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Better Safety and Emergency Focus on
Severely Ill Found in Top-Performing Hospitals
EVANSTON, IL — February 27, 2006 — Two new findings—concerning
the impact of higher patient safety on the patient's risk of dying
and differences in patient focus in the emergency department (ED)—were released today by Solucient®, the nation's leading source
of information products for the healthcare industry. Both findings highlight
major differences between high-performing hospitals and their peers.
The findings are part
of the Solucient 100 Top Hospitals®: National Benchmarks for Success,
13th Edition study which annually examines changing performance levels
in U.S. hospitals across five critical performance areas: outcome of care,
patient safety, efficiency, financial performance and growing community
service. In addition to the new findings, the study announced the nation's
new benchmark hospitals for organization-wide high performance. The 2005
list identifies benchmark-setting hospitals in five categories: major teaching
hospitals, teaching hospitals, large community hospitals, medium community
hospitals and small community hospitals. The 100 winners will be announced
in the February 27 issue of Modern Healthcare.
Research showed that EDs at winners
of the 100 Top Hospitals National award tend to have a higher percentage
of patients requiring more complex treatment or admission to the hospital
than EDs at non-winners. Benchmark hospitals were approximately 9 percent
more likely to have higher complexity or admitted patients from the ED,
after adjusting for hospital region and class.
Winners of the 100
Top Hospitals National award were also less likely to experience adverse
outcomes than peer hospitals. These adverse outcomes, also known as medical
injuries, can have serious and harmful consequences.
"The 100 Top Hospital award
winners continue to demonstrate significant distinctions in provision of
value to their communities, as shown by objective differences in clinical
outcomes, patient safety, efficient operations and financial stability,"
said Jean Chenoweth, senior vice president of Solucient's Center for Healthcare
Improvement, which is responsible for the 100 Top Hospitals program. "The
heavier volumes of the severely ill treated in EDs of these high-performing
hospitals may suggest different approaches to accommodating the physician
office-level needs of the community — possibly through partnerships
or alternate care services to streamline EDs."
Emergency department overcrowding
has become a major problem in the U.S. "Based on our research, it
appears that increases in numbers of patients at both ends of the acuity
spectrum contribute to ED overcrowding," explained Janet Young, M.D.,
M.H.S.A., senior scientist at Solucient and co-author of the study. "Some
increased volume may be due to severely ill patients who can now be treated
successfully in the ED, such as those with irregular heartbeat. At the other
end of the spectrum, a growing number of less sick patients are now coming
to the ED, particularly in areas without after-hours facilities. This is
an access problem."
In addition, the new study shows
objective data confirming significantly lower risk of death and lower costs
when hospitals increase patient safety, as defined by the Patient Safety
Indicators (PSIs) of the Agency for Healthcare Research and Quality (AHRQ),
a widely accepted measure of hospital safety. The research shows that the
presence of any adverse result on the PSI list significantly and negatively
impacted the risk of death, patient length of stay (LOS) and cost per case.
Consequences ranged from modest to severe, with the greatest impact per
case seen in the following situations:
- LOS was increased by more than 12 days for patients with PSI 7
(Selected Infections Due to Medical Care) compared to those without these
infections.
- Average cost per case was increased by almost $27,000 for patients
who experienced PSI 13 (Postoperative Sepsis) versus similar non-cases.
- The risk of death was more than 17 times higher among patients
who had PSI 11 (Postoperative Respiratory Failure) than among similar patients
who did not.
"This latest analysis also confirmed previous work indicating that
100 Top Hospitals have better patient safety," said David Foster,
Ph.D., M.P.H., chief scientist at Solucient. "Hospitals that won a
100 Top Hospitals award in the 2005 national study had risk-adjusted PSI
rates that were significantly lower than non-winners for nine of the 11
PSIs studied, while rates for the remaining PSIs were not significantly
different between winners and non-winners."
Other findings of the study include:
- If all acute care hospitals performed at the same level as the
nation's benchmark hospitals, as many as 106,312 more Medicare patients
could survive and an additional 117,000 patient stays could be complication-free
each year – at an estimated annual savings of $7.6 billion.
- For the second straight year, the Midwest region was home to the
highest number of national benchmark hospitals, confirming a shift from
the South, which previously had the highest number of national award winners
for nearly a decade.
- For the first time, a hospital—Evanston Northwestern Healthcare,
Evanston Ill.—has achieved national benchmark status 11 times.
- Survival rates were higher at benchmark hospitals (96.9 percent)
compared to the typical peer hospital (96.2 percent), translating into tens
of thousands of lives saved.
- The 100 Top Hospitals treated sicker patients requiring more complex
treatment, yet had better patient outcomes and lower costs.
- Salary and benefits were $1,500 per year higher per full-time staff
member than at peer hospitals.
The 13th edition of
the Solucient 100 Top Hospitals: National Benchmarks for Success
study uses a balanced scorecard approach and scores hospitals according
to nine key organization-wide measures: risk-adjusted mortality, risk-adjusted
complications, patient safety, growth in patient volume, severity-adjusted
average length of stay, expense per adjusted discharge, profit from operations,
cash to debt ratio and tangible assets per discharge.
About Solucient
Solucient® is an information products company serving the healthcare
industry. It is the market leader in providing tools and vital insights
that healthcare managers use to improve the performance of their organizations.
By integrating, standardizing
and enhancing healthcare information, Solucient provides comparative measurements
of cost, quality and market performance. Solucient's expertise and
proven solutions enable providers, payers and pharmaceutical companies to
drive business growth, manage costs and deliver high quality care. For more
information, visit www.solucient.com.
Media Notes:
More information on these studies and other 100 Top Hospitals research,
including "Emergency Departments Vary Widely" and "Consequences of Medical
Injuries," is available at www.100tophospitals.com.
An executive summary of the 100 Top Hospitals: National Benchmarks for Success
study is available to the media by emailing gsexton@solucient.com or by
registering at http://www.100tophospitals.com/media/Register.asp.
To schedule an interview
with Jean Chenoweth, senior vice president, performance improvement and
100 Top Hospital programs, Solucient Center for Healthcare Improvement,
contact Ginny Sexton at (847) 424-4358 or gsexton@solucient.com.
2005 Solucient's
100 Top Hospitals®: National Benchmarks for Success Award Winners
Note: Order does not reflect performance ranking. Hospitals are ordered
by Medicare ID.
Major Teaching
Hospitals (15)
University Medical Center, Tucson, AZ
Denver Health Medical Center, Denver, CO
Evanston Northwestern Healthcare, Evanston, IL
University of Chicago Hospitals, Chicago, IL
Advocate Lutheran General Hospital, Park Ridge, IL
Beth Israel Deaconess Medical Center, Boston, MA
University of Michigan Hospitals & Health Centers, Ann Arbor, MI
St. John Hospital & Medical Center, Detroit, MI
Mayo Clinic - Rochester Methodist Hospital, Rochester, MN
Summa Health System, Akron, OH
University Hospitals of Cleveland, Cleveland, OH
Geisinger Medical Center, Danville, PA
Vanderbilt University Medical Center, Nashville, TN
Scott & White Memorial Hospital , Temple, TX
University of Virginia Medical Center, Charlottesville, VA
Teaching Hospitals
(25)
Scripps Green Hospital, La Jolla, CA
Poudre Valley Hospital, Fort Collins, CO
Danbury Hospital, Danbury, CT
Memorial Hospital & Health System, South Bend, IN
St. Luke's Hospital, Cedar Rapids, IA
Bronson Methodist Hospital, Kalamazoo, MI
Munson Medical Center, Traverse City, MI
Genesys Regional Medical Center, Grand Blanc, MI
William Beaumont Hospital-Troy, Troy, MI
St. Cloud Hospital, St Cloud, MN
St. Luke's Hospital, Chesterfield, MO
Riverside Methodist Hospital, Columbus, OH
Jewish Hospital, Cincinnati, OH
Fairview Hospital, Cleveland, OH
Charles F. Kettering Memorial Hospital, Kettering, OH
Grandview Medical Center, Dayton, OH
Bethesda North Hospital, Cincinnati, OH
Providence St. Vincent Medical Center, Portland, OR
York Hospital, York, PA
Hamot Medical Center, Erie, PA
Lancaster General Hospital, Lancaster, PA
Sioux Valley Hospital USD Medical Center, Sioux Falls, SD
St. Mark's Hospital, Salt Lake City, UT
Southwest Washington Medical Center, Vancouver, WA
Columbia St. Mary's-Columbia Campus, Milwaukee, WI
Large Community Hospitals (20)
Exempla Lutheran Medical Center, Wheat Ridge, CO
Blake Medical Center, Bradenton, FL
Southwest Florida Regional Medical Center, Fort Myers, FL
Largo Medical Center, Largo, FL
Saint Joseph's Hospital of Atlanta, Atlanta, GA
Silver Cross Hospital, Joliet, IL
Shawnee Mission Medical Center, Shawnee Mission, KS
King's Daughters Medical Center, Ashland, KY
Baptist Hospital East, Louisville, KY
Willis-Knighton Medical Center, Shreveport, LA
Beverly Hospital, Beverly, MA
South Shore Hospital, South Weymouth, MA
Lake Hospital System, Painesville, OH
EMH Regional Medical Center, Elyria, OH
Licking Memorial Hospital, Newark, OH
Memorial Hospital, Chattanooga, TN
Baptist Medical Center, San Antonio, TX
East Texas Medical Center Tyler, Tyler, TX
Winchester Medical Center, Winchester, VA
Providence Everett Medical Center, Everett, WA
Medium Community Hospitals (20)
Andalusia Regional Hospital, Andalusia, AL
Yavapai Regional Medical Center, Prescott, AZ
Sebastian River Medical Center, Sebastian, FL
Wellington Regional Medical Center, Wellington, FL
Cleveland Clinic Florida Weston, Weston, FL
Piedmont Fayette Hospital, Fayetteville, GA
Centegra Northern Illinois Medical Center, McHenry, IL
Memorial Hospital of Carbondale, Carbondale, IL
Saint Joseph East, Lexington, KY
Cape Cod Hospital, Hyannis, MA
Newton-Wellesley Hospital, Newton, MA
Holland Hospital, Holland, MI
Mercy Hospital Anderson, Cincinnati, OH
Mercy Hospital Fairfield, Fairfield, OH
Blanchard Valley Regional Health Center-Findlay Campus, Findlay, OH
Southwest General Health Center, Middleburg Heights, OH
Adena Regional Medical Center, Chillicothe, OH
St. Charles Medical Center-Bend, Bend, OR
Providence Health Center, Waco, TX
St. Joseph Hospital, Bellingham, WA
Small Community Hospitals (20)
Chambers Memorial Hospital, Danville, AR
Desert Valley Hospital, Victorville, CA
Florida Hospital-Flagler, Palm Coast, FL
Meadows Regional Medical Center, Vidalia, GA
Shelby Memorial Hospital, Shelbyville, IL
Sarah Bush Lincoln Health Center, Mattoon, IL
Flaget Memorial Hospital, Bardstown, KY
Kentucky River Medical Center, Jackson, KY
Mecosta County Medical Center, Big Rapids, MI
Gerber Memorial Health Services, Fremont, MI
Grand View Hospital, Ironwood, MI
Ray County Memorial Hospital, Richmond, MO
Missouri Southern Healthcare, Dexter, MO
Duncan Regional Hospital, Duncan, OK
INTEGRIS Canadian Valley Regional Hospital, Yukon, OK
Silverton Hospital, Silverton, OR
Prairie Lakes Healthcare System, Watertown, SD
Trinity Hospital, Erin, TN
Childress Regional Medical Center, Childress, TX
Central Texas Hospital, Cameron, TX
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