Consumer Reports rates 5 E. Texas hospitals average or worse as surgery centers

LUFKIN, TX (KTRE) - Five East Texas hospitals have not received positive ratings from a Consumer Reports study grading all surgery centers in the US.

A new Consumer Report released Wednesday, called "Safer-Surgery Survival Guide," rated nearly 2,500 hospitals across the country. The report states that its intention is to try and force the health care industry to be more transparent and provide consumers with information on hospital quality in their area.

According to the report, "Less dramatic but often as serious and far more common is when things go wrong after you leave the operation room. Up to 30 percent of patients suffer infections, heart attacks, strokes, or other complications after surgery and sometimes even die as a result."

The new surgery ratings "for the first time make public a measure that some hospitals now use to track quality- the percentage of Medicare patients undergoing surgery who die in the hospital or stay longer than expected," according to Consumer Reports.

The report indicates that they are releasing these rankings as a way to give patients the information they need to make an informed decision when choosing a hospital for surgery.

The report rates each of the hospitals on a scale of better to worse.

Hospitals in Lufkin, Nacogdoches and Livingston scored from average to worse on the ratings scale.

Memorial Medical Center in Lufkin is rated a step above worse while Lufkin's Woodland Heights Medical Center scored average.

Nacogdoches Memorial Hospital is rated the worst while Nacogdoches Medical Center scored average.

Memorial Medical Center's Livingston branch also scored average.

196 Texas hospitals were ranked. Only 18 received a better rating and 20 received the rating just below better.

Consumer Reports used a health care consulting firm to analyze clinical records and medical claims. "The project uses billing claims that hospitals submitted to Medicare for patients 65 and older, from 2009 through 2011, and covers 2,463 hospitals in all 50 states plus Washington, D.C., and Puerto Rico," according to the report.

The report says that most hospitals track patients' recovery and report those results to state and national officials but that information rarely reaches the patients.

Peggy Mortensen, the chief operating officer at Memorial Hospital in Lufkin, said she appreciated Consumer Reports' efforts, but she does not agree with the rating.

"You know I have to applaud Consumer Reports for going out there and trying to put information out there in front of the public and I think as people look at the data to always remember that the report looks at 27 different surgeries, is focused on the older patients that are out there in the community and for our hospital it also means patients that often times don't have insurance and many times are challenged to get healthcare on a regular basis," Mortensen said.

"I don't agree with the ranking you know," Mortensen said. "Of course it's hard, I work here every day and I see the doctors and the nurses and the members of the clinical team that I work with. We're all focused on doing the best thing for the patient while they're here in the hospital and I think we take a lot of pride in the care that we provide here."

"The information about health care is complex," Mortensen said. "It's one of those things that difficult to understand and so we're always trying to figure out how can we best present information to the public that they can understand and granted Consumer Reports made an attempt at that I guess that's why I say I applaud them for that.

"Our surgical team is always looking for the newest and latest practices. I think over the years surgery has become less-evasive. We're using robotics. We're using a number of less invasive procedures which means less chance for complications with the patients and hopefully less time away from work. For Medicare patients it means getting back on their feet more quickly so they can do more things with their family.

"Other things that Memorial, like many other hospitals across the country are doing, is we have a multi-disciplinary team  called our surgery process team that works together, physicians, nurses  and other members of the hospital  on quality issues. Our infection prevention practitioner participates in those and one of the things that we've also done recently is to bring on board a peri-operative educator that will  help us in building our surgical team."

Casey Robertson, the Chief Operating Officer for Woodland Heights, released the following statement:

Woodland Heights Medical Center is committed to providing safe, high-quality medical care for our patients. Through the work of our outstanding medical staff and employees, our surgical care meets 100 percent of the national processes of care reported on, in ten out of eleven measures. These are measures that support the best possible patient outcomes. We encourage patients to consider a variety of sources for information when considering where to receive medical care, such as speaking with their doctor about their specific needs.

Beth Knight, the chief nursing officer at Nacogdoches Memorial Hospital, released the following statement:

Nacogdoches Memorial Hospital is a Level III Trauma Center and a stroke center and a chest pain center, so we handle some really complex cases.  We're the only hospital between Tyler and Houston and Shreveport that has all of those designations. Because of the acuity of some of our patients, we fall in line with some top-ranked hospitals that landed in the "worse" category with this Consumer Reports data. This month, US News and World Reports released their rankings of the best hospitals in the United States and three out of the top four ranked Texas hospitals fell into the two bottom ranked categories of this Consumer Reports surgery data. That puts us in good company with hospitals like Methodist Hospital in Houston, which US News and World Report ranked #1 in Texas, along with Baylor Medical Center in Dallas, #2, and St. Luke's in Houston, #4. We seem to suffer some of the same challenges of the bigger hospitals, without anywhere near the same resources.

Of course we would love to be listed in the "better" category, but this report seems to be based on billing claims data rather than actual clinical data from patient records – that means they've studied a bill to see the basic length of stay, but they don't really have the clinical reasoning behind that longer or shorter length of stay.  According to the latest core measure data that we report to and receive back from  the US government, the report regarding our Surgical Care Improvement Project Scores (SCIPS) composite process score currently averages 92.5 for surgeries including hips, knees, colon, heart, and gynecological surgery.

At Memorial, we admittedly struggle with our length of stay, but it's related to our discharge and communication processes, not our infection rate or surgery complication rates – all of which are at or below national standards.  Our length of stay is a daily battle, but that hurts us as a facility, not necessarily the patient. Medicare pays hospitals through a diagnostic related group or DRG system – that means that a hospital gets paid a certain amount for a procedure, for example a hip surgery, whether the patient spends three days in the hospital or five. So the patient may get extra hospitalization that they're not actually charged for and that Medicare doesn't pay for. That hurts us as a facility – we need to be able to get our patients home quicker in order to decrease our costs.

We try to deliver the best quality care that we can to all patients in our community  and we're always looking for opportunities to improve. We'll certainly be studying this report to see what opportunities might present from this study.

Scott Sundell, director of business development at Nacogdoches Medical Center, released the following statement:

At Nacogdoches Medical Center, providing safe, high-quality care to our patients is utmost priority.  We support the public reporting of quality measures because it can enhance the quality of care delivered by healthcare providers across the nation. Through this, we can all help patients become more active participants in their care.

It is important for patients to understand that no individual grading scale or rating system provides a complete picture of the care provided at a hospital and we encourage patients to work with their physicians to use all of the available tools to decide which healthcare decisions are best for them. The recently-released Consumer Reports safety ratings are one of many resources for patients. We are focused on continual improvement, and we use Medicare Claims Data, coupled with our comprehensive internal data, to continually evaluate and improve our performance.

Our hospital has a number of safety measures in place to ensure the care we provide is safe, appropriate and of the highest-quality. We have received numerous recognitions for our care, including the American Heart Association's Get With The GuidelinesTM Gold Performance Achievement Award for treating heart failure, CIGNA's Center of Excellence designation for Angioplasty, Spinal Fusion Surgery and Total Abdominal Hysterectomy and our hospital is a United Health Premium Specialty Center for Cardiovascular and Interventional Cardiology.

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