Higher-than-expected death rates in central Pennsylvania hospitals highlighted in report



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Most hospitals in central Pennsylvania had significantly higher than expected death rates for one or more of the most common medical conditions, according to a new report from the Pennsylvania Health Care Cost Containment Council.

For example, four had significantly higher than expected death rates for the most common condition listed in the report, blood infections, also known as sepsis. These are WellSpan Chambersburg Hospital, Mount Nittany Medical Center, UPMC Carlisle Hospital and UPMC Hospital Hanover.

The report also credits hospitals with above-average results. For sepsis, four hospitals in central Pennsylvania had significantly better death rates than expected: WellSpan Ephrata Hospital, WellSpan Good Samaritan Hospital and WellSpan York Hospital.

For the second most common condition, heart failure, Geisinger Danville had a significantly higher death rate than expected. UPMC Lititz Hospital had a significantly higher than expected 30-day readmission rate, which may also reflect issues with the care received.

Two hospitals, Lancaster General Hospital and WellSpan Waynesboro Hospital, had significantly better than expected readmission rates.

The report examines 16 common medical conditions and compares hospitals to see if their death rates – called death rates in the report – are significantly worse than expected, the same as expected, or significantly better than expected. He looks at 30-day readmission rates in a similar fashion, assuming that when patients have to return to hospital within 30 days, it may reflect poor initial care.

The council – called PHC4 – says it adjusts the risk to take into account factors like the severity of the disease and other factors that make a person’s death or complications more likely, giving hospitals a “Additional credit” for the treatment of critical illnesses and critical illnesses. patients at risk.

The report covers adult patients treated in hospitals in Pennsylvania between October 2018 and September 2019. The PHC4 advises people to use the report to compare the quality of care in hospitals and ask informed questions about what will be done for them. ‘ensure that they avoid complications and have a good result. PHC4, an independent public agency, also expects hospitals to use the report’s findings to focus on areas for improvement.

UPMC Pinnacle said it supports PHC4’s intention in releasing the report and is continuously monitoring its results to improve.

“The cases included in this report represent a small portion, less than 15%, of the patients we serve,” UPMC Pinnacle said in a written statement. “Almost all of the cases reflect patients whose chronic disease has passed to the terminal stage and whose wishes for end-of-life treatment have been supported. Other cases reflect sudden acute illness with very high disease severity and poor prognosis. “

WellSpan Health said, “We recognize that we have room for improvement and, in fact, we have already taken steps to improve patient safety and outcomes.” WellSpan detailed some of the improvements in a statement appearing at the end of this article.

Here are some of the report’s other findings:

  • Three hospitals in central Pennsylvania had significantly worse than expected death rates for infectious pneumonia, another of the most common conditions: UPMC Carlisle Hospital, UPMC Hanover Hospital, and WellSpan Ephrata Hospital. Tower Health Reading Hospital had a significantly poorer than expected readmission rate.
  • Three of them had significantly worse death rates than expected for stroke patients: Geisinger Danville, Geisinger Holy Spirit (the report covers a period before Holy Spirit became part of Penn State Health) and Mount Nittany . Three had significantly better than expected death rates: Penn State Health St. Joseph, Tower Health Reading Hospital and WellSpan York.
  • None of the Harrisburg area hospitals had higher than expected death rates for heart attack patients who received angioplasty or stents.

Here is the full statement from York-based WellSpan Health in response to the report:

At WellSpan Health, we strive to deliver exceptional, patient-centered care for every patient, every time. We recognize that we have room for improvement and, in fact, we have already taken steps to improve patient safety and outcomes. We use real-time data through our new electronic health record to work on the continuous improvement of our patient care.

At WellSpan Chambersburg Hospital, our recent successful implementation of the Epic electronic health record system includes tools to help identify and treat sepsis earlier and more aggressively. WellSpan’s central alert team and its use of Epic were recognized earlier this year with the John M. Eisenberg Award for Patient Safety and Quality, and we are actively implementing these best practices at the hospital. WellSpan Waynesboro Hospital continues to explore better treatment opportunities for aspiration pneumonia to achieve the best outcomes for our patients, while the clinical and quality improvement teams at WellSpan Ephrata Community Hospital examine pneumonia cases every month to determine opportunities for improvement. Monitoring all patients with sepsis through the above alert team also helps to ensure that proper protocols are followed in the hospital.

We are always focused on recruiting and retaining the best physicians, clinicians and members of the care team, ensuring that we have the right team in place to provide the exceptional care our patients expect from WellSpan Health.

All Pennsylvania Health Care Cost Containment Council reports are available here.

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