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Hospital execs stand by quality

By JODIE TILLMAN
Published March 22, 2007

By the looks of all those minus marks, Pasco County's five hospitals didn't fare well in a national evaluation released this week.

Two hospitals, Regional Medical Center at Bayonet Point and Florida Hospital Zephyrhills, performed below average in treating heart attacks, heart failure and pneumonia, according to the report by the Joint Commission, the nation's leading hospital accreditation agency. And none of the county's hospitals performed above the national average in treating the three conditions.

So what should Pasco County residents make of the findings? The Joint Commission says some hospitals are better than others in treating certain conditions and recommends patients do their homework.

Local administrators, meanwhile, cautioned against drawing conclusions about their hospitals based on the three overall scores.

Sometimes they say the explanation is in the documentation. Medical staff may have done what they were supposed to do but did not document it, said Regional Medical Center spokesman Kurt Conover.

"If you don't happen to record it, the data doesn't show up," he said, adding that the hospital has improved the documentation process since July 2006, the most recent date for which the Joint Commission's data is available.

Conover and others also said that there are other measurement tools for hospitals. He cited the American Heart Association's recognition of Regional Medical Center last summer as having exceeded the association's guidelines for cardiac and stroke care.

Community Hospital now includes the disbursement of aspirin in its admission and discharge orders for heart attack patients, said the hospital's quality control manager, Susanne Gammon. She said that some doctors had previously told patients to pick up aspirin at the drugstore but didn't document that request.

In addition, administrators say, the number of patients treated is so low in some cases that the overall score may be misleading.

Gammon said that in one quarter, Community Hospital had four heart attack patients who should have, within 30 minutes of arrival, received a medication that breaks up blood clots. Two did. A third was delayed because the patient refused to take it initially, she said. A fourth received the medication a couple of minutes after the 30-minute guideline.

The result: a 50 percent compliance rate.

"Just a couple of failures can cause your numbers to skew," Gammon said.

Each condition is graded on how the hospital fared on a number of different performance measures.

Under heart attack care, for instance, the benchmarks include: Did the patients get aspirin on arrival? Were they offered advice on how to quit smoking?

The study looked at how many patients were eligible for each treatment option and what percentage actually got it.

The report tallied up all the patients who were eligible for each treatment, and the percentage who got it, and rolled those numbers into the final figure, said Joint Commission spokeswoman Charlene Hill. A hospital that received a below-average score may have performed well on some treatments but received low scores on others.

Jim Conway, senior vice president at the nonprofit Institute for Healthcare Improvement in Boston, said the report can be an important education tool. He said he hopes patients use it to ask questions of their doctors.

He said history has shown that such reports are viewed more often by hospitals and insurance companies than by patients. Still, he said, the report is part of "an agenda for accountability."

Gammon, the Community Hospital official, said she realized people might be taken aback when they see signs signifying below-average performance in some areas. But she said the data is not new to hospitals, which have been making changes to do better on future surveys.

"We're already addressing" some of the problems in the report, she said. "We take this very seriously."

Jodie Tillman can be reached at (727) 869-6247 or jtillman@sptimes.com.

[Last modified March 22, 2007, 01:05:42]