Ratings
To see the ratings, search online for “Hospital Compare” or go to www.medicare.gov/hospitalcompare/search.html to search for hospitals within a certain distance from your ZIP code. Then choose up to three hospitals to compare.
Is the best hospital within 50 miles of Chattanooga located a few hundred feet off Interstate 75 in Calhoun, Ga.?
That's what the federal government's new star rating system for hospitals says.
The 69-bed Gordon Hospital, part of a chain managed by the Seventh-day Adventist Church, is one of only two hospitals in Georgia to win a five-star rating. The other is in Columbus. Two hospitals in Alabama also achieved that distinction but none in Tennessee.
"It is a testament to our talented and dedicated team of physicians, nurses, and care providers, as well as the fine community that we are blessed to serve," said Gordon President and CEO Pete Weber. But, he added, "While we appreciate the recognition, our focus at Gordon Hospital is not on ratings and rankings, but on providing the best patient care possible as we extend the healing ministry of Christ to all whom we serve."
Officials at CHI Memorial in Chattanooga, which earned four stars, also were happy. "We're very pleased with our results," said Chief Operating Officer Janelle Reilly. "These ratings are helpful to the public, which is the intent."
And Parkridge officials said the information in the ratings is useful.
"We believe our staff provides excellent health care every day and welcome any information that will help make the care we provide to our community even better," said Darrell Moore, president and CEO of Parkridge Health Systems.
But the star rankings have drawn criticism from some hospital officials, especially those from large teaching hospitals. They argue the federal Center for Medicare and Medicaid Services' method of calculating the rankings favors smaller hospitals that offer only a limited menu of services and is biased against the largest hospitals that care for a more diverse and challenging patient population.
"Patients will make decisions as to where they prefer care - the star system is not the system for them to use for these very important decisions in their life," said Dr. Janis Orlowski, the chief health care officer at the Association of American Medical Colleges.
Erlanger Hospital, for example, where University of Tennessee College of Medicine students train, was awarded only two stars, while Atlanta's Grady Memorial Hospital, the teaching facility for Emory University School of Medicine, got only one.
"Under CMS's methodology, only 3 percent of five-star hospitals are major teaching institutions, while more than 80 percent of the five-star hospitals are non-teaching hospitals," said Erlanger chief medical officer Dr. Will Jackson. "This is simply incongruent with what most industry observers [and patients] recognize about the quality of health care delivered in the United States."
Vanderbilt University Medical Center, the place many Chattanooga patients probably would consider if they believe local doctors are not good enough, earned three stars, the same as troubled Hutcheson Medical Center in Fort Oglethorpe, which filed for bankruptcy last year and since has reopened under new ownership.
The idea behind the ratings is good, but the way they are produced still needs refining, said Dr. Gerald Hickson, senior vice president for quality, safety and risk prevention at Vanderbilt.
"I'm very much in favor of these rankings. Ultimately we need to get there," Hickson said. "But the measurement tools are not quite there yet."
The major criticism is the ratings don't consider a hospital's patient mix. Major trauma hospitals take very sick or injured patients, including some transferred from other hospitals, as well as anyone ambulances bring to their doors. Those patients' evaluation of their hospital experience may be much more critical than that of patients who go to the hospital for elective surgery.
"If a mom comes in and has a well baby, everyone has a good experience," said Orlowski. "But if you are a hospital doing gunshots and trauma, and having complex patients flown in to you, you have people at a very different point in their life in terms of what is going on. There's a difference in perception."
Large teaching hospitals also are more likely to treat more poor patients, who often lack the resources to care for themselves after release. They are more likely to be readmitted, which lowers the hospital's score.
"There are a host of factors that influence the outcomes of care," said Hickson. "Some relate to the care we deliver, and some to the support that patients and families have in their community or in their homes such as the availability of access to home care, or family member support, things of that nature."
But federal health officials defend their decision to release the ratings.
"We have received numerous letters from national patient and consumer advocacy groups supporting the release of these ratings because it improves the transparency and accessibility of hospital quality information," said Dr. Kate Goodrich, Director of CMS' Center for Clinical Standards and Quality.
The ratings themselves are detailed, although some of the information may be difficult for consumers to understand. To see the ratings, search online for "Hospital Compare" or go to www.medicare.gov/hospitalcompare/search.html.
Once on the web site, you can search for all of the hospitals within a certain distance from your ZIP code. Then you choose up to three hospitals to compare.
Separate tabs on the web page provide comparisons for different services or procedures.
One reports the results of patient surveys on 12 issues such as bathroom cleanliness, whether the room was quiet at night, whether pain was managed well, how good the doctors and nurses were at communicating, and whether a patient would recommend the hospital to others.
Another tab compares the timeliness of various procedures in areas such as heart attacks, pneumonia, surgery, emergency rooms, children's asthma and blood clot prevention. For example, the report shows how long a patient with a broken bone had to wait in the emergency room before getting pain medication or before seeing a health care professional.
There is a section on how often patients had complications after treatment, and another examining the readmissions rate after several procedures such as a stroke, heart attack or pneumonia. Information is provided on how often and in what ways hospitals used imaging, such as MRIs or CT scans, and a final section examines how the cost of the procedure compares to the national average.
Hospital officials say they hope the ratings will continue to improve, but they will never replace the need for a patient to discuss a treatment plan with a family physician or primary care doctor.
"When making health care decisions, patients should use all available tools at their disposal such as talking with friends and family and consulting with doctors, nurses and other health care providers," said Moore.
"Physicians have a really good idea where the quality nursing staffs and quality organizations are," added Reilly. "And other factors come into play, such as the proximity of care. Patients do need to be thoughtful about considering a lot of other factors when making their decisions."
Contact staff writer Steve Johnson at 423-757-6673, sjohnson@timesfreepress.com, on Twitter @stevejohnsonTFP and on Facebook, www.facebook.com/noogahealth.