Trinity, Doctors again Top Performers [The Augusta Chronicle, Ga.]

Oct. 31--For the second year in a row, Doctors Hospital and Trinity Hospital are among the top quality hospitals on an annual list from their accreditation agency. And many of those measures are similar to ones that increasingly affect the bottom line and employee morale, Trinity CEO Jason Studley said.

The Joint Commission released its Top Performer hospitals list and Trinity and Doctors were among the 1,099 out of 3,300 hospitals surveyed that reached 95 percent or above on key quality measures. The hospitals were among 424 who were on the list last year and Doctors was among 182 that have been on the list all three years, the agency said. The more than 1,000 hospitals receiving the Top Performer distinction is 77 percent more than the 620 who received the distinction last year, Commission President and CEO Mark Chassin said.

"This year there is dramatic evidence that patients are more reliably getting the treatments they need," he said. "This year's report is heartening also because it shows how hard hospitals are working to do the right thing every time and provide the kind of safe, high-quality health care we all expect and deserve."

Doctors and Trinity met the measures for quality in treating heart attacks, pneumonia and in surgical care. Doctors also met the criteria for treating heart failure but Trinity fell a couple of cases short of the minimum 30 cases needed for evaluation or it would have qualified in that as well, Studley said. The list in past years has been dominated by smaller, for-profit hospitals: Doctors' parent company, HCA, had 110 hospitals on the list, or 80 percent of its hospitals; Trinity's parent company, Community Health Systems, had 63 hospitals on the list, roughly 75 percent of the hospitals it has.

Academic medical centers, even those with a great reputation, have largely been absent from the list because they tend to see higher volumes and sicker patients, which makes it harder to get above 95 percent on quality measures, said Dr. Peter J. Pronovost, senior vice president for patient safety and quality at Johns Hopkins Medicine. But this year, three Johns Hopkins hospitals made the list and out of 124 major academic medical centers 24 met the standards, six times more than previous listings, Chassin said.

"The inclusion of Johns Hopkins Hospital, a large complex academic medical center, on the list shows what is possible when leaders commit to a clear goal and measures, when they provide support to improve and they create transparency and accountability," Pronovost said.

At Trinity, there are daily reviews of each quality measure, Studley said.

"Every one of these measures has an assigned group of employees from across the hospital that actually meet every one of these and we do concurrent reviews of all of our patient records in order to make sure that we are meeting all of these standards on a daily basis," he said.

Every day also has a "safety huddle" where they not only review patient safety and potential problems but talk about staff safety as well, Studley said.

Every workman's compensation case gets a thorough review in a "non-punitive" manner to explore how it happened and how it can be prevented, he said. That is paying off in lower insurance costs and no repeat cases of the same type so far this year, and better staff morale, Studley said.

But these quality measures mean more than acclaim from The Joint Commission now -- the Centers for Medicare and Medicaid Services is basing some payments on how well hospitals perform on very similar quality measures. Hospitals get 1 percent of their Medicare payments withheld -- in Trinity's case it is about $5 million -- that they have to earn back by performing well on those quality measures and can even earn bonuses for doing really well, Studley said.

"That is definitely significant," he said. "Every hospital in the country is going to have to buckle down and pay attention to quality."

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