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FRESNO -- Hospitals in the central San Joaquin Valley scored poorly on a first-ever Consumer Reports safety survey released this month. And while hospital leaders were critical of the report, they acknowledged its value for patients. Hospitals were given a safety score of 0 to 100, with 100 being the safest. No Valley hospital had a score greater than 46, and a hospital in Hanford was at the bottom among California hospitals surveyed. Valley hospital officials cited the region’s doctor shortage and large numbers of poor patients as possibilities for the low ratings, and said Consumer Reports did not take those factors into account, among other failings. But they recognized that hospitals now can be compared as easily as appliances, cars and televisions. “The fact that Consumer Reports is covering this is really going to alter the way the public perceives hospitals and how the public chooses to get health care,” said Dr. Mark Garfield, vice president and chief medical officer for Kaweah Delta Health Care District. Consumer Reports recognized that consumers want and need hospital comparisons, said Dr. John Santa, director of Consumer Reports’ Health Ratings Center. “We published this,” Santa said, “because we think there’s enough information there that it could make a difference for hundreds of thousands of consumers.” Consumer Reports rated hospitals on infections, readmissions, communication with patients, overuse of imaging tests, complications and mortality. The six measures were compiled into a composite rating. Data was taken from government and independent sources to rate 1,159 hospitals in 44 states, about 18 percent of hospitals nationwide, the organization said. Six Valley hospitals were rated — Fresno Heart and Surgical Hospital, Community Regional Medical Center and Saint Agnes Medical Center in Fresno; Clovis Community Medical Center; Kaweah Delta Medical Center in Visalia; and Hanford Community Medical Center. Fresno Heart and Surgical received a score of 46, Saint Agnes a 41, Clovis Community a 39, Community Regional a 36, Kaweah Delta a 29 and Hanford Community a 25. Hanford’s score was the lowest of 168 California hospitals rated, and placed it in the bottom 10 nationwide.
“It’s discouraging, but it’s not who we are, and it’s not where we’re at,” said Kristen Johnson, vice president of Adventist Health Central Valley Network, which operated Hanford Community until the hospital moved to a different location under Adventist Medical Center in 2010. The survey data was from before the hospital’s move, Johnson said. There have been a lot of changes since then, she said. “Our patients are safe. We do provide quality care.”
What dragged Hanford’s score down was its rating for duplicative scanning. Doctors sometimes order double scans because they believe they provide more useful information than single scans. But often the second scan is not needed and exposes patients unnecessarily to radiation, a Consumer Reports medical consultant said. Consumer Reports said a 2009 study suggests CT scans, equivalent to between 100 and 500 chest X-rays, might contribute to an estimated 29,000 cancers a year nationwide. It set 5 percent or fewer as the cutoff for duplicative abdominal and chest scans for hospitals to receive a top rating. In Hanford, 60 percent of scanned patients received double abdominal CT scans and 52 percent received double chest scans, according to the survey. Since the Hanford its hospital’s move to Adventist Medical Center, a new radiology group has been brought aboard, Johnson said. The hospital also has two new scanners and software that produce better pictures, she said. Criticisms of the survey Adventist doesn’t argue that it has room to improve, but Johnson said she takes exception to the ratings. Consumer Reports included only 38 percent of California hospitals, and 18 percent of the nation’s institutions, she said. Consumer Reports said data wasn’t available for all hospitals, because not all volunteer a full report of patient harm data. Valley hospital officials also criticized the report for using old data and not enough measurements. The six criteria used to rate the hospitals give only a partial picture of safety measurements that hospitals track, they said. For example, the report rated hospitals on bloodstream infections, but failed to include other infections such as ventilator-associated pneumonia, said Dr. Thomas Utecht, chief quality officer for Community Medical Centers. Both Fresno Heart and Clovis Community hospitals, which are operated by Community Medical Centers, happened to score badly for bloodstream infections.
