A first-time ranking of surgical safety by Consumer Reports shows mixed results for Upstate hospitals.
Bon Secours St. Francis Health System and Greenville Hospital System’s Patewood Memorial Hospital got the top rankings, while Greenville Memorial got the lowest score.
AnMed Health in Anderson scored above average, while Baptist Easley, GHS’s Greer Memorial and Hillcrest Hospital in Simpsonville, and Spartanburg Regional Healthcare System scored in the middle of the pack.
Dr. Tom Diller, vice president of quality and patient safety at Greenville Health System, said there are a number of reasons why Greenville Memorial didn’t fare as well as Patewood Memorial and its other sister hospitals.
For instance, while mortality is usually a good indicator, using length of stay as a measure of complications is inappropriate, he said.
“The longer length of stay could be complications,” he told GreenvilleOnline.com. “It also could be that the patient was just really, really sick, or other mitigating circumstances.”
The consumer group looked at Medicare data for 27 surgeries from 2009 to 2011 for nearly 2,500 hospitals nationwide. It based its rankings on the percentage of patients who died or stayed longer than expected after surgery, which the group says is linked to complications like infections and heart attacks that afflict up to 30 percent of patients.
“Consumers have very little to go on when trying to select a hospital for surgery, not knowing which ones do a good job at keeping surgery patients safe and which ones don’t,” said Lisa McGiffert, director of Consumers Union’s Safe Patient Project.
Diller said that MUSC and Palmetto Health Richland and Palmetto Health Baptist also scored low.
“The four biggest hospitals in the state ranked poorly, and that’s because we’re taking care of the really sick patients,” he said. “Now Patewood Memorial did extremely well. And surgeries there are lower risk and not urgent cases ... by design.”
Patewood typically handles orthopedic, ear, nose and throat, and plastic surgeries, as opposed to heart, brain and other critical operations performed at Greenville Memorial, he said.
Diller also said he wasn’t sure about the adequacy of the Consumer Reports’ risk adjustment methods, and that the data is already two to four years old and doesn’t reflect current conditions.
Dr. George Helmrich, chief medical officer at Baptist Easley, agreed.
“All of us are on this quality journey, and the difference of two years is a pretty big difference,” he said.
“And using length of stay as a surrogate for complications seems like a good idea. But the problem is we have a lot of trouble with factors that are independent of patient care, like arranging home health care ... and there’s no way to pull out some of the things that add to length of stay but do not involve complications.”
Nonetheless, Helmrich said length of stay is “on the forefront of everybody’s process improvement list” and that Baptist Easley continues to keep quality as a front-burner issue.
Consumer Reports said its findings were risk-adjusted for characteristics such as age, gender and other health conditions like high blood pressure and diabetes.
And higher-risk patients were accounted for in the statistical model, Doris Peters, associate director of Consumer Reports Health Ratings Center, told GreenvilleOnline.com. She added that the ratings are based on the most recent Medicare data available.
She said that prolonged length of stay could be related to issues other than complications. But she added that the longer a patient is hospitalized, the more likely he is to suffer a complication like an infection or medication error.
The group also looked at variables such as teaching status, urban versus rural hospitals, size and volume, she said. The biggest drivers of a score were geography and specialization, with rural and specialty hospitals faring better, Peters said.
Teaching hospitals did no better or worse than others, she said, while volume and size had some effect, but weren’t major factors in the scores. And big-name hospitals also didn’t always “live up to their reputation” based on the rankings.
Johnna Reed, vice president of business development/heart and vascular services at St. Francis, said the hospital was pleased with its ranking, saying it reflects its patient safety and quality initiatives.
“Our focus is on the highest quality patient care and we welcome any data that helps us obtain that,” she told GreenvilleOnline.com.
“The ranking helps consumers compare surgery rates all across the country and especially where they live. Our ranking is a result of quality care and excellent team work ... (and) one indicator we are getting it right.”
Michael Cunningham, vice president for advancement at AnMed Health, said quality care is a focus of the hospital.
“We are excited about the recognition,” he said. “But more than anything, it reflects our commitment to patient care. We always focus on high quality and a great outcome for all our patients.”
Spartanburg Regional officials couldn’t be reached for comment. Greer Memorial and Hillcrest are part of GHS.
Consumer Reports said the ratings are just one measure of hospital performance and there are others that patients can consult, such as Medicare’s Hospital Compare website.
“We wish we had access to more comprehensive, standardized information, but this is the best that is available,” said Dr. John Santa, medical director of Consumer Reports Health.
“Our surgery ratings give patients more information so that they can make informed choices before surgery. And we hope that by highlighting performance differences, we can motivate hospitals to improve.”