The state recently released its sixth annual New Jersey 2009 Hospital Performance Report, and Palisades Medical Center in North Bergen had the highest scores in Hudson County.
Jersey City Medical Center got the next highest scores, while Bayonne Medical Center, Hoboken University Medical Center, and Christ Hospital in Jersey City all ranked in the bottom half of hospitals across the state.
The report, completed by the New Jersey Department of Health and Senior Services, analyzed how patients fared in four areas: heart attacks, pneumonia, surgical care, and heart failure.
For the first time this year, patient safety indicators were also included, counting how many medical errors could have been avoided.
The data was gathered from 2008 patient records from hospitals across New Jersey.
“It’s a real team effort.” – Miriam Stablein
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Heart attacks cause 500,000 deaths each year. Pneumonia accounts of 1.2 million admissions to each year and is the second most common infection acquired while staying at a hospital.
Scored 98’s and 100’s
According to the report, Palisades Medical Center on River Road scored in the top 10 percent of hospitals in the state for their care of heart attacks, surgical care improvements, and heart failure. In those sections, they received 100, 98, and 100 percent respectively.
The percentages represent the number of patients that are treated properly and released. Therefore, 100 percent of patients admitted for heart attacks were correctly treated.
For pneumonia, PMC received 98 percent, which was greater than 50 percent of hospitals in the study.
“We are very, very pleased,” said Miriam Stablein, the director of quality assurance at PMC. “The staff is obviously feeling proud because it is they who provide the care directly to the patients, and they are the ones that have contact with the patients on an ongoing basis.”
Stablein said that communication between departments and with the leadership was the reason behind their current rating.
Other hospitals
PMC received the best score from the state of New Jersey out of all of the hospitals in Hudson County.
Bayonne Medical Center, Hoboken University Medical Center, and Christ Hospital of Jersey City all ranked in the bottom half of hospitals across the state, but they said that they are already making improvements.
BMC received 80 percent in heart failure treatment, 82 percent in surgical care, and 88 in pneumonia treatment. They received 95 percent for heart attack treatment.
“The hospital performance report indicates performance in 2008,” said Allyson Miller, vice president of business development for Bayonne Medical Center. “Bayonne Medical Center emerged from bankruptcy in 2008 under new ownership and management. New ownership recognized that our performance based indicators were not in the acceptable range, and several strategies have been implemented since then. Our efforts are continuing and we expect that the 2009 report will show substantial improvement.”
Christ Hospital received an 81 percent for their heart attack care, an 88 percent for surgical care, and 92 percent for pneumonia and heart failure treatment.
President and C.E.O. Peter A. Kelly said that the data of the report is one year behind and that the hospital focused on their shortcomings throughout 2009 and has made changes along the way. Their performance improvement department, which collects the data for the report, has been working hard to make appropriate changes, said Kelly.
“We were aware at the end of 2008 of the areas that we had to improve,” said Kelly. “Our 2009 year data… shows a significant increase in all of those areas. As a C.E.O., I am never pleased with anything other than the best, the other issue here is recognizing where we need to improve and implementing the changes which we need to do to make that improvement here.”
Hoboken University Medical Center received 95 percent for heart failure care, 93 percent for surgical care improvement, and 92 percent for pneumonia and hearth attack treatments.
Director of External Affairs Joan Quigley explained that in some of the categories where their scores needed improvement, the cause was due to hospital employees not following the correct procedure for documentation. For example, she said that if a patient wanted a flu shot, they would write that down, but if they declined, that was often not written down.
She said that there were changes to be made, but that they did not represent an issue with the care patients received.
“We discovered that last year and have intensified our efforts to work with the staff to get them to make sure that everything is written down and signed as needed and checked on a monthly basis,” said Quigley. “In most areas, we are close to 100 [percent and] we are very pleased with progress we’ve made.”
In the middle
Jersey City Medical Center did the second best in Hudson County. They received 95 percent for treatment of pneumonia cases and 97 percent for heart attack, heart failure, and surgical care.
Meadowlands Hospital Medical Center in Secaucus was a mixed bag. They received 82 percent for their surgical care, 93 percent for pneumonia treatment, 96 percent for heart attack cases, and 97 percent for their heart failure care.
“The scores at Jersey City Medical Center and Meadowlands Hospital are excellent and show a continuous improvement over every prior year, but we are not yet satisfied,” said Joseph F. Scott, president and chief executive officer of Liberty Health, which operates and manages both facilities. “One of our strategic goals for 2009 is to be 100 percent across the board in all quality and safety measures.”
According to Martin Baicker, Senior Vice President and administrator at Meadowlands Hospital, the improvement is already evident – the Secaucus hospital has scored 100 percent in virtually all categories during the first eight months of 2009, he said.
One problem
In a patient safety indicator section, where post-operative sepsis [a bad blood infection] was analyzed, Palisades did not do as well.
The 2004 national average was 11.4 cases per 1,000 people treated, and statewide, the 2007 rate was 13.9 per 1,000 cases. However, Palisades Medical Center had a high-post operative sepsis rate of 42 per 1,000.
Christ Hospital had only 13.4 incidents per 1,000. BMC had 25.3, and Jersey City Medical Center had 0 incidents per 1,000 cases.
Attention to detail
Palisades Medical Center received a 98 in their pneumonia treatment because of a few factors, according to the report. It stated that 98 percent of patients received the correct antibiotic timing, while 93 percent received blood cultures.
For surgical care, 98 percent of patients started on the correct preventative antibiotic, while 90 percent of patients stopped the antibiotic at the correct time. According to the report, it is important to start and stop antibiotics at the correct time to prevent infection.
PMC’s rating in the patient safety indicator section of the report also was good. Only 0.03 of patients admitted received accidental punctures or lacerations, while the national average is 3.6.
Stablein said there is always room to improve, but the reason for PMC’s high scores was their attention for detail and their goal to exceed expectations. She also said that leadership from C.E.O. Bruce J. Markowitz and others helped open communication between nurses, doctors, and those being treated.
Stalblein, who had previously spent 13 years in nursing administration, said that her department is small, but that they are able to “tackle” issues by reviewing processes every day and looking at where improvements can be made for patients, said Stalblein.
“We currently have the confidence that we are able to provide the best of care in the best interest of our patients,” said Stalblein.
She also said that educating patients and following up with them is important, as is appropriately diagnosing patients.
“It’s a real team effort,” said Stalblein.
To check out the report, visit www.nj.gov/health/hpr.