What Hospital are our Commenter's Talking About?
Among the comments on the Hospital Bond, there are lots of criticisms of the Hospital Administration, Hospital Staff, Management, level of care, and the oft used anecdotal quote that "Local Dr's tell me to goto _______ hospital, not MMH."
I may not be an investigative journalist, but I like to base my opinion on some kind of reliable data or measure to see exactly how poorly, or well, our hospital may be performing. HealthInsight.org is a non-profit organization that helps improve the quality of health care system in Nevada and Utah, and as part of that mission, they have developed a methodology of
"[computing] hospital rankings using publicly reported data downloaded from the Centers for Medicare & Medicaid Services (CMS) Hospital Compare website (www.hospitalcompare.hhs.gov - last accessed 3/26/09). This data set contains hospital-specific performance on 25 quality measures for over 4,500 hospitals nationwide."
There are some caveats to using the data, but it can provide some useful comparisons and trend analysis to see if any of the statements of our commenter's hold any water. Specifically the data is in presented in percentiles, so hospitals are ranked against themselves, and some small hospitals which only perform one type of service will rank higher than full service hospitals. Generally speaking, I would start worrying about a hospital which is in the bottom third of hospitals, or in the 33rd percentile or lower. So, what do the figures say?
Midland Memorial Hospital is in the 51st percentile of performance Nationally. Which means it is barely in the top half of hospitals in the US. But what about Lubbock, only the Lubbock Heart Hospital, LP is ranked higher than MMH (63rd percentile). UMC and Covenant are 45th and 37th respectively. Dallas isn't a bad bet, with Baylor (86th) Parkland (73th) and Methodist (69th). Houston isn't that bad either, with Hermann (71th), St. Lukes (64th) and St. Joseph (62nd). Though you may want to avoid the short drive to Odessa. Ector County's Medical Center Hospital clocks in at the 18th percentile and ORH in the 8th.
So what about trends?
From Q4 of 2006 MMH has risen from a performance rating of 81 with a National Percentile ranking of 33 to a performance rating of 91 and with a National Percentile ranking of 51. To me that is a pretty good trend line, which means the current administration must be doing something right.
Ector County isn't so lucky, over the same time period, they have risen from a 77 to an 82 performance ranking, but because so many hospitals have raised their performance levels also, their percentile rank has actually dropped from 20th to 18th.
Digging into the individual data points, a comparison of MMH and UMC Lubbock reveals that UMC beats the pants off of MMH in room cleanliness, quietness, getting a 9 or 10 on outpatient surveys which then translates into only 66% of patients recommending MMH to 79% recommending UMC to friends and family. Oddly enough, UMC nurses got 3% better for communication, but MMH doctors were 3% better at communication. The rest of the health care based measures were pretty much a dead heat (save poor Pneumonia treatment scores at UMC). Which makes me wonder if the perception that Lubbock is a better hospital comes from non-professional staff, facilities and facility upkeep, because treatment and professional staff are similar (with Midland performing better in many areas) according to HSS Survey data.
Just looking at the data, I would have to say that MMH has made some great strides in the last 3 years and if the comparison to UMC Lubbock is instructive, MMH may be perceived as a poorer hospital just because of the way it looks, because the objective care measures and staff competence measures don't correlate to the wide gap between UMC's perception and MMH's perception.
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12 Comments
The comparison on these facilities are somewhat confusing as many have incomplete values, which sums up to me that the criteria used was sent in by each entity and not conducted and judged utilizing surprise inspections. For instance, Reagan Co. (100) has three missing values while Dimmitt Co. (1st) has all categories. Looking at nearly all health facilties, many of the values are missing. MMH has dropped from 33rd to 51st since 2006. Not one category listed them in order of their physical appearance. As one can see, some of these health centers are large while others are very small. They hold varying positions on the national scale, and I know some holding higher positions are smaller and lesser asset value than Midland Memorial. Doesn't that explain that bigger and more expensive won't embrace the notion that MMH will ever get beyond #51?
HW, you are reading the data backward. In 2006 MMH was in the 33rd percentile of performance (bottom 1/3) and now it is in the 51st percentile, or top 1/2. Also, I did mention the data caveat, and cautioned that the data points are incomplete for hospitals that don't perform all the procedures. Which is why I pointed to trends and comparisons between hospitals of similar size and scope of service and their relative scores and percentile rankings.
The higher the percentile number, the better the hospital. The site takes percentage survey data from HHS that looks at the % of time a standard procedure is administered in a certain amount of time, and the % of time the hospital receives as 9 or 10 in a subjective category (like cleanliness, communication, etc.) and then averages them. In 2006 on the performance measures, MMH performed the recommended procedure within the time criteria, or received top marks in patient surveys (9 or 10 on 10 point scale), 81% of the time. In the 1st Quarter of 2009, MMH performed the recommend procedure within the time criteria, or received top marks in patient surveys 91% of the time.
As for my inference on physical appearance, room cleanliness and quietness are a function of the design and look of the building. A 1950s era building with stained linoleum and rusted out pipes isn't going to score well next to a modern room made from newer modern materials, no matter how hygienic or clean the actual interior surfaces may be. The HHS survey asked what -patients- though of the cleanliness and quietness of the rooms, they didn't go in there and test surfaces and use sound meters, so they were subjective measures about how patients felt about the facilities.
Though I support the bond, for the most part I'm just trying to inject more data into the debate and try and get people away from the preconceived notions of the hospital. If anything, I was surprised at what I learned about the improvements in meeting standard care milestones and improvements in patient surveys about their care. It makes me more comfortable that MMH has been preparing to make the next step and is on the path to utilize a new facility. If the hospital was declining in performance, I sure wouldn't want to be supporting their efforts at this point in time.
Note to All:
Whether you choose to go for the issue or against the issue you should ALWAYS copy your comment to your clipboard before submitting it in case you are rejected by the anti-spam CAPTCHA device.
On many occasions I have typed in what I know to be the correct sequence of letters only to be rejected and forced to re-type my comment from scratch.
I think what happens is that if you take too long to type in your comment the CAPTCHA routine updates the sequence of letters in the background but doesn't update the sequence it displays to the commenter so when you finally hit "Submit" the machine doesn't think the sequences match.
So, again: Before you submit your comment make sure you COPY IT TO YOUR CLIPBOARD so that if it is rejected you can then just PASTE the comment into the box and try again.
This flaw affects everyone regardless of their stance on the issue at hand so we can have the black helicopters recalled.
I'll vouch for that, several of my diatribes were not submitted because (I think) it took so long to compose and the security sequence updated itself. Anyway, being (abviously at this point) someone for the hospital issue and had the same thing happen, I learned the copy function fast. Thanks for the update site admin. Hog Wash, I am sorry, but again, conspiracy theories abound from you...
I think I'll go in this afternoon or tomorrow morning and vote FOR this damn hospital issue( collective gasp).
I have been an "aginer" all my life and shall continue to do so . HOWEVER !................
The issue of the hospital will enrich the lives and health of ALL Midlanders , rather than making the fat cats downtown fatter.
Although there is nothing wrong with getting rich......just so long as you ain't using MY money to do so.
Pay close attention to the pledged funds from the private donors as this election progresses. 60 million has been reduced to 53 and no proof, and the taxpayers portion has jumped from 115 million to 175 million. If the election is successful, watch the donor's portion disappear, and the taxpayers' portion climb. And I'll reserve my position on the black helicopters and conspiracy jokes until after the election.
from day one $60M has been put forth as the Goal, and $53M is pledged to date.
There is no reduction, just an un-met goal. If you're gonna sling criticism, at least be as fair and accurate as you can.
Aginner's spouting inaccurate and easily refutable statements aren' effective.
I have always thought that I was an born aginner but I don't think that even I have in my skill set to portray $53 million pledged towards a goal of $60 million as Fat Cats somehow about to screw the public out of $7 million.
I'm impressed.
Wals, I believe you have misinterpreted my comment.
I am voting For the bond issue as it will help many West-Texans.
Screwing the public out of a measly 7m is not an issue OR even any accusation by me .
My issue was with these other bond "events" of converting downtown Midland into the new Austin or
Chicago, by using public money to enrich property owners.
Feel free to take me to task on that...but on the hospital issue , my friend , we are on the same page.
Otto:
I believe that Walser was responding to Hog Wash's 12:19PM comment.
Oh ! My Bad .
Sorry Wals..I DID ,however , mosey into the tax building this morning along with a WHOLE BUNCH of gray headed Midlanders and voted FOR the hospital bond.
Lord Lord ! It took every ounce of fortitude I owned to vote YES and I think I lost ten pounds for the effort but I am sure I'll feel much better after my nap .
Back later....So sleeepppppyyy...
I submitted a posting challenging the reports mentioned by this poster. The past few days, I have posted several against the hospital bond election, and all have been rejected on first try. If you choose to go against this issue, best copy your posting or you will lose it when attempting to post it.