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Care Comparison 

A government Web site offers statistics showing how various hospitals stack up

Comparison-shopping for furniture is one thing, but comparison-shopping for hospital care is quite another. Location, physician preference and other factors generally take precedence for most people over amenities and statistics.

Despite that, the people behind Hospital Compare, a Web site of the U.S. Department of Health and Human Services (www.hospitalcompare.hhs.gov), seek to make potential patients more aware of how hospitals stack up against each other.

"It's a barometer of how we're doing," points out Kathy Goff, director of quality and outcomes management at University Medical Center (UMC). "It's a great indicator of how we're comparing with others."

Seven local hospitals participate. These include the three Carondelet Health Network facilities—St. Mary's, St. Joseph's and Tucson Heart Hospital—along with Northwest Medical Center, Tucson Medical Center (TMC), UMC and University Physicians Healthcare Hospital at Kino.

The most recent information, much of which was gathered in 2007 and 2008 and is presented cumulatively, was published a few weeks ago. The data is broken down into several categories, including surgical care, heart-attack process, pneumonia process, heart-failure process, children's asthma and hospital readmission rates.

Of particular interest is the patient-satisfaction section. Based on random survey results, the section includes 10 different categories, ranging from whether doctors and nurses "always" communicated well, to whether the patient's room was "always" clean.

Tucson Heart Hospital has the highest score in nine of the 10 categories, while St. Mary's is the lowest in six of them. TMC is at the bottom in three other categories.

One of the criteria in which TMC scored lowest, at 50 percent, was "percent of patients who gave their hospital a rating of 9 or 10 on a scale from 0 (lowest) to 10 (highest)."

"It's no secret that a couple of years ago, TMC had financial and organizational trouble," spokeswoman Julia Strange admits, "but there's been a change of culture at the hospital. Patient satisfaction is a top issue for the board of directors."

As proof of that shift, Strange points out that the May 2009 results in that hospital-rating category were 62 percent, only slightly less than the national average of 64 percent.

"We begin to make changes or celebrate (the figures) before the public ever sees them," Strange says of TMC's approach to Hospital Compare. "We don't wait until it comes out."

The percentage of patients who would "definitely recommend" a hospital ranged from a high of 83 for Tucson Heart Hospital to a low of 52 for St. Mary's.

"St. Mary's has had semi-private rooms for decades," explains Letty Ramirez, a Carondelet spokeswoman, offering one reason for the hospital's low score. (Patients share amenities in semi-private rooms.) "Tucson Heart Hospital (a much newer building) has all private rooms, nursing stations closer to the rooms and other patient amenities."

To address the situation at St. Mary's, 30 private rooms will be established there this summer, Ramirez says.

Kino Hospital received a 59 percent ranking in the "definitely recommend" category. Hospital representative Sarah Frost writes in an e-mail: "We set target benchmarks of our own and are confident that we are making progress."

For its part, Northwest Hospital had the highest score—83 percent—when it came to providing patients with information about what they needed to do after going home.

On the other hand, Northwest received a score of 43 percent for "always" being quiet at night, a score near the middle when compared to Tucson hospitals. That figure compares to 56 percent as the national average, and 51 percent for all Arizona hospitals.

"That's something we're committed to working on," acknowledges hospital spokeswoman Kim Chimene. "A new team is leading that effort and looking at little things, like pads on cabinet doors, as well as big things like mechanical equipment."

University Medical Center tied Tucson Heart Hospital for the highest score of 58 percent in the "patients who reported that staff 'always' explained about medicines before giving (the medicines) to them."

"We try to focus attention on that," comments UMC's Goff. Despite the locally high ranking, she continues: "We want to be better than that. We need to work on it."

Almost every Tucson hospital was ranked as "no different than the U.S. national rate" in each of three mortality areas. The one exception was St. Joseph's Hospital, which received a "worse than the U.S. national rate" in the category of death rate for heart-failure patients.

"Based on our review of internal data for (calendar year) 2008 and the first two quarters of 2009," Ramirez writes in an e-mail, "St. Joseph's Hospital is approaching the state and national benchmarks for heart-failure mortality."

Representatives of all local hospitals stress they use Hospital Compare information, along with other statistical data, to improve the quality of their service.

"We're constantly trying to harvest data to improve our performance," says Dr. Patrick Smith, chief medical officer at St. Joseph's.

Smith adds they try to learn from other organizations, like the hotel industry, on upgrading a patient's experience.

"We believe in transparency," Smith says, "and consumers will use information (like Hospital Compare) to make choices. We're under the glass, so to speak."

When asked how the public should utilize the Hospital Compare data, Goff at UMC—along with most of the other hospital representatives interviewed for this story—had some words of caution.

"They need to use it carefully," she says of the public, "since it's about 1-year-old data."

Detailed information can be found at www.hospitalcompare.hhs.gov.

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