Metro Atlanta / State News 8:50 p.m.
Friday, November 6, 2009
Emory’s name doesn't ensure its high standards
Medicare data reveals some partner hospitals’ shortcomings
Medicare data reveals some partner hospitals’ shortcomings
By Carrie Teegardin
The Atlanta Journal-Constitution
The Atlanta Journal-Constitution
Patients who arrive for care at Emory-Adventist Hospital might reasonably assume that the Cobb County facility is run by Emory University
Those turning to Emory Eastside Medical Center in Snellville and Emory Johns Creek Hospital in North Fulton might also believe they are entrusting their care to the folks who operate the highly regarded teaching hospital on the Emory campus.
But Emory’s name on the sign out front does not mean Emory is completely in charge. And it doesn’t ensure that high quality standards are always met.
Medicare statistics measuring the quality of care at the nation’s hospitals reflect shortcomings at two hospitals using the Emory name, according to an Atlanta Journal-Constitution study.
Of the five metro Atlanta hospitals in the Emory Healthcare system, Emory University exclusively manages just two: Emory University Hospital on Clifton Road and Emory University Hospital Midtown on Peachtree Street.
The other three Emory hospitals are joint ventures with other hospitals chains. In each case, Emory helps oversee operations but leaves much of the day-to-day management to its partners.
Academic hospitals such as Emory’s Clifton Road and Midtown facilities partner with community hospitals to extend their reach into suburban areas. Some jointly run the hospitals. Others team up to create a specialty unit within a hospital, said Dr. Joanne Conroy, chief health care officer at the Association of American Medical Colleges.
Conroy said quality control is key for the academic hospitals.
“When their brand is out there, they want to make sure that patients have an expectation and receive the same level of services they would receive at the mother ship,” she said.
Emory Eastside, a joint venture between Emory and the health care company HCA Inc., posted a high death rate among pneumonia patients admitted between 2005 and 2008. Emory-Adventist, which is co-owned by Emory and Florida-based Adventist Health System, earned some of the worst marks in the state on 2008 patient satisfaction data compiled by Medicare. The numbers are the most current statistics available to the public.
John T. Fox, Emory Healthcare’s chief executive officer, said Emory sets quality standards and demands good results. Emory doctors serve on each hospital’s board of directors and also work at each facility monitoring quality statistics. He said Emory has closely worked with its partner to address problems highlighted in the Medicare reports.
“We would not enter into a joint venture with anyone who had a lower standard of commitment on quality,” Fox said. “We obviously take our name and our reputation very seriously and we are careful with how we use the brand.”
Fox said Emory staff constantly monitor a range of statistics measuring outcomes and satisfaction.
“Whenever we see a number that is below our expectations, and we see it long before it ever gets published, we go to work on it,” Fox said. “That’s independent of whether it’s a joint venture or a 100 percent Emory-owned hospital.”
As one of its many measures of hospital quality, Medicare surveys the nation’s patients after a hospital stay.
On seven of the 10 patient satisfaction questions, Emory-Adventist posted scores that ranked it no better than third-worst in the state, according to an AJC analysis of the data covering overnight admissions in 2008.
Only two Georgia hospitals scored worse than Emory-Adventist on overall satisfaction and only one scored worse on the percentage of patients who said they would not recommend the hospital. Only one Georgia hospital scored worse on the measure of how well doctors communicated with patients and only two hospitals scored worse than Emory-Adventist on communication with patients by nurses.
No hospital had a more negative rating than Emory-Adventist on how well pain was controlled and only two had higher negatives on whether patients received help quickly when they called for assistance.
Emory owns 35 percent of the 88-bed Emory-Adventist through a 1995 joint venture. Adventist Health System, a nonprofit chain with 37 hospitals nationwide, owns the majority stake of Emory-Adventist and handles most day-to-day operations.
The facility gets more than 80 percent of its admissions through its emergency room, the hospital said.
Emory appoints four of the facility’s 10 board members, one of whom is the chief quality officer at Emory Hospital Midtown.
Insurance companies and government regulators are paying close attention to customer feedback. “Patient satisfaction is clearly an important component of quality,” said William S. Custer, a Georgia State University professor who is an expert in health care and insurance.
Custer said if he were a consultant to Emory-Adventist, he would study emergency room operations since the vast majority of patients start there.
“What this shows is that they need to change the culture to have their employees communicate with patients better at every step,” Custer said.
Emory Eastside and Emory Johns Creek are joint ventures with HCA Inc., a Tennessee-based health care company that operates hospitals nationwide.
At both Eastside and Johns Creek, an Emory doctor monitors quality statistics. Fox said Emory doctors are also assigned to serve as “hospitalists” at the facilities — internal medicine specialists available to nursing staff around the clock. Emory doctors serve on each hospital’s board of directors.
HCA, however, oversees most day-to-day details.
Emory Johns Creek earns strong marks on patient satisfaction surveys and quality measures.
Emory Eastside’s patient ratings were better than Emory-Adventist’s, but below state averages on most questions.
Emory Eastside scored poorly on Medicare’s pneumonia mortality rate, in spite of earning high scores from Medicare for following protocols designed to prevent pneumonia deaths. The hospital is among 14 across Georgia that Medicare highlighted for posting high 30-day death rates among patients admitted with a pneumonia diagnosis over a three-year period, the latest data available.
The Atlanta Journal-Constitution published an in-depth story in October about Georgia hospitals’ poor performance on Medicare’s measurements of clinical outcomes.
Larry Kloess, president of HCA’s division that includes Georgia, said the foundation of HCA’s partnership with Emory is a “shared commitment” to delivering the highest quality care possible.
In a prepared statement, Kloess also said it’s important for consumers to realize that some publicly reported data lags months behind current performance. Medicare does reach back to 2005 to calculate its current pneumonia death rates.
Emory Eastside said it is making a special effort to work with patients suffering from chronic conditions after they leave the hospital to try to improve results. Emory Eastside’s Web site prominently displays its affiliation with Emory Healthcare, but not with HCA.
Dr. John Santa, director of the health ratings center for Consumer Reports magazine, said many patients would assume Emory alone runs a facility that bears its name.
“If they find out differently, doesn’t that kind of sound like a bait-and-switch?” he said.
Some patients might want to know, Santa said, they are going to a hospital where a for-profit company is involved in management. Santa described Emory as a “very impressive brand.”
“I would assume that Emory has business reasons for being willing to share their brand,” he said. “How that involves quality and performance is a good question.”
Administrators at Emory-Adventist are working furiously to improve patient satisfaction ratings, including making changes to assure feedback is accurate.
Ed Moyer, the hospital’s chief operating officer, said the changes include phones instead of call lights, message boards displaying key staff names and a “turn-down” service offering patients a clean gown or fresh sheets.
The hospital’s most recent internal data show significant improvements in satisfaction ratings for patients admitted this year.
Adventist Health System is affiliated with the Seventh-day Adventist Church. “We take seriously our mission to extend the healing ministries of Christ,” Moyer said.
Fox, the Emory Healthcare chief, said he is very comfortable with the quality of care being delivered at all hospitals in the system. But he said he wants to see improvements at each facility, including the highly regarded hospital on the Emory campus that does ground-breaking work every day.
“I want perfection,” he said. “That does not exist in the Milky Way in terms of health care.”
Online rankings
Patient opinions about their experiences in a hospital have historically been limited to what friends and neighbors share. Today, Medicare’s “Hospital Compare” Web site allows consumers access to detailed patient survey data collected in a scientific manner and made available for almost every hospital in the country.
Many consumers have grown accustomed to checking online reviews before making a purchase. Medicare’s data is backed by hundreds of responses, not just the feedback of patients who happened to post comments on a Web site.
To review detailed quality and satisfaction data for hospitals around the country, go to: www.hospitalcompare.hhs.gov
How we got the story
To examine how well Georgia hospitals performed on patient satisfaction surveys, The Atlanta Journal-Constitution studied the most recent data collected by Medicare for every hospital in Georgia. The newspaper reviewed the latest quality measures published for each hospital. The AJC also interviewed hospital executives and experts in hospital quality and management.
But Emory’s name on the sign out front does not mean Emory is completely in charge. And it doesn’t ensure that high quality standards are always met.
Medicare statistics measuring the quality of care at the nation’s hospitals reflect shortcomings at two hospitals using the Emory name, according to an Atlanta Journal-Constitution study.
Of the five metro Atlanta hospitals in the Emory Healthcare system, Emory University exclusively manages just two: Emory University Hospital on Clifton Road and Emory University Hospital Midtown on Peachtree Street.
The other three Emory hospitals are joint ventures with other hospitals chains. In each case, Emory helps oversee operations but leaves much of the day-to-day management to its partners.
Academic hospitals such as Emory’s Clifton Road and Midtown facilities partner with community hospitals to extend their reach into suburban areas. Some jointly run the hospitals. Others team up to create a specialty unit within a hospital, said Dr. Joanne Conroy, chief health care officer at the Association of American Medical Colleges.
Conroy said quality control is key for the academic hospitals.
“When their brand is out there, they want to make sure that patients have an expectation and receive the same level of services they would receive at the mother ship,” she said.
Emory Eastside, a joint venture between Emory and the health care company HCA Inc., posted a high death rate among pneumonia patients admitted between 2005 and 2008. Emory-Adventist, which is co-owned by Emory and Florida-based Adventist Health System, earned some of the worst marks in the state on 2008 patient satisfaction data compiled by Medicare. The numbers are the most current statistics available to the public.
John T. Fox, Emory Healthcare’s chief executive officer, said Emory sets quality standards and demands good results. Emory doctors serve on each hospital’s board of directors and also work at each facility monitoring quality statistics. He said Emory has closely worked with its partner to address problems highlighted in the Medicare reports.
“We would not enter into a joint venture with anyone who had a lower standard of commitment on quality,” Fox said. “We obviously take our name and our reputation very seriously and we are careful with how we use the brand.”
Fox said Emory staff constantly monitor a range of statistics measuring outcomes and satisfaction.
“Whenever we see a number that is below our expectations, and we see it long before it ever gets published, we go to work on it,” Fox said. “That’s independent of whether it’s a joint venture or a 100 percent Emory-owned hospital.”
As one of its many measures of hospital quality, Medicare surveys the nation’s patients after a hospital stay.
On seven of the 10 patient satisfaction questions, Emory-Adventist posted scores that ranked it no better than third-worst in the state, according to an AJC analysis of the data covering overnight admissions in 2008.
Only two Georgia hospitals scored worse than Emory-Adventist on overall satisfaction and only one scored worse on the percentage of patients who said they would not recommend the hospital. Only one Georgia hospital scored worse on the measure of how well doctors communicated with patients and only two hospitals scored worse than Emory-Adventist on communication with patients by nurses.
No hospital had a more negative rating than Emory-Adventist on how well pain was controlled and only two had higher negatives on whether patients received help quickly when they called for assistance.
Emory owns 35 percent of the 88-bed Emory-Adventist through a 1995 joint venture. Adventist Health System, a nonprofit chain with 37 hospitals nationwide, owns the majority stake of Emory-Adventist and handles most day-to-day operations.
The facility gets more than 80 percent of its admissions through its emergency room, the hospital said.
Emory appoints four of the facility’s 10 board members, one of whom is the chief quality officer at Emory Hospital Midtown.
Insurance companies and government regulators are paying close attention to customer feedback. “Patient satisfaction is clearly an important component of quality,” said William S. Custer, a Georgia State University professor who is an expert in health care and insurance.
Custer said if he were a consultant to Emory-Adventist, he would study emergency room operations since the vast majority of patients start there.
“What this shows is that they need to change the culture to have their employees communicate with patients better at every step,” Custer said.
Emory Eastside and Emory Johns Creek are joint ventures with HCA Inc., a Tennessee-based health care company that operates hospitals nationwide.
At both Eastside and Johns Creek, an Emory doctor monitors quality statistics. Fox said Emory doctors are also assigned to serve as “hospitalists” at the facilities — internal medicine specialists available to nursing staff around the clock. Emory doctors serve on each hospital’s board of directors.
HCA, however, oversees most day-to-day details.
Emory Johns Creek earns strong marks on patient satisfaction surveys and quality measures.
Emory Eastside’s patient ratings were better than Emory-Adventist’s, but below state averages on most questions.
Emory Eastside scored poorly on Medicare’s pneumonia mortality rate, in spite of earning high scores from Medicare for following protocols designed to prevent pneumonia deaths. The hospital is among 14 across Georgia that Medicare highlighted for posting high 30-day death rates among patients admitted with a pneumonia diagnosis over a three-year period, the latest data available.
The Atlanta Journal-Constitution published an in-depth story in October about Georgia hospitals’ poor performance on Medicare’s measurements of clinical outcomes.
Larry Kloess, president of HCA’s division that includes Georgia, said the foundation of HCA’s partnership with Emory is a “shared commitment” to delivering the highest quality care possible.
In a prepared statement, Kloess also said it’s important for consumers to realize that some publicly reported data lags months behind current performance. Medicare does reach back to 2005 to calculate its current pneumonia death rates.
Emory Eastside said it is making a special effort to work with patients suffering from chronic conditions after they leave the hospital to try to improve results. Emory Eastside’s Web site prominently displays its affiliation with Emory Healthcare, but not with HCA.
Dr. John Santa, director of the health ratings center for Consumer Reports magazine, said many patients would assume Emory alone runs a facility that bears its name.
“If they find out differently, doesn’t that kind of sound like a bait-and-switch?” he said.
Some patients might want to know, Santa said, they are going to a hospital where a for-profit company is involved in management. Santa described Emory as a “very impressive brand.”
“I would assume that Emory has business reasons for being willing to share their brand,” he said. “How that involves quality and performance is a good question.”
Administrators at Emory-Adventist are working furiously to improve patient satisfaction ratings, including making changes to assure feedback is accurate.
Ed Moyer, the hospital’s chief operating officer, said the changes include phones instead of call lights, message boards displaying key staff names and a “turn-down” service offering patients a clean gown or fresh sheets.
The hospital’s most recent internal data show significant improvements in satisfaction ratings for patients admitted this year.
Adventist Health System is affiliated with the Seventh-day Adventist Church. “We take seriously our mission to extend the healing ministries of Christ,” Moyer said.
Fox, the Emory Healthcare chief, said he is very comfortable with the quality of care being delivered at all hospitals in the system. But he said he wants to see improvements at each facility, including the highly regarded hospital on the Emory campus that does ground-breaking work every day.
“I want perfection,” he said. “That does not exist in the Milky Way in terms of health care.”
Online rankings
Patient opinions about their experiences in a hospital have historically been limited to what friends and neighbors share. Today, Medicare’s “Hospital Compare” Web site allows consumers access to detailed patient survey data collected in a scientific manner and made available for almost every hospital in the country.
Many consumers have grown accustomed to checking online reviews before making a purchase. Medicare’s data is backed by hundreds of responses, not just the feedback of patients who happened to post comments on a Web site.
To review detailed quality and satisfaction data for hospitals around the country, go to: www.hospitalcompare.hhs.gov
How we got the story
To examine how well Georgia hospitals performed on patient satisfaction surveys, The Atlanta Journal-Constitution studied the most recent data collected by Medicare for every hospital in Georgia. The newspaper reviewed the latest quality measures published for each hospital. The AJC also interviewed hospital executives and experts in hospital quality and management.