Upstate Medical University Hospital has been placed on a ‘watch list’ for the hospital’s high frequency of safety concerns, complications and patient deaths.

The Niagara Health Quality Coalition, a hospital performance research group, included University Hospital along with 20 other New York state hospitals on the list as part of an annual report card. The report card has been released for the last nine years, said David Duggan, University Hospital’s medical director and chief quality officer.

The report states statistics of patient deaths, patient dissatisfaction and complications, Duggan said. Data was risk-adjusted, meaning that hospitals with sicker patients would be fairly compared against hospitals with less sick patients.

The coalition was formed to create a way of continuously improving the quality of more than 200 New York state hospitals and physicians. The reports are based on the relationship between different diagnosis and complication rates, not by simply counting the number of complications, Duggan said.

Reports created by Niagara are based off data released by the University Health System Consortium, a medical center alliance, which said University Hospital had high mortality rates, safety concerns and below average abidance by core measures, Duggan said.

Core measures include Medicare-mandated processes, such as giving heart attack victims aspirin, while mortality rates include all deaths that are not risk adjusted. And though the values are less-than-average, they have gradually improved since 2008, Duggan said.

‘With the core measures, the report lists the times that we didn’t get it right, and our rates of not doing it right have gone down. Our rates of complications have also gone down. And then mortality rate’s aren’t risk-adjusted so nothing can be said about those,’ he said.

Data from the reports is public and widely available, which poses a problem as people begin to draw comparisons between hospitals and relating one outcome to another without knowing the information excluded in the diagnostic codes, Duggan said.

‘They were never designed to be used as comparisons. They were used as comparisons because they can be. And I think that comparing often gives an inaccurate representation of things,’ Duggan said.

Bruce Boissonnault, president and CEO of the Niagara Health Quality Coalition, said that today’s definition of quality health care is mostly steeped in the amount of effort a hospital puts in, when it should be determined by results. While a hospital can put in the right amount of effort each day, they can still have a lousy heart attack rate, he said.

Boissonnault said that the report card lists rare events and that people should not be intimidated by a hospital’s placement.

‘It doesn’t mean that people will receive subpar care — people should not be afraid of their hospitals,’ he said. ‘And it also doesn’t mean that everyone who goes to America’s safest hospitals is going to receive safe care either.’

Though the coalition gave University Hospital a two-star rating, Boissonnault said it does not mean that the hospital is average since the rating follows the New York state standard of care, which has high standards compared to other states.

‘If you think you’re having a heart attack or stroke, or you have some sort of medical issue, that’s not the time to check the report,’ Boissonnault said. ‘You go to the hospital.’

The coalition wants hospitals to take the results seriously, without dismissing them. Worse-than-average results are often attributed to human error that may lead to complications. Because of this, hospitals need to take all possible measures to reduce such factors, Boissonnault said.

University Hospital has developed a system to improve the hospital, which covers two main areas. The first is to reduce the rate of complications by changing the way people practice, while the second is to take great care in recognizing diagnosis correctly. With this system, the hospital has improved in terms of patient safety dramatically, Duggan said.

‘We are always trying to get better, I don’t want to underemphasize that,’ Duggan said. ‘We’ve got teams working every day to get better. And, unfortunately, things do go wrong, and our job is to do as best as we can to limit that to the minimum number, and we’ll continue trying to do that.’

Syracuse University Health Services often sends students to University Hospital, either by referral or through SU Ambulance. Students have a choice on where they want to go, and many choose University Hospital, said Paul Smith, a Health Services representative.

‘If we have a student, we can take them anywhere they choose, they can go to the health center or to one of the hospitals,’ Smith said. ‘It depends on their preference, their condition and the situation. But we usually let them choose.’

meltagou@syr.edu

Published on September 18, 2011 at 12:00 pm

Contact Marwa: meltagou@syr.edu | @marwaeltagouri