Hospital Compare 5-star ratings released

CEDAR RAPIDS — There are plenty of things to consider when choosing a hospital — its specialties, the cost of care, readmission rates.

But what about the patient experience? How fast do nurses respond, and how well do doctors communicate?

The Centers for Medicare and Medicaid Services (CMS) hopes to answer those questions with the release of its Hospital Compare five-star ratings this past Thursday of more than 3,500 of the nation's hospitals.

The ratings are based on patient-experience surveys, which measured patient satisfaction in areas such as how well doctors or nurses communicated with patients, responsiveness of hospital staff and cleanliness of the hospital.

Hospitals were given an overall summary score as well as scores — from one star up to five stars — for each of the 11 categories for which patients were surveyed. The starred ratings will be updated each quarter, CMS said.

The Corridor's hospitals all received midrange scores. The University of Iowa Hospitals and Clinics and Mercy Medical Center in Cedar Rapids each scored a 3; Mercy Iowa City as well as UnityPoint Health-St. Luke's Hospital ended up with 4 stars each.

The state's 62 hospitals that received scores averaged a 3.8-star rating, with the majority receiving a score of 3 or 4 stars. Only two hospitals scored a 2-star rating — Broadlawns Medical Center in Des Moines and Ottumwa Regional Health Center.

Database: Highest, lowest rated hospitals in Iowa

Click to find out what rating your local hospital received from the CMS.

And about a dozen of Iowa's hospitals scored a 5 — all of which are located in cities with populations of fewer than 12,000 people. That followed national scores, in which the 250 or so hospitals that received a 5-star rating where smaller or very specialized, said Sherrie Justice, St. Luke's performance improvement director.

Smaller hospitals tend to perform better when it comes to patient satisfaction, she said, because they often see fewer patients and are perceived as more friendly and intimate.

St. Luke's was pleased with its overall 4-star rating, but Justice said she's not sure how helpful the ratings are for patients.

'It might help consumers differentiate between a 1-star and a 5-star,' Justice said. 'But really, what does it tell you for hospitals that score 3- or 4-stars?'

That doesn't mean St. Luke's doesn't have room for improvement, she added. For example, the hospital scored 3 stars in a category that asked survey respondents how well staff communicated the necessary information about medications needed after discharge.

This was an area St. Luke's already was working to improve, she said, because the hospital realized the discharge information, including medications, provided to patients is confusing.

'It's just not patient-friendly or that clear,' she said, adding she believes the hospital's scores in that category have come up since it has initiated those changes.

One area with which it was particularly pleased was the 4-star rating it scored for staff responsiveness.

'Nurses are juggling multiple patients, so there are people with urgent needs and people who want something to drink,' Justice said. 'We have nurses touch base with patients periodically — not just to get someone's blood pressure — so that patients don't have to call you. They meet needs before needs occur.'

Justice did caution that the patient surveys are measuring only a select part of the population — Medicare patients — and limited services.

Mercy Medical Center representatives echoed that sentiment.

'It's not really telling you who scored really well and who didn't because it's grading on a curve,' said Dr. Mark Valliere, Mercy's senior vice president of medical affairs and chief medical officer. 'It's just telling you which hospitals scored better than others.'

Mercy received a 4-star rating in the areas of care transition and overall hospital experience and a 3-star rating in the areas of communication about medicines and staff responsiveness.

Mercy worked hardest to bring up its staff-responsiveness rating, he said, which for patients frequently amounts to 'how fast will the nurse answer the call light.'

'The answer is, they can always answer the call light faster,' he said.

Valliere also pointed out that the surveys only focused on the patient experience and did not ask patients about the successfulness of procedures.

That doesn't mean the patient experience isn't important, he said, explaining the hospital is implementing a national program that focuses on patient-centered care — from the foods served to the types of signs used.

Mercy will be evaluated, and hopefully certified, this summer, he said, and those changes should spill over into its CMS ratings.

'There are months when we're outstanding, and there are months when we struggle,' he said.