© 2024 St. Louis Public Radio
Play Live Radio
Next Up:
0:00
0:00
0:00 0:00
Available On Air Stations

Two local hospitals ranked as best hospitals; high-profile centers not on list

This article first appeared in the St. Louis Beacon, Sept. 21, 2011 - SSM St. Joseph Hospital West in Lake St. Louis isn't on U.S. News and World Report's list of best hospitals. Nor is Gateway Regional Medical Center in Granite City. But the influential Joint Commission has singled out these two health facilities for excellent care for several health conditions, including heart attack and pneumonia.

As the body that accredits hospitals, the commission's word carries weight. For the first time this year, it decided to rank hospitals, and its report is noteworthy partly for what it doesn't say. Missing from the list are many highly regarded hospital systems, including Johns Hopkins in Baltimore, Massachusetts General in Boston, the Mayo Clinic in Rochester, Minn., the Cleveland Clinic in Cleveland, and Barnes-Jewish Hospital in St. Louis.

The Joint Commission's findings are based on how hospitals performed on nearly two dozen measurements relating to five conditions -- heart attack, heart failure, pneumonia, surgical infection prevention, and children's asthma care. It gave high quality and safety rankings to 405 hospitals.

A hospital had to show high performance care for at least one of these five conditions to rank at the top. The two St. Louis-area hospitals, St. Joseph and Gateway Regional, scored high on care in four of the five conditions. Some measurements sound like no-brainers: Was the heart patient given an aspirin upon arrival? Were heart failure patients given sufficient discharge instructions? Was a blood culture taken before giving out the first antibiotic for pneumonia? Did the patient get an antibiotic an hour before surgery? Such questions suggest that good outcomes can depend as much on basic procedures as on high-tech medicine.

The Joint Commission says its rankings also relate to how well hospitals use evidence-based procedures associated with good patient outcomes. Several VA hospitals, including one in Chicago, also made the commission's quality-care list.

Some administrators say they are honored to see their hospitals on the commission's list, but they add that they never set out to improve care as a means toward recognition.

"I wasn't surprised by the outcome," said Dr. Michael Handler, chief medical officer for the 127-bed SSM St. Joseph Hospital West. "I honestly didn't know that the Joint Commission was doing these recognitions. But we're doing everything we can to achieve the best possible outcome for our patients in terms of quality and safety. This is something we've been concentrating on for several years as a way to improve and get to these ends."

Dan Kernebeck, director of quality at Gateway Regional, which has 382 beds, says improving a hospital need not cost a bundle.

"Actually, it was pretty low budget," he says. "It wasn't high tech. What it cost most is investing in the time with employees to make sure they understand why we do what we do, why it's so important to make it a priority."

Many hospitals, he says, "have protocols, paper trails and concurrent reviews. But we've made it part of the culture, part of the everyday work flow. It's built in, not an extra step. And there's the accountability issue of making everyone understand that we are responsible for this care."

In addition, he says it's a mistake when "we ask people to do things, but we don't give them the why, the rationale. That was a key element, making sure everyone understands what we do and what this leads to as far as patients are concerned -- fewer infections, better outcomes, more patient satisfaction."

He concedes that reimbursement figured into the goal of improving care. Next fall, the federal government is expected to begin reducing reimbursements by 1 percent for hospitals that make avoidable medical errors.

"With health-care reform, reimbursement is getting more difficult for (repeating) some of the same (procedures). A challenge all hospitals are facing is how do we ensure that we get paid to provide the care that we do. But there's that expectation that it has to be high quality, safe and cost effective."

Historically, he says, quality care wasn't tied to any financial incentive or disincentive. "They were kind of separate. But now, quality, safety and good outcomes are directly related to reimbursement."

Although some might be surprised that two relatively low-keyed area hospitals rose to the top of the Joint Commission's list, their achievements were already recognized by a local business organization. Both were singled out for their quality in the recent health-care industry overview study. That report, citing 2009 data, was done by Karen Roth of the St. Louis Business Health Coalition through funding by the Missouri Foundation for Health.

Nationally, Roth's report says, hospitals have been improving on quality and patient-safety measures, but the report adds that performance fell for 15 of 29 hospitals in the St. Louis area.

Regional Hospitals on the Map


View Joint Commission's recognized hospitals in a larger map

Markers represent hospitals in Missouri and Illinois recognized in at least one category. Click the marker to see what categories the hospital was recognized in.

  • Yellow: One category
  • Teal: Two categories
  • Magenta: Three categories
  • Purple: Four categories

Funding for the Beacon's health reporting is provided in part by the Missouri Foundation for Health, a philanthropic organization that aims to improve the health of the people in the communities it serves.

Robert Joiner has carved a niche in providing informed reporting about a range of medical issues. He won a Dennis A. Hunt Journalism Award for the Beacon’s "Worlds Apart" series on health-care disparities. His journalism experience includes working at the St. Louis American and the St. Louis Post-Dispatch, where he was a beat reporter, wire editor, editorial writer, columnist, and member of the Washington bureau.