will want to make things better.”

Boissonnault agreed, noting that public awareness of medical issues within hospitals will force administrators to address those issues promptly.

The federal government offers hospital reports through its Hospital Care website, based on data hospitals are required to submit in order to receive Medicare reimbursements. 

Information on the site is typically between nine and 12 months old, and data must be validated by federal representatives, Rietsema noted.

Statistics from Hospital Care show that CVPH is on average with New York state and national statistics in most areas.

— News Editor Suzanne Moore contributed to this report.

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LEARN MORE

To access the Niagara Health Quality Coalition 2013 report card, visit www.myhealthfinder.com. To review the federal report on hospitals, visit www.medicare.gov/hospitalcompare.