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Best and Worst Hospitals for 30-Day Mortality

Cheryl Clark, for HealthLeaders Media, September 15, 2011


So now, Hackensack's leaders are trying to look at unit-based care, and "how to create highly functional and collegial teams" that work similarly across units. "We're training workers to emulate teams like people in nuclear submarines and power plants, where you can't afford to make a mistake."

 


Yale New Haven Hospital, New Haven, CT

Another high-performing hospital with low readmissions is 996-bed Yale New Haven Hospital. I contacted Thomas Balzecak, MD, vice president of performance management and associate chief of staff.

Many best practices and procedures play a role, including a strong institutional mandate to achieve clearly set goals with "a high level and clear executive level support," he said.

But what is it really? I ask. Balzecak says that if he had to name just a few things, he would point to the speed, experience and precision of Yale New Haven's heart care, especially its catheterization lab and door-to-balloon times, as extremely influential for the hospital's low mortality rates. The cardiology department has high volume, veteran operators.

"It's hard to say that 'yes, there are these three individuals,' when really it's just an incredible team," Balzecak said.

As the saying goes, time equals muscle, and when heart attack and heart failure patients are treated promptly, there is less ischemia, less muscle damage and less mortality down the road.

Those physicians make sure patients see a doctor within a week of discharge, that patients have a list of medications, and physicians follow-up diligently to ensure the meds are taken correctly. Of course, lots of hospitals do that too, but perhaps Yale New Haven's effort is special.


Southwest Mississippi Regional Medical Center, McComb, MS

HospitalCompare lists two hospitals with the highest rates of death in all three categories. And I wondered why.

So I phoned Southwest Mississippi Regional Medical Center in McComb, MS, a 175-bed facility in an underserved area and spoke with CEO Norman Price.

Price explained that a primary reason his hospital scored so poorly was due to an administrative error in which patients designated for palliative care, who presumably were imminently terminal, were incorrectly coded so that the record did not reflect a do not resuscitate order.

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1 comments on "Best and Worst Hospitals for 30-Day Mortality"


Ed Tucker (9/20/2011 at 11:07 AM)
I wonder if there is any correlation between the Medicare Wage Index and these outcomes? As you know, Medicare pays much less than the average DRG base rate in the southern states and much more than the base rate in the highly populated areas. This has been locked in since 1983 and has stifled the ability of hospitals in rural states to get staff pay up to the levels in the urban states. This disparity allows the urban areas to attract the best staff, so one would expect better outcomes. And, has Medicare compared the cost of care in these hospitals to the cost of care in the less performing hospitals? It would seem without both sides of the equation - cost and quality - this information, while good, is incomplete.