Mid-Shore Health Futures: How Our Regional Hospitals Measure Up

Susan Coe was in search of cottage cheese.

The chief experience officer and senior vice president at University of Maryland’s Shore Regional Health was looking in on a new patient at UM Medical Center at Easton. The patient, she learned, wanted her cottage cheese not in a small compartment on a tray but on a plate.

“She had her heart set on the platter,” Coe said.

The nurse immediately called food services to make the change but Coe said she decided to go get the plate of cottage cheese herself.

“It’s about respecting the patient,” she said.

That attention to patient satisfaction is part of a major change in hospitals, including at Shore Regional Health. Before 2007, hospitals largely measured their success by looking at “hard” data that evaluate patient safety and outcomes for specific procedures or events, such as heart attacks or infections. But in the past decade, the federal government began requiring that hospitals also measure how satisfied patients are with their care. Each hospital patient is given a 27-question survey that asks a range of questions, from how well the doctors and nurses communicated, to how noisy and clean the hospital was, to whether the patient would recommend the hospital to a friend.

And Shore Regional Health didn’t like what it was seeing, at least in one area.

Robert Carroll, regional director performance measurement & improvement, said that for the last eight quarters patient satisfaction ratings had been declining at the Easton and Dorchester facilities (considered one entity in ratings) and at its Chestertown hospital. The latest published data, from April 2015 to the end of March 2016, show that the Shore Regional Health hospitals score below average in patient satisfaction nationally and statewide. This is the despite the fact that the hospitals scored average or above average in most of its quality and safety ratings both statewide and nationally.

By contrast, the latest data show that Anne Arundel Medical Center in Annapolis and Peninsula Regional Medical Center in Salisbury rate better than average statewide and nationally in patient satisfaction. Peninsula also scored better than average in quality and patient safety ratings statewide and nationally. And Anne Arundel rated better than average nationally in quality and a safety, while it rated average statewide. In Maryland, consumers can go online to get information on safety, quality and satisfaction ratings at the Maryland Health Care Commission website (http://healthcarequality.mhcc.maryland.gov).

In December, Shore Regional Health launched a program called HEART to change patients’ perception of their care. And that, Coe said, required that caregivers consciously reconnect with what brought them into health care in the first place. “It’s about empathy, communication and connection,” Coe said. “It’s listening, watching, understanding.”

In the first phase of the program, 25 peer counsellors were trained. From January through March, those counsellors then led three-hour sessions among Shore Regional Health’s more than 2,000 employees. The focus, Coe said, was on helping caregivers see the hospital experience through the patient’s eyes.

“Every patient is reluctant to enter the hospital,” said Trena Williamson, regional director of communications and marketing at Shore Regional Health. “But for the medical staff, this is their normal.”

A new mother with a sick baby might see things differently than a veteran nurse with other, sicker patients, Williamson said. The HEART program helps staff “recalibrate” so as to see the situation from the patient’s perspective, she said.

Coe said patient satisfaction surveys are helpful but it is the comments that are most useful.

“The scores give us a number but the comments give us gifts of insight and direction,” she said. “We really look at comments– and we follow up.”

Keeping a patient-centered focus is “baked into the culture” at Anne Arundel Medical Center, where about 10 percent of hospital patients and 1 in 5 office visitors are from the Eastern Shore, said Maulik Joshi, executive vice president of integrated care delivery and chief operating officer.

Joshi said new hires are made based on their willingness not only to deliver the best medical care but also to make sure patients feel a personal connection.

“We own ‘I care’ behavior,” he said. “I—I sit down and talk with a patient at the beside; C—I connect with patients by smiling and saying hello; A—I answer quickly when someone has a question; R—I always tell everyone my role; and E—I always escort people.”

At Peninsula, the team approach and employees who live in the community and have worked many years at the hospital are key to both a high quality of care and patients’ happiness, said Sheri Matter, the hospital’s vice president of patient services.

Nurses and doctors together visit the patient to ensure everyone—including the patient—understands the plan of care, both in the hospital and when the patient goes home, she said.

And, she said, there is a “direct correlation” between patient satisfaction and “higher quality outcomes.”

“You have to listen,” she said.

Coe, at Shore Regional Health, would agree.

There, HEART has entered Phase 2: coaching and helping hospital staff put the program into practice. After that, “we’ll expand, go deeper,” she said.

In the meantime, Carroll said he is not worried about the ratings.

“We’re doing this because it’s a better way to do it,” he said. “The numbers will take care of themselves.”

The Regional Overview

If you have a heart attack, bicycle accident or need knee surgery, it’s useful to know how your hospital rates in quality of care, safety, and patient satisfaction.

Thanks to a growing trend in healthcare that looks at outcomes instead of just treatments, many government and private groups collect and disseminate data on hospitals’ performance. The information includes everything from specific comparisons about the likelihood of getting a hospital-acquired infection to how quiet the hospital corridors are at night. Hospitals are graded on these benchmarks and can be compared across a state or against a neighboring state.

In Maryland, which has a unique arrangement with the federal government for hospital reimbursements, consumers can go to a state website to see how their hospitals compare on many of these milestones.

The Maryland Health Care Commission, an independent agency, has an online consumer guide that can help answer many of your questions:

Sources: Shore Regional Health; Peninsula Regional Medical Center; Anne Arundel Medical Center

For example, you can use the website to look at a combined quality and safety score for every hospital in the state. Most hospitals in the state rank average on combined quality and safety compared with other Maryland hospitals, including the University of Maryland Shore Medical Centers at Easton, Chestertown and Dorchester. The only ones listed as better than average statewide are Peninsula Regional Medical Center in Salisbury, the Johns Hopkins Bayview Medical Center in Baltimore, and the University of Maryland St. Joseph Medical Center in Towson. Anne Arundel Medical Center, rated average statewide, is among 21 Maryland hospitals rated better than average compared with hospitals nationwide.

Much of the data come from the federal government, through the Centers for Medicare & Medicaid Services. The federal site also has its own hospital comparison tools. You can also go directly to the centers’ site: Medicare.gov. The direct link to the hospital compare site is found here.

Using that site, you can find and compare hospitals across the nation and check them out against the ones in your own backyard.

With all the information that is collected, using the sites can be a little daunting. But there is a way to cut through the clutter to find what you’re looking for.

Start out with the overall ratings to see how the hospitals stack up

Zero in on areas that align with your procedure–for example, maternity care or orthopedic surgery.

Look at the patient satisfaction measures, which tell you things like how well the hospital staff communicates with patients about the discharge instructions, prescriptions, etc.

If you have to go to the emergency room, there’s also information on how quickly you’ll get attention from the medical staff. Easton, Chestertown and Peninsula hospitals were rated better than average in six measures for how quickly emergency room patients were handled compared with other hospitals in the state. Anne Arundel was below average in four of the six measures.

 

Spy Contributor Robert Tiernan was managing editor of Consumer Reports from 2006 to 2015. Spy Contributor Ridgely Ochs covered health care, personal health and medicine for more than 20 years at Newsday on Long Island. They both now live on the Eastern Shore of Maryland.