Controversial survey rates hospital performance

By Jennifer Thurbide

Hospitals across the country had mixed reactions to a controversial new ranking system published by CBC and unveiled on their the fifth estate program last week.

After months of investigating medical facilities in small towns and urban centres, the news establishment launched Rate My Hospital, an assessment tool that graded Canadian hospital performance and that provided a ranking of between A+ and D to more than 140 hospitals in Canada.

On the list were institutions like the Red Lake Margaret Cochenour Memorial Hospital (RLMCMH), Lake of the Woods District Hospital and the Dryden Regional Health Centre.

Last week RLMCMH President and Chief Executive Officer Paul Chatelain says in an effort to be transparent he responded to the CBC’s request for information noting the data they were seeking was not confidential and would eventually be gathered through other means.

“I think it was a good opportunity to raise awareness about health care which is a sensitive subject these days,” said Chatelain on April 11. “I didn’t realize it was quite the controversial story that has been put out.”

The local hospital did not receive an overall ranking, which was common for institutions that did not handle surgeries, however, was given a B for “nursing –sensitive adverse events, medical patients” and a D for “readmission after medical treatments”.

Chatelain says the latter ranking was inevitable as the indicator does not take into account the isolation factor.

“When a patient comes in for a chest cold or possible pneumonia and they come in next week with a possible broken foot – that is counted as a readmission. I mean where are they going to go, Dryden? To me, I don’t believe in that indicator at all.”

CBC says an A+ grade means that data reported by the hospital shows its patient outcomes in the areas measured are substantially better than a typical hospital of the same size; a B means they are similar; a C that they are lower and a D that the are substantially lower than a typical hospital of the same size.

The Dryden Regional Health Centre was the only regional hospital to receive an overall ranking, garnering a B. Two Winnipeg hospitals in the large-community category received a A+ ranking – Grace Hospital and Victoria General Hospital, and 140 hospitals across the country received B grades. Thunder Bay’s Regional Health Science Centre received C rating. Eight hospitals received a D grade, four in British Columbia, three in Alberta and one in Saskatchewan.

Jack Tu, a cardiologist at Schulich Heart Centre at Sunnybrook Hospital in Toronto and a member of the five-person panel that provided the assessments, told the public last week report cards on medical institutions are controversial due to a lack of standardization in approach.

“Every hospital wants to do well on these reports, and so by making this information public, it can help to galvanize hospital administrators and clinicians into making necessary system changes to improve their performance,” said Tu.

Chatelain agreed. The CEO notes processes like these raise awareness and “keeps management and the board on our toes that we need to do it better.”

“I think we have done really well and I think that if we would have received a score it would have been a B or something close to that. It’s a snapshot of how we are doing,” he added.

The Ontario Hospital Association’s CEO and President Pat Campbell criticized the scoring system, citing concerns with the methodology.

“Patients providing commentary on hospitals, CBC providing commentary on hospitals, that’s all fair game,” she told media last week. “What we’re concerned about is patients relying on this information to make decisions on when and how to access care when it’s not necessarily grounded in good evidence.”

CBC says the data collected for the project came from the Canadian Institute of Hospital Information, a publically funded, non-profit organization, and a survey sent to more than 600 hospital CEOs earlier this year.

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