New England’s Best Hospitals Rated By Patients

New England’s Best Hospitals Rated By Patients

What are New England's top hospitals, according to patient feedback?

While annual rankings such as US News and World Report's and safety grades by groups like The Leapfrog Group shine the light on a number of criteria by which to judge a hospital's efficacy, there is another measurement by which they are rated -- and that is by the patients who have been there.

The annual Hospital Consumer Assessment of Healthcare Providers and Systems, also known as the HCAHPS Survey, is a government sponsored survey that looks at patient satisfaction for such metrics as communication by doctors and nurses to cleanliness and quietness of facilities. GoLocal looked at the most recent patient responses at 176 hospitals in New England, and analyzed the patient responses to emerge with rankings for the region, as well as each state.

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"This is a whole new era for healthcare, and it's been a long time coming," said Joseph W. Spinale, DO, Senior Vice President & Chief Medical Officer at Kent Hospital. "Hospitals have for long time been physician centric, not patient centric. Healthcare has been late in doing that -- this is one way we're able to do that.

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Rhode Island had eight hospitals land in the top 50 in New England, including two Lifespan Hospitals -- Newport Hospital and Miriam Hospital -- the the top five.

"Relative to patient experience measurement, the HCAHPS Survey is sent to a sample of patients who were admitted to our hospitals for an overnight stay and who were discharged to home. Clearly, within the established survey parameters, the HCAHPS survey is only capturing a small segment of our patient population," said Cathy E. Duquette Executive Vice President, Nursing Affairs at Lifespan.

In a theme common among hospitals who weighed in on the HCAHPS surveys, Duquette noted that they were just one method of gathering information about patient satisfaction.

"Our aim is to gather feedback from our patients and their families across multiple settings using a number of different mechanisms. In some settings we solicit patient feedback at the conclusion of the care experience and in others we make follow-up phone calls or send our own surveys," said Duquette. "We believe the HCAHPS survey process is just one tool to assist us as we work to evaluate our performance against our mission for delivering health with care."

Kent's Spinale noted that while the data reported each year is for a time period over a year old, the hospital compiled its own real time data to make assessments -- and changes where opportunities were seen.

"I view it as an accurate depiction of the hospital -- a year ago," said Spinale. "Some patients are savvy enough to go online, but that's not the way most patients make a choice. If you live in Kent County, or another area in the state, you usually go to the one closest by. If you have a good experience, you'll go back. if you wait six hours, you'll probably look elsewhere."

See Rhode Island Hospital Rankings HERE

Spinale spoke to measures the hospital was taking based on data it received -- and more. "The biggest thing that we've done was to reengineer our ER, for the survey showed us that was a major factor. Now we have among the shortest waiting times in the state, and are in the top ten percentile in the county."

Still, Spinale said the hospital was seeking additional feedback. "At Kent we started our first patient family advisory council, which is a group of patients and/or their family members who have had a good -- or bad -- experience at the hospital. They'll be be a group of advisers, on every new policy we put in place. We look at programs from physicians, nurses, health care providers perspectives -- and now especially patients."

Hospitals, Nurses on Data

“Hospitals can put action plans in place for improvement on any of the topic areas included in the survey. Action plans may be for specific units or the hospital as a whole," said Pat Noga, PhD, RN, Vice President of Clinical Affairs at the Massachusetts Hospital Association. "In general, we’re seeing more focus on trying to ensure a quiet care environment for patients, so units can be as conducive to healing as possible. Many hospitals also now have staff education and training programs in place that focus on enhancing the patient experience.”

The Massachusetts Nursing Association, however, took issue with the use of the data collected.

"These surveys are only mildly helpful to the patients and they do not reflect the actual quality and safety of patient care in our state’s or our nation’s hospitals. We need to be doing more to improve care and prevent poor outcomes, not just survey patients impressions of care, which really don’t reflect the true quality of care in hospitals," said MA Nursing Association President, Donna Kelly-Williams, RN.

See Massachusetts Hospital Rankings HERE

"One outcome that is measured by the federal government, not reflected in this survey is the number of times patients are readmitted to the hospital: which refers to those patients that need to come back to the hospital for complications in their care that are the result of their not receiving appropriate care in the first place. When it comes to that measure, Massachusetts hospitals rank 42nd in the nation for their ability to prevent readmissions," said Kelly-Williams.

Kelly-Williams continued, "Put another way, we are among the eight worst states in America for failing our patients who come to us for care. Coincidently, excessive patient assignments for nurses is a key reason why Massachusetts does such a bad job of providing care to hospitalized patients. Our nurses are forced to care for too many patients at once, which is resulting not only in excessive readmissions, but also in medical errors, hospital infections and falls. The CDC estimates that 2,000 patients a year a dying in our state’s hospitals due to infections they acquire in the hospital. Again, the number of patients assigned to a nurse is directly related to the number of infections patients receive."

Patient Safety Trends

Patricia McGaffigan, COO & Sr. Vice President of Programs at the National Patient Safety Foundation, which is currently recognizing "Patient Safety Awareness Week," from March 2 to March 8, told GoLocal, "We've recently updated our vision statement, which is "creating a world where patients and those who care for them are free from harm."

"Workplace safety, both physical and mental, is a precondition for patient safety," said McGaffigan. "This is not a brand new finding, we've done some really great work on this the National Patient Safety Foundation think tank, the Lucien Leape Institute, who looked at critical concepts for system level attention and action."

McGaffigan noted Former Secretary of the Treasury Paul O'Neill's formalizing the workplace-based approach to safety, from his days at Alcoa, with the following leadership tenets: 

Am I treated with dignity and respect by everyone I encounter at whatever level?
Am I given everything that I need so that I can make a contribution that gives meaning to my life?
Am I recognised everyday for what I do by someone I respect in the organization?

"Those are the guiding principles to operationalize making the workforce safe before any products or services can be productive," said McGaffigan. "Those principles are being increasingly addressed in the healthcare industry. People are looking for ways to embed those questions in employee surveys, to visualize a safe workforce."

"If workforce safety isn't where it's supposed to be, the outcomes are affected. Creating an essential precondition that needs to be addressed is critical. Some hospitals now have real-time dashboards to report workplace safety metrics," said Gaffigan. "This is well aligned with [O'Neill's] suggestions."

Chart: All 176 Hospitals in New England