Federal rating of University of Iowa hospitals leaps

University of Iowa Hospitals and Clinics Chief Executive Officer Suresh Gunasekaran meets in 2019 with The Gazette's editorial board. (Liz Martin/The Gazette)

IOWA CITY — After scoring a dismal two out of a possible five stars in a 2018 federal rating, the University of Iowa Hospitals and Clinics has rebounded now with four stars — but still is dogged with sluggish patient satisfaction.

Three years ago, UIHC achieved just two stars in an overall rating from the U.S. Centers for Medicare & Medicaid Services, which annually conducts a Hospital Consumer Assessment of Health Care Providers and Systems survey across more than 4,500 hospitals.

Dragging down that 2018 rating was UIHC’s patient-satisfaction performance, falling below state averages in all but one of 10 categories and below national averages on all but three measures.

With its two-star rating, UIHC fell to be among just 18 percent of the studied hospitals. The largest cluster of hospitals got three stars — about 28 percent of the surveyed hospitals.

UIHC Chief Executive Officer Suresh Gunasekaran in 2019 told The Gazette his campus had a “healthy appetite for improving” and he promised the Board of Regents his hospital system would do better.

“Absolutely we take it seriously,” he said at the time.

Indeed, UIHC has improved its overall rating to four of five stars, putting it on par or above 86 percent of the 3,355 U.S. hospitals considered in the ratings.

About 14 percent, or 455 hospitals, earned the top five-star rating in the most recent update, based on April 2021 results. The survey doesn’t, however, take into account how sick a hospital’s patients are or how many a hospital treats every day. That puts a hospital like UIHC that sees the state’s sickest and most complex patients at a disadvantage.

“It is a reality that university medical centers tend to more often than not be four stars than five stars,” Gunasekaran told regents Thursday, but added, “There are enough university medical centers that are five stars that we can do it, too. And we intend to.

“We think that over the next couple of years this is an achievable and realistic goal,” he said. “But it's going to require us to continue to improve.”

The overall ratings are based on quality and performance in five areas: mortality, safety and care, readmission, patient experience and timely and effective care.

The survey’s most recent update shows UIHC is on par with national averages for mortality; above or on par with national averages in seven of eight safety categories, but below average in one; and the same as national averages for readmission.

And while it’s overall rating has improved from two to four stars, its patient experience rating category remains stagnant at three stars.

UIHC, according to the most recent data, did better than or the same as the national average in four of 10 patient satisfaction categories — falling below the national average in six. UIHC did worse than Iowa’s state average in eight of 10 patient satisfaction categories.

It performed poorest in response to two questions:

59 percent of UIHC patients reported they “always” received help as soon as they wanted, below the Iowa average of 74 percent and the national average of 70 percent;

50 percent of UIHC patients reported the area around their room was “always” quiet at night, below the Iowa average of 68 percent and the national average of 62 percent.

UIHC did better than both the state and national averages in two categories:

89 percent of patients said they received information about what to do during their home recovery, above the 88 percent Iowa average and 87 percent national average;

77 percent said they would “definitely” recommend the hospital, topping the Iowa average of 76 percent and the national average of 72 percent.

Gunasekaran told regents the key to improving its overall standing to five stars lies in its safety scores and timeliness of care. UIHC reports a higher percentage than average of emergency room patients who leave without ever being seen — 4 percent, compared with the 2 percent state and national averages.

“In terms of the timeliness of care, we need to continue to expand the capacity of our programs and services because patients having to wait is what is costing us a significant deal there,” Gunasekaran said.

A state board recently denied UIHC a certificate it needs to build a new $230 million facility in North Liberty — a project that would expand its emergency department capacity. UIHC recently reapplied in hopes for approval this time.

“As you know,” Gunasekaran told regents Thursday, “we're working very hard to expand our capacity.”

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