Choosing Quality Health Care A consumer guide to hospitals in St. Louis We all want to make the best possible health care decisions for ourselves and our families. However, it can be difficult to know which treatments, hospitals and physicians offer the greatest opportunity for the best result. What s Inside: Hospital Readmission Rates Hospital Safety Scores Hospital Infection Rates This brochure contains hospital quality and safety information from the federal government and national quality organizations. This information can help patients and their physicians choose a hospital for certain conditions or procedures. Why do I need to know? Adverse medication events cause more than 770,000 injuries and deaths each year at a cost as high as $5.6 billion annually. 1 An estimated $19.5 billion dollars in health care costs are attributable to medical errors. 2
Patient Satisfaction How often were patients treated at my hospital satisfied? St. Louis Area Hospitals Central Line-Associated Bloodstream Infections (ICU Only) Standardized Infection Ratio, 2013-2014 What is Hospital Compare? It is a joint project of the Centers for Medicare and Medicaid and the Hospital 1.52 Quality Alliance. It looks at 1.37 0.45 how often hospitals use well known Gateway Regional Med. Ctr. 1.19 ways to help patients recover and feel 0.74 1.02 better. 0.36 National Benchmark 1.00 Right now, Hospital Compare s 0.99 0.37 recommended care measures focus on St. Joseph Hospital-West 0.85 heart care, 1.85 pneumonia and infections Missouri Baptist Med. Ctr. 0.76 0.91 after a surgery. St. Alexius Hospital 0.76 2.29 0.65 0.70 What does the graph mean? St. Elizabeth s Hospital 0.59 On the graph, hospitals are ranked Christian Hospital 0.55 according to how they performed 2013 Missouri 0.51 Average 0.40 compared to hospitals nationally. The number represents the hospital s Alton Memorial 0.49 percentile ranking. The length of the line 0.45 0.37 2013 Missouri Rate reflects the hospital s composite score. 0.26 0.35 Average 0.43 The composite rates how well a hospital 0.27 1.05 does on all measures using a formula to St. Mary s Health Center 0.20 blend them into one score. 0.20 St. Anthony s Med. Ctr. 0.17 0.14 St. Luke s Hospital 0.10 0.14 St. Clare Health Center 0.44 Mercy Hospital Washington Anderson Hospital 1.78 Saint Anthony s Health Ctr. 0.0 0.50 1,00 1.50 2.00 2.50 Source: CMS Hospital Compare. The standardized infection ratio (SIR) used to adjust for risk by CMS is calculated by dividing the number of observed infections by the number of expected infections, using infection rates from a standard population during a baseline time period. Lower scores are better Want to know more about the quality of care at your hospital? Visit www.whynotthebest.org Visit www.hospitalcompare.gov
Hospital Safety How safe is your hospital? The Leapfrog Hospital Safety Score is an A, B, C, D, or F letter grade reflecting how safe hospitals are for patients. This score can be used as one source of information about the safety of hospitals in your area. The Leapfrog Hospital Safety Score is assigned based on a hospital s performance across 26 measures, ranging from rates of hospital acquired infections to whether the hospital has systems in place to prevent medication errors. The measures used in the score are determined with the guidance of a panel of patient safety experts from across the country. Leapfrog Hospital Safety Score assigns equal weight to hospital efforts to improve patient safety (process and structural measures) and outcomes. Leapfrog Hospital Safety Score St. Louis Area Hospitals, May 2015 Saint Anthony s Health Ctr. St. Joseph Hospital-Breese Alton Memorial Barnes-Jewish W. County Mercy Hospital Washington Missouri Baptist Med. Ctr. St. Clare Health Center St. Elizabeth Hospital St. Luke s Hospital St. Mary s Health Center Anderson Hospital Christian Hospital Gateway Regional Med. Ctr. Progress West Healthcare St. Anthony s Med. Ctr. St. Joseph Hospital-West St. Alexius Hospital F 0.0 1.0 2.0 3.0 4.0 C B A Leapfrog Hospital Safety Score Process & Structural Measures Leapfrog Hospital Survey Computerized Physician Order Entry ICU Physician Staffing Safe Practices - Leadership Structures & Systems - Culture Measurement - Teamwork Training & Skill Building - Identification/Mitigation of Risks & Hazards - Nursing Workforce - Medication Reconciliation - Hand Hygiene - Care of the Ventilated Patient Hospital Compare (Recommended Care) Antibiotic 1 hour prior to surgical incision Appropriate Antibiotic Antibiotics stopped 24 hours after surgery Blood Clot Prevention Treatment Urinary catheter removed after surgery Outcome Measures Hospital Compare (Hosp.-Acquired Condition) Foreign object retained after surgery Intravascular air embolism Stage 3 or 4 pressure ulcer (bedsore) A Fall Central-Line Catheter Infections Catheter-Associated Urinary Tract Infections Surgical Site Infection of the Colon AHRQ Patient Safety Indicator Death among surgical inpatients Iatrogenic Pneumothorax (lung collapse) Accidental puncture or laceration Postoperative Measures: - Respiratory Failure - Pulmonary embolism or deep vein thrombosis (lung or leg blood clot) - Wound dehiscence (surgical incision reopens) after abdominal surgery Some performance survey answers may be taken from the American Hospital Association survey.
Recommended Care How often did my hospital provide recommended care? St. Louis Area Hospitals All-Cause, Risk-Adjusted 30-Day Readmission Rates, 2012-2013 Saint Anthony s Health Center St. Anthony s Medical Center St. Alexius Hospital St. Joseph Hospital-Highland Progress West Healthcare Center St. Elizabeth s Hospital St. Mary s Health Center Christian Hospitals Touchette Regional Hospital St. Joseph Hospital-Breese Missouri Baptist Medical Center Gateway Regional Medical Center St. Joseph Hospital West Barnes-Jewish West County Jersey Community Hospital National Rate Community Greenville Regional Hospital Carlinville Area Hospital St. Clare Health Center Mercy Hospital Lincoln Alton Mercy Hospital Washington Anderson Hospital Missouri Baptist-Sullivan St. Luke s Hospital 18.5% 17.6% 17.4% 17.3% 17.2% 16.6% 16.5% 16.4% 16.4% 16.3% 16.2% 16.2% 16.2% 16.1% 16.0% 15.9% 15.8% 15.8% 15.8% 15.6% 15.6% 15.6% 1 1 1 15.3% 15.3% 15.1% 15.0% 14.8% 14.8% 14.7% 14.5% 14.2% 13.9% 14.8 12.0% 0.0% 4.0% 8.0% 16.0% 20.0% Want to know more about the quality of care at your hospital? Visit www.whynotthebest.org Visit www.hospitalcompare.gov
Hospital Readmissions How often did patients at my hospital need to return? Every year more than a million Americans have hip and knee replacements, which account for 1 in 5 orthopedic surgeries. The number of these surgeries is only expected to grow as the population ages. Arthritis is the most common reason for joint replacement in the elderly. Meanwhile, an increase in overweight and obese individuals is driving demand among younger adults. The graphs below show the variation in readmissions and complications rates of these common procedures. St. Louis Area Hospitals Risk-Standardized Readmission Rate Elective Hip and Knee Surgery, 2010-2013 7.5% St. Joseph Hospital-West 6.9% Alton Memorial Mercy Hospital Lincoln St. Luke s Hospital Progress West HealthCare St. Elizabeth s Hospital Saint Anthony s Health Ctr. Christian Hospital National Rate St. Mary s Health Center Missouri Baptist Med. Ctr. St. Clare Health Center Gateway Regional Med. Ctr. St. Joseph Hospital-Highland St. Anthony s Med. Ctr. Anderson Hospital Mercy Hospital Washington Barnes-Jewish W. County 6.1% 6.1% 6.1% 6.0% 5.9% 5.6% 5.4% 5.2% 5.2% 5.2% 5.1% 5.1% 5.0% 4.9% 4.8% 4.7% 4.6% 4.6% 4.2% 4.1% 3.8% 0.0% 2.0% 4.0% 6.0% 8.0% St. Louis Hospitals 2010-2013 Elective Hip and Knee Surgery Complication Rates 4.7 St. Elizabeth s Hospital 4.7 St. Mary s Health Center 4.7 St. Anthony s Health Ctr. 4.4 4.0 3.7 Alton 3.6 Mercy Hospital Lincoln 3.6 St. Clare Health Center 3.6 St. Joseph Hospital-Highland 3.5 St. Joseph Hospital-West 3.5 3.4 3.4 National Rate 3.3 Barnes-Jewish W. County 3.3 St. Anthony s Med. Ctr. 3.3 Christian Hospital 3.2 Progress West HealthCare 3.2 3.2 Anderson Hospital 3.1 St. Joseph Hospital-Breese 3.1 St. Luke s Hospital 3.1 Gateway Regional Med. Ctr. 2.9 2.8 Mercy Hospital Washington 2.8 2.7 2.7 Missouri Baptist Med. Ctr. 2.7 Source: Medicare.gov. Want to know more about the quality of care at your hospital? Visit www.whynotthebest.org Visit www.hospitalcompare.gov
8888 Ladue Road, Suite 250 St. Louis, MO 63124 314-721-7800 www.midwesthealthinitiative.org References 1 Agency for Healthcare Research and Quality 2 Norton s Bankruptcy Law Advisor, May 2000 3 New England Journal of Medicine, April 2009