Valley Lacks Timely Medical Care

All three Coachella Valley hospitals – Desert Regional Medical Center, Eisenhower Medical Center and John F. Kennedy Memorial Hospital — rank below the national average in providing timely medical care.

Each of the acute-care hospitals also ranks below the national average in other areas:

• Desert Regional Medical Center also ranks below the national average in mortality, safety of care and patient experience.
• When it comes to having a good patient experience JFK Memorial also ranks below the national average.
• In Rancho Mirage, Eisenhower Medical Center ranks below the national average in the effectiveness of care it provides, according to the newly released report from the Centers for Medicare & Medicaid Services (CMS) is that.

“While we were disappointed to note these scores in these two areas it does allow us to look for other opportunities for process improvement,” Christine Johnstone, vice president of Quality and Performance Improvement at Eisenhower, told Uken Report.  “At Eisenhower, we have a large Medicare population with very high seasonal volumes, and we are often challenged to move patients through the health system as efficiently as we can when we are faced with those high volume Emergency Department and hospital visits.”

Based upon these process improvement opportunities, Johnstone said the hospital plans to evaluate patient flow and throughput in key high volume areas.

“We have already begun an RN-led LEAN process improvement pilot between surgical and medical surgical floor areas to improve nursing report hand-off turnaround and efficiency with the goal of applying to other key patient flow areas,” Johnstone said. “We look forward to expanding those efforts.”

Richard Ramhoff, director of marketing and public relations at Desert Regional Medical Center, spoke for both Desert Regional and JFK Memorial. Both are Coachella Valley Tenet Hospitals.

“Nothing is more important to us than delivering safe, high-quality care to our patients, and we are disappointed that this commitment is not reflected in our recent star performance,” Ramhoff said in an email interview. “We are focused on continuous quality improvement and have implemented a number of measures to elevate the level of care provided to our community.”

It is important for patients to understand that no individual grading scale or rating system provides a complete picture of the care provided at a hospital, Ramhoff added. “We encourage patients to work with their physicians to use all of the available tools to decide which healthcare decisions are best for them.”

It is critical to note that all three hospitals rank above the national average in at least one area; Eisenhower scores above the national average in a triplet of areas, including mortality, safety and readmission rates. Desert Regional Medical Center also ranks above the national average in its readmission rates, one of the most closely monitored aspects of a hospital’s medical care.

Hospitals can be penalized for having too many patients returning within a month of their discharge. In 2017, Medicare penalized more than 2,500 hospitals in the country for its readmission rates. The federal government in October started cutting those hospitals’ payments by as much as 3 percent for a year.

In Indio, JFK Memorial ranked above the national average for patient safety.

The information is compiled at Hospital Compare, which has information about the quality of care at more than 4,000 Medicare-certified hospitals, including more than 130 Veterans Administration (VA) medical centers, across the country. You can use Hospital Compare to find hospitals and compare the quality of their care.

Hospital Compare provides information for patients and caregivers on how well hospitals deliver care and encourages hospitals to improve the quality of care they provide.

The overall rating for hospitals ranges from one to five stars. The more stars, the better a hospital performed on the available quality measures. The most common overall rating is 3 stars.

Eisenhower Medical Center was the only hospital in all of Riverside County to receive five stars, cementing its footprint among some of the best hospitals in the nation. Less than 10 percent of hospitals nationwide received five stars.

The highly coveted ranking was no accident. In an email interview, Johnstone said the five-star ranking was achieved in a variety of ways.

“Our multidisciplinary quality improvement teams across the care continuum have focused in several areas to improve patient care,” Johnstone said.

They include:

• Protocols to reduce the number of days a patient is on a ventilator to reduce infection and improve survivability outcomes.
• Inpatient Respiratory Care Therapists formally collaborate with the Pulmonary Clinic team nurses to get patients in for earlier patient appointments. “This keeps patients out of the hospital.”
• A new Care Transition Team reaching across inpatient and outpatient settings composed of RN Case Managers, Ambulatory Nurse Navigators in Cardiac and Primary Care Clinics, respiratory therapists and leaders who collaborate to improve the coordination of patient care to keep our patients well post discharge from the hospital such as patients with high risk or fragile medical conditions COPD (chronic obstructive pulmonary disease, congestive heart failure, and following a heart attack). “These coordination teams have to ensure that they connect with the patients within a window of time to facilitate their cardiac rehabilitation schedule, primary care and specialty physician appointments.”

“Our Quality Council multidisciplinary team, which has strong physician leadership, helps determine where we should focus improvements each month, and also importantly in our annual strategic plan to achieve larger reaching goals,” Johnstone added.

For example, last year Eisenhower Medical Center focused on prevention of catheter associated urinary tract infections (CAUTI) in its admitted patient population by employing a CAUTI prevention model called “Exfoleyate” which was to promote the timely removal of catheters to prevent infection in our patients.

“Nurses and physicians rallied around this campaign and, as a result, the hospital achieved scores above the national average for lower than expected infections improving overall patient safety,” Johnstone said.

JFK Memorial received two stars; Desert Regional received a single star.

“Our hospital has a number of measures in place to ensure the care we provide is safe, appropriate and of the highest quality,” Tenet’s Ramhoff said. “We have instituted several quality improvement initiatives, such as:

• Every weekday we review our patients’ need for treatments that are at high risk for infection. These would include catheters and central lines for administering medications. These treatments are vital for the right patient but should be removed as quickly as possible when they are no longer needed.
• We are tracking current patient satisfaction scores, which are not reflected in this release. Year over year, our patient experience scores have improved significantly as we focus on enhanced communication with our patients and their families.

“With these efforts and others, we are confident that our data has already begun improving and that will be apparent in future CMS releases,” Ramhoff said.

To read and compare all the results for the Coachella Valley hospitals, click HERE.