Sacred Heart Medical Center & Childrens Hospital and Deaconess Medical Center scored the highest overall patient-satisfaction ratings among Spokane Countys four main hospitalsand exceeded state and national averagesin evaluations made public recently for the first time.


Data showing what patients thought about the care they received at hospitals throughout the state now are being posted on the Washington State Hospital Associations Web site, at www.wsha.org, along with other quality-related data and hospital charges for more than 500 types of treatments and services.


At the associations Web site, visitors can view the satisfaction ratings by clicking on the Hospital Transparency window, then clicking on the Hospital Quality Measures link.


Hospital-specific patient evaluations provide new information individual hospitals can use to improve their quality and safety, said Leo Greenawalt, the associations president, in an April 8 press release.


Also, he said, such information allows patients and purchasers to make informed decisions about where they choose to seek care. How patients view the care they received is precisely the kind of information consumers value. Including this information greatly enriches patients understanding of the ways in which their local hospitals excel.


Sacred Heart and Deaconess had overall satisfaction ratings of 68 percent and 67 percent, respectively, followed by Holy Family Hospital, at 63 percent, and Valley Hospital & Medical Center, at 60 percent. Those satisfaction levels compare with state and national averages of 64 percent, and 63 percent, respectively.


Two smaller Eastern Washington hospitals, Pullman Regional Hospital, in Pullman, and St. Josephs Hospital, in Chewelah, received the highest satisfaction ratings in the state, at 82 percent and 78 percent, respectively. Mount Carmel Hospital, in Colville, was at 60 percent, and Deer Park Hospital, which closed two months ago, was at 58 percent.


Sacred Heart, Holy Family, Mount Carmel, and St. Josephs all are part of the Spokane-based Providence Health Care network, as was the Deer Park hospital, and Deaconess and Valley Hospital both are part of Spokane-based Empire Health Services.


Denise Dominik, director of performance improvement at Sacred Heart, says she regards the patient satisfaction data mostly as an incentive to improve.


We feel good about the scores, as compared with the state and nation, Dominik says, but we feel were the best in the Northwest, and we want our scores to reflect that.


She says, We have several things that have been happening across the medical center to address the results of the survey and make improvements.


One example is hourly rounding, or having a nurse or nursing assistant check in with patients or family members on an hourly basis, she says. The hospital initiated that effort last fall in one unit, and the (satisfaction) results on that unit went up dramatically, so it plans to expand the practice.


Along with providing reassurance to the patients and their relatives, she says, The end result is that the noise level on the unit goes down because there is less call lights, and work flow for nurses who work in the unit improves.


The state hospital association notes that many hospitals collect information from their patients about their satisfaction with the care they receive. Until now, though, it says, there hasnt been a national standard that allows the public to make valid comparisons between hospitals, nor has there been a method for publicly reporting that data.


The data are being compiled by the federal Centers for Medicare & Medicaid Services, and reflect patient satisfaction levels at the time they were discharged from the hospital from October 2006 through June 2007. It will be updated quarterly. The patient survey used to gauge satisfaction levels includes 27 questions, and answers are grouped into 10 categories. Along with the overall rating, those categories are: willingness to recommend the hospital, communication with nurses, communication with doctors, responsiveness of staff, pain management, communication about medication, cleanliness of hospital, quietness of hospital, and discharge information.


The data are posted on the Centers for Medicare & Medicaid Services Web site, but that site is difficult to use and allows users to display data from only three hospitals at a time, the state hospital association says. The associations list, by comparison, shows the ratings in all 10 categories for all of the hospitals across the state from which data were available.


Information wasnt listed for a large number of the states 97 hospitals, but those not reporting were mostly smaller facilities, says Cassie Sauer, spokeswoman for the association. Some of them, called critical-access hospitals, arent required to collect the data, because of their small size, and others likely will release the data after theyve been gathering survey information for a full year or as soon as theyve collected enough for it to be statistically valid, she says.


The states average satisfaction ratings equal or exceed the national ratings in eight of 10 categories. Deaconess matched or topped the state average in seven categories, while Sacred Heart, Holy Family, and Valley Hospital each did so in three categories. Mirroring statewide and national patterns, Sacred Heart and Deaconess both received their highest marks in discharge information, patient communications with doctors and nurses, and willingness of patients to recommend the hospital, and their lowest marks in quietness and staff-explained medicine.


Spokane County hospitals also fared well compared with the state average, for the most part, in quality indicators relating to treatment for heart attack, heart failure, pneumonia, and prevention of infections. In the treatment of heart attacks, for example, Sacred Heart, Deaconess, and Holy Family all were well above state and national averagesscoring at or near 100 percentin having patients take aspirin and blood pressure-lowering beta blockers after they arrived at the hospital and when they were discharged, and in advising them about smoking cessation.


Hospital charges


Comparing hospital charges here with those across the state is more difficult because the portion of the associations Web site devoted to pricing requires picking a single hospital, then a specific type of care from among eight general categories and a couple of dozen subcategories.


A cursory review suggests, though, that hospital charges here remain substantially below the state average for most types of care. For example, the listed average charge for a vaginal delivery birth with no complications at hospitals in Spokane County was $4,516, or more than $2,000 less than the $6,572 average charge for all hospitals in the state.


Similarly, the average Spokane County hospital charges for treatment of chest pain and simple pneumoniaalso among the 10 most common types of hospitalization in the statewere $7,944 and $13,253, respectively. Those figures compare with statewide average charges of $9,845 for chest pain and $14,606 for pneumonia.


Among common hospitalizations that are more expensive, the average charge at Spokane County hospitals for a heart bypass operation with cardiac catheterization, on a patient who hasnt been diagnosed as having major heart disease, was $69,399. That compares favorably with a $91,760 average that hospitals statewide charge for that procedure.


Comparing the average charges among hospitals here, Sacred Heart ranked as the most expensive in all of the most common types of hospitalization, and either Valley Hospital or Holy Family ranked as the least expensive in all but one category.


For some types of hospitalization, the difference in charges was minimal, such as for cardiac catheterization without complications. In other cases, though, Sacred Heart was much pricier than the other hospitals here. For example, Sacred Hearts average charge of $10,305 for an uncomplicated cesarean section was nearly double Valley Hospitals $5,195 average charge.


In all cases, the charges are for hospital services only, and dont include physician charges, such as those for a surgeon or anesthesiologist. Also, because the information pertains only to charges, viewers of the data would need to contact their insurers to determine how much the insurers would pay and how much they personally would have to pay for the selected service. Insurers negotiate discounts with hospitals on behalf of the patients they represent, and Medicare and Medicaid pay according to a set fee schedule that also represents a discount from a hospitals billed charges.


Along with the charges, the pricing-related data include the number of patients cared for at each hospital for each service and the average number of days patients who received a service stayed in the hospital. Also included is information about how much of each hospitals business and payments come from different sources, the level of government underpayment, and the amount of care each hospital provides for which it receives no payment.


A third section in the transparency portion of the hospital associations Web site provides answers to common questions about hospital bills, along with information about the availability of charity care and financial assistance.


Contact Kim Crompton at (509) 344-1263 or via e-mail at kimc@spokanejournal.com.