Sarasota Health News

SMH, Venice stand out in bleak quality report

David Gulliver - posted 9:15 p.m. Tuesday, July 14

Few Florida hospitals excel at stopping at the “revolving door” of readmissions, but Sarasota Memorial Hospital is a rare exception, according to a new federal study of three years of Medicare patients’ cases.

Sarasota Memorial Hospital was the only Florida hospital that excelled at preventing readmissions of patients with heart attack, heart failure or pneumonia, three conditions examined in a major new federal study.

Readmission rates -- how frequently a patient has to return after being discharged -- have become a bellwether for hospital quality. In part, they measure how well the hospital handled the patient’s problem, and how well it avoided errors that would send the patient back for follow-up treatments.

Virtually every organization working on improving health care, including the National Quality Forum, Institute for Healthcare Improvement and Agency for Healthcare Research and Quality, has zeroed in on readmissions as way to help patients and reduce wasted spending.

“The readmission issue is one area where you can improve quality and cut costs,” said Dr. Harlan Krumholz, a Yale University professor and cardiologist, and one of the federal study’s developers.

The findings are available at Hospital Compare, a website run by Medicare’s parent agency. The site, launched in 2005, last week added readmission data for the first time. It examines cases at nearly 5,000 hospitals from 2005 to 2008.

For each hospital, researchers calculated “risk-adjusted” readmission rates, meaning hospitals that handle less complex or severe cases gain no advantage over those taking on more challenging cases. Researchers then compared those rates to the national average.

The results show Florida may have work to do.

For example, just four Florida hospitals were significantly better than average at preventing heart attack readmissions, the study found. That was about 3 percent of participating Florida hospitals. Nationally, about 11 percent of hospitals were better than average.

For heart failure, about 8 percent of Florida hospitals excelled at preventing readmissions, compared to 10 percent nationwide. And for pneumonia, only 2 percent of Florida hospitals were standouts, compared to 8 percent nationwide.

In that disappointing picture, two local hospitals stood out.

Sarasota Memorial readmitted 15.4 percent of heart attack patients within 30 days, the lowest readmission rate in Florida, and second-best in the country, placing it well ahead of the national average, 19.9 percent.

Performing nearly as well was Venice Regional Medical Center, with a heart attack readmission rate of 16.5 percent. Both hospitals landed in the select “better than national average” group.

Experts caution that looking at the rates alone is deceptive; some low-rate hospitals are not in the top-performing group because of how the rates are calculated and compared to the average.

Sarasota Memorial was one of 14 Florida hospitals that outperformed the national average for heart failure, posting a 19.6 percent rate. It also was one of three Florida hospitals that stood out for limiting pneumonia readmissions. No other Suncoast region hospital placed in either group.

But with that typical readmission for heart failure at 24 percent -- nearly one patient in four -- and nearly 20 percent for heart attack, the national average is too low a bar.

“The high rates and the modest variation may indicate uniformly poor performance with respect to the transition from inpatient to outpatient status,” Krumholz wrote in a cardiology journal article that analyzed the new Hospital Compare data.

“The readmission rates are quite high and may represent a marked opportunity for improvement.”

Officials at Sarasota Memorial said the hospital’s cardiac rehabilitation unit and heart failure centers limit readmissions. But they also pointed to the hospital’s linkages to the Sarasota County Health Department, which has programs to get uninsured and indigent patients into regular, primary care.

Judy Milne, Sarasota Memorial’s director of quality improvement, echoed Krumholz’s point about the transition to outpatient care. “We’re only going to be as successful as the network that follows us.”

----

To learn more about readmissions, see reporter David Gulliver’s ongoing series at HealthNewsFlorida.org.

www.healthnewsflorida.org/index.cfm/go/public.articleView/article/12285
www.healthnewsflorida.org/index.cfm/go/public.articleView/article/12509

To see how Suncoast hospitals performed, click to see our chart.

And examine the federal study’s readmission and mortality data at www.hospitalcompare.hhs.gov





	SMH, Venice stand out in bleak quality report David Gulliver - posted 9:15 p.m. Tuesday, July 14 Few Florida hospitals excel at stopping at the “revolving door” of readmissions, but Sarasota Memorial Hospital is a rare exception, according to a new federal study of three years of Medicare patients’ cases. Sarasota Memorial Hospital was the only Florida hospital that excelled at preventing readmissions of patients with heart attack, heart failure or pneumonia, three conditions examined in a major new federal study. Readmission rates -- how frequently a patient has to return after being discharged -- have become a bellwether for hospital quality. In part, they measure how well the hospital handled the patient’s problem, and how well it avoided errors that would send the patient back for follow-up treatments. Virtually every organization working on improving health care, including the National Quality Forum, Institute for Healthcare Improvement and Agency for Healthcare Research and Quality, has zeroed in on readmissions as way to help patients and reduce wasted spending. “The readmission issue is one area where you can improve quality and cut costs,” said Dr. Harlan Krumholz, a Yale University professor and cardiologist, and one of the federal study’s developers. The findings are available at Hospital Compare, a website run by Medicare’s parent agency. The site, launched in 2005, last week added readmission data for the first time. It examines cases at nearly 5,000 hospitals from 2005 to 2008. For each hospital, researchers calculated “risk-adjusted” readmission rates, meaning hospitals that handle less complex or severe cases gain no advantage over those taking on more challenging cases. Researchers then compared those rates to the national average. The results show Florida may have work to do. For example, just four Florida hospitals were significantly better than average at preventing heart attack readmissions, the study found. That was about 3 percent of participating Florida hospitals. Nationally, about 11 percent of hospitals were better than average. For heart failure, about 8 percent of Florida hospitals excelled at preventing readmissions, compared to 10 percent nationwide. And for pneumonia, only 2 percent of Florida hospitals were standouts, compared to 8 percent nationwide. In that disappointing picture, two local hospitals stood out. Sarasota Memorial readmitted 15.4 percent of heart attack patients within 30 days, the lowest readmission rate in Florida, and second-best in the country, placing it well ahead of the national average, 19.9 percent. Performing nearly as well was Venice Regional Medical Center, with a heart attack readmission rate of 16.5 percent. Both hospitals landed in the select “better than national average” group. Experts caution that looking at the rates alone is deceptive; some low-rate hospitals are not in the top-performing group because of how the rates are calculated and compared to the average. Sarasota Memorial was one of 14 Florida hospitals that outperformed the national average for heart failure, posting a 19.6 percent rate. It also was one of three Florida hospitals that stood out for limiting pneumonia readmissions. No other Suncoast region hospital placed in either group. But with that typical readmission for heart failure at 24 percent -- nearly one patient in four -- and nearly 20 percent for heart attack, the national average is too low a bar. “The high rates and the modest variation may indicate uniformly poor performance with respect to the transition from inpatient to outpatient status,” Krumholz wrote in a cardiology journal article that analyzed the new Hospital Compare data. “The readmission rates are quite high and may represent a marked opportunity for improvement.” Officials at Sarasota Memorial said the hospital’s cardiac rehabilitation unit and heart failure centers limit readmissions. But they also pointed to the hospital’s linkages to the Sarasota County Health Department, which has programs to get uninsured and indigent patients into regular, primary care. Judy Milne, Sarasota Memorial’s director of quality improvement, echoed Krumholz’s point about the transition to outpatient care. “We’re only going to be as successful as the network that follows us.” ---- To learn more about readmissions, see reporter David Gulliver’s ongoing series at HealthNewsFlorida.org. www.healthnewsflorida.org/index.cfm/go/public.articleView/article/12285 www.healthnewsflorida.org/index.cfm/go/public.articleView/article/12509 To see how Suncoast hospitals performed, click to see our chart. And examine the federal study’s readmission and mortality data at www.hospitalcompare.hhs.gov