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Best and worst hospitals in NYC area

March 1, 2012 2:41:12 PM PST
The new list is out of the best and worst hospitals in our area.

Consumer Reports came out with its rankings.

It looked at everything from how well doctors and nurses do to how patients recover.

According to Consumer Reports the five worst hospitals in the nation when it comes to patient safety are all here in the New York City area.

Jacobi Medical Center ranked lowest, (68 percent worse than the national average.)

Nassau University Medical Center, Forest Hills Hospital, St. Joseph's Medical Center and St. Johns Riverside Hospital also received low scores.

The highest score goes to St. Francis hospital in Rosyln but it was only 22 percent better than average.

Peconic Bay Medical Center, Saint Barnabas, Glen Cove Hospital and Robert Wood Johnson also ranked among the highest here, but not nationally.

"NYC hospitals and their CEO'S are not prioritizing safety and they need to," says Dr. John Santa with Consumer Reports.

Dr. Santa says they graded hospitals in four areas, infections, the number of patients re-admitted to the hospital, and how well staff communicated with patients about medications and discharge planning.

Many hospitals responded to Consumer Reports by saying city hospitals have unique challenges a lot of patients that speak a lot of different languages and a lot of low income patients that don't always have regular health care/

"But what we point out is that hospitals in very similar circumstances in other parts of the country have figured this out," adds Dr. Santa.

Jacobi Medical Center which had the lowest scores declined an on camera interview but said in a statement that the new report: "Does not include more recent hospital data that shows significant improvements in hospital acquired infections, readmissions and communication with our patients who speak over 150 languages."

LINK: CONSUMER REPORTS FULL REPORT

LINK: NYC AREA HOSPITAL RANKINGS

Hospital Responses:

Statement to WABC-TV from Jacobi Medical Center

While the data used by Consumer Reports reflects the currently available publicly reported data, it does not include more recent hospital data that shows significant improvements in hospital acquired infections, readmissions and communication with our patients who speak over 150 languages. Jacobi Medical Center remains focused on becoming one of the nation's safest hospitals and we are confident the next publicly reported data will reflect our recent patient safety improvements.

Jacobi Medical Center's response to Consumer Reports January 23, 2012 query:

Jacobi Medical Center is deeply committed to patient safety and quality improvement. We have a rigorous internal quality improvement system to ensure the very highest quality of care and to reduce the potential for adverse incidents. We are a Joint Commission accredited institution and have been commended on our quality improvment initiatives by the Hospital Association of New York State, the National Association of Public Hospitals and The American Hospital Association. We have recently been awarded distinct competitive designations and Centers of Excellence recognition for our radiology and breast care imaging services, our breast care surgical services, and for bariatric surgery to name a few.

In recent years, there has been a proliferation of hospital report cards. Each has a different methodology and therefore different results. All of the various hospital report card methodologies have limitations, and can never fully reflect a hospital's comprehensive efforts to improve quality and patient safety. In addition, much of the data these report cards compile could be significantly outdated and do not reflect more recent improvements made by healthcare facilities.

Some of our specific performance improvements not reflected in the outdated (CY2010) Hospital Compare report include:

Hospital Infections CLABSI ? CY 2011 & SSI CY 2011

We have gone 12 full months without a CLABSI in our surgical units including our SICU. And in our Medical ICU we have gone 9 consecutive months without an infection. This is GREAT NEWS and proof that our efforts are achieving the intended results. Similar results for Surgical Site Infection.

How did we do it? Several years ago we partnered with the Institute for Healthcare Improvement and have since hardwired several evidence-based initiatives into hands on care protocols These initiatives are designed to reduce Hospital Acquired Infections and involve but are not limited to wide-spread staff training and compliance monitoring via direct observation on all inpatient units and treatment areas in the use of these approved protocols. We have identified physician and nursing champions, improved communication across disciplines, drill down anytime an infection occurs looking for causative factors (reportable or not) and have an antibiotic stewardship program in place, whose goal is to ensure the appropriate use of antibiotics.

Readmission Data

In keeping with our hospitals mission Jacobi Medical Center serves a predominantly impoverished population comprised of patients who also suffer from multiple medical and psychosocial issues including chronic and persistent mental illness, substance abuse, as well as co-morbidities such as diabetes, obesity and end stage renal disease. The published re-admission data does not focus on re-admissions associated with the original admission but re-admission for any reason. The effects of poverty on medical care and outcomes are well documented. Our patients often present with more advanced conditions. Our patients are often homeless, or reside in shelters compromising their abilities to receive follow up services and are uninsured placing our patients at increased risk for future admissions.

Clearly our job is far more difficult than the majority of Institutions we are being compared with. For this reason we have taken this challenge to improve seriously and are part of two major initiatives to decrease readmissions. The first has been in progress for about a year, Project Red (Re-engineering Discharge) which currently focuses on decreasing readmissions rates for patients originally admitted with Heart Failure. We plan to expand improvements from this project to all patients who we've identified as being at high risk for readmission. The other initiative is the Greater New York Healthcare Association (GNYHA) and Hospital Association of New York State (HANYS) federally funded Partnership for Patients which will provide us with additional tools to improve care and reduce readmissions. We believe the lessons learned here will help us with all of the diagnoses being monitored.

Our commitment is to standardize evidence based practices including a formal pre-discharge health education program, increasing ambulatory care access to provide more intensive OPD services to prevent re-admissions, formalizing arrangements for home care services, improving communication and transfer of information to patients receiving their follow up care outside of our hospital system. This past year we completed several pilot projects with promising results.

HCAPS

Both our Nursing and Physician Leadership have embarked upon performance improvement projects and training initiatives including creating a Service Excellence Program to address patient and staff satisfaction in all areas. We have initiated and completed TeamSTEPPS training as it is a powerful tool to support good communication among staff, which will translate into improved care to patients. We now train all employees in a customer service program called S.M.I.LE- an acronym that represents all the components of positive interaction with our patients essential for patient satisfaction.

We take these scores extremely seriously and expect to see marked improvement in all of our HCAPS for CY 2011 as a result of the numerous initiatives and projects currently in place including increased interdisciplinary rounds with all of the health care team members to increase communication with each other and with the patients, implementation of Project Red which takes a proactive focused approach to discharge preparation including aftercare instructions, follow up care and medication management, implementation of a Nursing care model that changed the way patients were assigned to nurses and ancillary personnel to improve coordination of care. Our Nursing Staff now wear color coded uniforms to help patients readily identify their Registered Nurse and our physicians will shortly distribute business cards with their photographs on them to assist in communication.

Again we have special challenges to meet. English is not the primary language of our patients and we have invested heavily in simultaneous translation systems to assist us in meeting the incredibly varied needs of our patients (over 150 languages).

STATEMENT TO WABC-TV FROM FOREST HILLS HOSPITAL:

Like all North Shore-LIJ Health System hospitals, Forest Hills is transparent in sharing its quality and performance information with the public, including infection rates and data we have been sharing with the US Centers for Medicare and Medicaid Services for the past six years as part of a voluntary pay-for-performance project. Whenever information contained in the various "hospital report cards" identifies a quality issue, we are already aware of it and working aggressively to resolve it. We do this routinely as part of our ongoing internal operations and analysis (no matter how high our grades may be), so that we can provide the best patient experience possible.

With regard to the report from Consumer Reports, the data publicly reported to NY State in 2010 (for CLABSI and SSI in the years 2008-2009), has Forest Hills Hospital's infection rates falling within the New York State average. In the past two years (2010-2011), those numbers have shown significant, steady improvement -- to the point that the hospital's performance is now better than the state average. Regarding the CMS and HCAHPS reports, despite the increased influx of patients due to the closure of several hospitals in the Queens area, our most recent data shows that Forest Hills has experienced significant improvement in all quality metrics. We are confident that this will be reflected in the results of the next reporting period.

Terry Lynam, Spokesman

STATEMENT TO WABC-TV FROM NASSAU UNIVERSITY MEDICAL CENTER

Provision of quality care and patient safety is our number one priority and continuous improvement is a never-ending job for all our health care professionals. We are deeply committed to patient safety and quality improvement.

The data reflects that NY metropolitan area hospitals have unique challenges, and that the analysis may not take into account these issues. That having been said, the Nassau University Medical Center takes responsibility to deliver the highest quality care to all our patients. The overall data indicates significant improvement over the past few years, which culminated in our being awarded the Nassau Suffolk Hospital Council 2011 Excellence in Patient Safety Award for our work in minimizing central line infections.

Shelley Lotenberg, spokeswoman for the Nassau University Medical Center

STATEMENT TO WABC-TV FROM ST. JOHN'S RIVERSIDE HOSPITAL

Patient Safety and Quality Improvement are primary goals at St. John's Riverside Hospital. During 2011, we welcomed a new administration whose number 1 priority is patient safety and quality. We've seen a dramatic decrease in our infection rates and readmission rates. We've become involved in another initiative, the Greater New York Hospital Association's Partnership for Patient Safety, whose goals include the reduction of infections and readmissions.

We are confident that when the current data is reported we will be well within the national averages. In addition recognizing all the improvements that have been made in this time period, St. John's is the only hospital in Westchester to have received the 2011 outstanding achievement award from the American College of Surgeons Commission on Cancer.

Denise C. Mananas Director of Marketing & Public Relations

St. Joseph's Response:

Let me start by assuring you that Saint Joseph's Medical Center strives to provide the highest quality of care to our patients. We monitor a variety of indicators to assure that the steps we have taken to continuously improve the quality of care are effective. For example, the appearance of a high infection rate for central lines in 2010 has been aggressively addressed by the medical center. As a result of our efforts, we significantly reduced the number of infections in 2011 (1 infection in 804 central line days). This was recognized by the New York State Department of Health during the 2011 site visit for the Hospital Acquired Infection Reporting program. An official from the Department of Health stated "We would like to take this opportunity to recognize staff in reducing the central line associated bloodstream infection rate."

As is the case with the central line infections, and other safety indicators, we approach every opportunity to improve with the same high level of commitment.

Once again, I want to thank you for the opportunity to make this statement for your report. Please do not hesitate to call me at (914) 378-7816 if you have any further questions.

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