St. Rose breaks ranks with disclosure on quality of care

By Marshall Allen

Wednesday, Sept. 8, 2010 | 2 a.m.

The St. Rose Dominican Hospitals are winning plaudits for being the first hospitals in Nevada to provide to patients previously internal information about quality of care — including details about certain hospital-acquired infections and injuries.

St. Rose posted the information on its website. Most of the information is compiled from reports available publicly elsewhere, such as patient satisfaction and general quality of care information.

But the nonprofit chain of three hospitals also posted information that Nevada Hospital Association lobbyists have been fighting to keep secret for almost a decade.

By reporting sentinel events — hospital-acquired infections and injuries among them — St. Rose is acting as a leader in the Las Vegas medical community and setting a precedent for transparency that serves as a challenge to other hospitals.

St. Rose’s action “will put pressure on the other hospitals to conform,” said Assemblywoman Sheila Leslie, D-Reno, who has worked on many health care-related laws in Nevada.

St. Rose is posting the information in response to a Las Vegas Sun investigation, “Do No Harm: Hospital Care in Las Vegas,” which found thousands of cases of hospital-acquired injuries and infections in Las Vegas hospitals in 2008 and 2009. The Sun’s investigation included analyzing hospital billing records on file with the state to provide information to patients that hospitals withhold and that consumer advocates argue they have a right to know.

Dr. Steve Jones, chief medical officer for the three St. Rose campuses — Rose de Lima, San Martin and Siena — said the hospitals “have always had a philosophy of being transparent with our patients and the community when it comes to our quality.”

In the two months since the Sun’s first story, it took considerable effort to assemble the complicated and voluminous information in a way that consumers can understand, Jones said.

Jones described the website as a “work in progress.” The site shares the rates of health care-associated infections — such as Methicillin-resistant Staphylococcus aureus, or MRSA, and Clostridium difficile, known as C. diff — and compares the St. Rose rates of infection with national benchmarks from the National Healthcare Safety Network, which is run by the Centers for Disease Control and Prevention.

For the most part, the St. Rose hospitals compare favorably to national benchmarks.

The site also reports certain sentinel events, such as falls that result in injury, hospital-acquired bed sores and injuries or death caused by surgery.

Jeanine Thomas, a patient advocate who founded the MRSA Survivors Network, called the St. Rose site a “step in the right direction” but of little meaning to consumers because it lacks the type of specifics people really want to know, such as the number of infections that occurred during knee replacement, hip replacement or heart surgeries.

Nationally, health care facilities are in the process of identifying information that can be used to compare facilities, Jones said. There are few established national standards for gathering information and reporting it to the public, and much of the information is not verified for its integrity.

St. Rose has also limited the internal quality indicators it has made public. Readmission rates for the three hospitals are not posted, nor are the mortality rates for certain procedures. Jones said some information was not included because it’s difficult to find a meaningful comparison for the statistics — in part because no other Las Vegas hospitals make them available — and St. Rose did not want anyone misinterpreting the information. He said the information may be posted on the site in the future, and that he is open to sharing it with individual patients if they are interested.

Leslie Johnstone, executive director of the Health Services Coalition, a group of self-funded insurance plans, said the information about sentinel events is more than has ever been provided. She praised St. Rose’s efforts, and noted that the website undermines any arguments by hospitals that such information cannot be shared with the public.