Who among us hasn’t used Consumer Reports to help make an important purchase?
I suspect we all have. Consumer Reports is trusted because nobody can pay for or influence their ratings. In the case of their first-ever ratings of hospitals for surgery, I didn’t know the ratings were coming out until I received a congratulatory note from one of our St. Luke’s team members.
Consumer Reports rated 2,463 U.S. hospitals in the survey published in the September 2013 edition. They evaluated hospital performance for 27 surgical procedures in “an ongoing effort to shed light on hospital quality and to push the hospital industry toward more transparency.” St. Luke’s has pushed for increased transparency and we are always looking at how we can become more transparent.
Selecting surgery was a logical approach because, as Consumer Reports pointed out, “Up to 30 percent of patients suffer infections, heart attacks, strokes, or other complications after surgery and sometimes even die as a result.”
Consumer Reports focused on the percent of Medicare patients undergoing surgery who die or have longer stays in the hospital than expected, and to be fair to hospitals, only considered scheduled surgeries, since emergency surgeries are inherently more risky and unpredictable.
The data is from 2009-2011, which coincides with the period during which St. Luke’s began a System-wide approach to patient safety and quality. The exciting part is that many of our newer care innovations have been implemented since then, so I expect St. Luke’s performance will be even better in future reports.
"Big name hospitals don’t always live up to their reputation when it comes to these surgery Ratings,” the authors observed. They noted “wide variation, sometimes between hospitals only a few miles apart.”
Much can go wrong with surgery, and complications can include surgical site infections, blood stream infections from intravenous lines, urinary tract infections from catheters, blood clots in the legs that can break off and cause pulmonary emboli, adverse drug events, and falls with injuries.
So, how did the ratings come out for Idaho?
Consumer Reports gives five ratings, and only three hospitals received the highest rating, including St. Luke’s Boise and Meridian. Congratulations to our colleagues at Kootenai Medical Center in Coeur D’Alene and Portneuf Medical Center in Pocatello for also achieving this highest rating!
There were only two hospitals that received the next-highest rating: St. Luke’s Magic Valley Medical Center and Northwest Specialty Hospital in Post Falls. All other Idaho hospitals that had sufficient volume to be rated scored the middle rating, halfway between “better” and “worse.”
There is no perfect hospital rating system, but there is a difference between hospitals. Patients needing surgery should talk to their physicians, and can use information like that from Consumer Reports as a guide.
Magnet hospitals are one difference. Magnet designation by the American Nurses Credentialing Center recognizes health care organizations for quality patient care, nursing excellence, and innovations in professional nursing practice, and I'm proud that St. Luke's holds one of only two Magnet designations in Idaho.
And technology is great, but only when peer-reviewed medical studies show that the technology improves outcomes. Fancy technology that does not improve outcomes merely adds to the cost of care, and healthcare consumers should be wary of enticing advertisements about any care organization’s technology. There is a critical difference between hospitals, but it is not technology.
Look for quality and safety initiatives. That’s what I do.
David C. Pate, M.D., J.D., is president and CEO of St. Luke's Health System, based in Boise, Idaho. Dr. Pate joined the System in 2009. He received his medical degree from Baylor College of Medicine in Houston and his law degree from the University of Houston Law Center.