We in the press are accustomed to PR folks “advising” us of all the good things that hospitals do. They open new pavilions named for wealthy benefactors of new cancer and heart centers and children’s care, with media coverage of the ribbon-cutting ceremonies attended by famous faces. They buy big new machines that smash and diagnose illness and want the world to know about that, too.
But a press release that just popped up in my email offered a new twist. It announced that New York-Presbyterian Hospital, the one that treats the Clintons and other celebs, had earned two energy Star Awards from the U.S. Environmental Protection Agency. The press release said the hospital earned a “Combined Heat and Power Award for the hospital’s highly efficient combined heat and power system at its Weill Cornell Medical Center campus.”
What the press release called a “state of the art” system creates a self-generating source of electricity and heat for the campus, which protects it from blackouts during hurricanes and summer heat. That sounded like a good thing, but just because the hospital might fare better than other New York hospitals during the next hurricane may not be reason enough to be a patient there. I wouldn’t consider it a top factor in choosing a hospital — assuming you can even choose one.
That point became clear when I checked out a new online tool released by the Association of Health Care Journalists (AHCJ). AHCJ is making hospital inspection reports from the Centers for Medicare and Medicaid Services (CMS) available at the AHCJ’s new website. The tool is not perfect, and there’s a lot of missing information, but still it provides some information about hospitals that has been lacking and offers a basis for asking questions.
I looked up New York-Presbyterian and found reports for an inspection visit made by government surveyors in August 2011. The violations listed dealt with such matters as stabilizing patients’ treatment, delays in examination or treatments, posting signs, and keeping a log in the emergency room.
Looking closer at the reports, I learned that the hospital has not “engaged in a safe practice for psychiatric emergency care in that they have not formalized a procedure that arranges the provision of timely or immediate on-site initial psychiatric assessment of ambulatory patients who present to the emergency department for assessment and treatment of emergency mental health needs.”
This doesn’t exactly sound like rocket science, but it did raise the question of whether the hospital could respond effectively to patients with serious mental illness who showed up in their ER. The government inspector remarked: “Despite the hospital having an inpatient psychiatric unit, the emergency department does not have a dedicated comprehensive psychiatric emergency department.”
In another case, the hospital “failed to provide timely medical screening of a patient with abnormally elevated blood sugar.” The patient, whose blood sugar levels reached 391 as determined by a non-fasting finger stick, had had no access to insulin for one week and was asking for help in getting some. The inspector noted “there was no evidence that a medical screening examination was performed nor did the patient receive any insulin.” Nor was there any evidence of a social service referral. Did the hospital really want to help this person?
The fact that New York-Presbyterian has received eight Partner of the Year Awards for Sustained Excellence in Energy Management means nothing to the patients who can’t get basic care in the hospital emergency room. What can you say about cases like this at one of New York City’s premier hospitals that likes to tell the public about the good things it does?
One of the shortcomings of the CMS hospital reports is that there’s no information about plans of corrections, and the government does give hospitals a chance to clean up their act. No doubt New York-Presbyterian did just that. But we would need to look at new inspection surveys to really know for sure.
One thing we do know for sure is that press releases about new heart pavilions, the latest whiz-bang technology, and awards for energy efficiency are not the way to judge a hospital. I know that’s what a lot of the public uses to form their judgments about quality health care, but maybe now the access to hospital inspection reports provided by AHCJ and CMS will begin to change their perceptions.
Trudy Lieberman is a journalist and an adjunct associate professor of public health at Hunter College in New York City. She blogs regularly on the Prepared Patient Forum.