Utah is one of the smallest hospital markets in the country and also one of the best at providing quality patient care. And the hospitals here can become even better if they're willing to examine both strengths and weaknesses, admit errors and embrace some of the practices that make corporations successful.
That word came this past week from Jean Chenoweth, executive director of Solucient 100 Top Hospitals Benchmarks of Success Program. Solucient is an independent health research organization that uses publicly available outcome data to find what she calls "top-performing" hospitals. Chenoweth was at St. Mark's Hospital to discuss with area hospitals how to achieve consistently better medical outcomes.
That translates into patients' lives, she said. Solucient believes if all hospitals excelled at the benchmarks achieved by hospitals on its Top 100 list, 65,962 more people would survive. That means in a teaching hospital about 39 more patients would survive, while in a major teaching hospital, the number would average 46. And 38 complications would be avoided at those large teaching hospitals on average each year.
"Top hospitals reduce mortality at twice the rate" of other hospitals.
The secret is maintaining the focus on clinical care but giving equal emphasis to system-wide practices that are effective and financially sound, she told the Deseret Morning News. They also need to take advantage of "shifts in the industry." For instance, magnetic resonance imaging nearly erased the need for exploratory surgery, improving the outcome and reducing costs.
A national report several years ago by the Institutes of Medicine noting the number of medical errors caught the nation's attention. If you peel away the layers, she said, you'll find errors are "not usually due to one doctor or nurse, but due to system problems."
Financial management is important because "if you have no money, you have no mission," she said.
The very best hospitals have a "very special kind of leadership. They are organizations able to function on all cylinders" as a team without problems like in-fighting, Chenoweth said.
Errors need to be explored without a lot of blaming going on so they can be learned from, she said. Blaming encourages people to hide bad outcomes instead of learning from them.
Hospitals also need to "be more responsive in the ways consumers want. Most of the industry has not done that yet," she said.
Utah is lucky because it benefits from top-notch competition in the health-care field, she said. "This community has hospitals that keep improving over time. We're not just looking at eclectic measures; we are looking at overall performance."
Only a handful of communities, including Boston, Spokane and Nashville, have had two competing hospitals make the top 100 list. Salt Lake City's St. Mark's and LDS hospitals both made the top 100 this year in the cardiovascular category. And both have been on the list before, she said. St. Mark's was on the list as an overall 100 Top Hospital. In the small community hospital category, Valley View Medical Center in Cedar City was listed, as was Ashley Valley Medical Center in Vernal.
Utah hospitals make a lot of lists, which each use different criteria. For instance, Logan Regional Hospital has made the Top 100 list. U.S. News and World Reports listed LDS Hospital and University of Utah Medical Center among "America's Best Hospitals." And Money Magazine's top hospitals list honored St. Mark's in the categories of hip fracture and pneumonia treatment, while LDS Hospital was lauded in heart attack and total hip replacement categories. Verispan dubbed Intermountain Health Care the No. 1 integrated health-care system.
That doesn't mean improvements aren't possible, Chenoweth said. And adopting sound business practices will play a large role in improving quality of care in the community.
E-mail: lois@desnews.com