Heather Latter
Riverside Health Care Facilities, Inc. earned a ‘B’ from “Rate My Hospital”—a resource developed by CBC’s The Fifth Estate to rank Canadian hospitals.
A first in Canada, the initiative was designed to “bring more transparency and accountability to our health-care system and to arm Canadians with the information they need to inform themselves when preparing for a hospital stay.”
“I think overall, Riverside is pleased with it’s ‘B’ rating but it’s not going to change the fact that what we want to do is improve our quality every day,” noted Riverside CEO Allan Katz.
“And that is our priority at Riverside—Emo, Rainy River, and Fort Frances sites, 24 hours a day, seven days a week,” he stressed.
But looking at the scoring, Katz said Riverside was compared with national averages, which he only can assume includes all hospitals in the country.
While they might seem a bit behind in some areas on a national level, Katz indicated Riverside is right on target regionally.
“In as much as I’d like to compare La Verendrye with the Vancouver General and the Winnipeg Health Sciences Centre, we can’t because we don’t have those resources,” he explained.
“But comparing our rates within the region, there are similarities and it’s good to know that we are not statistically significant in a different way.”
Still, CBC indicates the ‘B’ rating given shows Riverside gets about the same results overall as an average small hospital.
The rating is based on three important risk-adjusted indicators measuring how well patients do after surgery or medical treatment.
Looking at “nursing-sensitive adverse events, medical patients,” Riverside had a 14.4, meaning 14.4 patients out of 1,000 developed problems tied to nursing care such as urinary tract infections, bed sores, pneumonia, or broken bones.
They were given a ‘B’ grade in this category, which shows Riverside reports about the same number of adverse events tied to nursing care for medical problems as an average hospital of the same size.
“The national average is 29.19, so I think we’re doing exceptionally well,” said Katz, adding the regional rate was just over 23.
“So I think that our lower rates do indicate that the nursing we have at all of our sites is exceptional and we have to thank the staff for being exceptional every day,” he added.
Another area Riverside was scored on was “readmission after surgery,” where it had an 8.87—above the national average of 6.51.
It received a letter grade of ‘C’ as the data shows more patients are readmitted to this hospital within 30 days of discharge following surgery than to an average hospital of the same size.
Katz indicated the regional rate in Northwestern Ontario was just over eight percent.
“So we’re on par with our regional peers,” he stressed.
Meanwhile, for “readmission after medical treatment,” Riverside’s rate was 16.66, above the national average of 13.31, giving Riverside a ‘C’ grade in this category, as well.
The regional average was 15 percent.
“So we’re looking forward to working with our partners, like the Northwest Community Care Access Centre, which is in the process of launching a new program to help patients who are discharged settle into the community more effectively and more safely,” noted Katz.
He added Riverside is anticipating that program will help bring that rate down.
“We know we have to improve and we will continue to improve,” Katz vowed, though saying he feels people should keep in mind how the smaller population in Rainy River District can impact statistics used by the “Rate My Hospital” comparisons.
For instance, one or two people in a community of a million is not going to greatly affect the statistic.
“But we only have about 2,000 weighted cases a year, so a small change makes a much bigger difference,” he explained.
“Having these [statistics] boil down to letter grades people can understand [is one thing],” he conceded.
“But when we’re talking statistics, I think we should always be aware of the fact that there has to be some application of statistical principles to ensure we are comparing apples to apples.”
Katz said Riverside contributes all of its information each year to the Canadian Institute for Health Information (CIHI)—a taxpayer-funded, non-profit organization that acts as a storehouse of statistics on Canadian hospitals and other health-care data where CBC got its information from.
“There are many reports CIHI produces on a regular basis,” he remarked. “We analyze and trend many of them for our own internal purposes.
Katz said some of the information also is posted on Riverside’s website, as it is mandated to do by the Ministry of Health and Long-Term Care.
This includes infection control rates for C. difficile and MRSA, as well as surgical site infection rates and handwashing rates.
“So there is a lot of information that’s already publicly available,” he stressed.
“We are always trying to do a better job of communicating that information,” Katz stressed. “We’re not perfect yet.
“I don’t think we ever will be,” he admitted. “But we’re trying to do a better job communicating the quality of care that we provide to the residents of Rainy River District on a daily basis in a better, more easy to understand method.”
Katz said he feels the letter grade offered by “Rate My Hospital” goes too far into the area of simplicity.
“It doesn’t tell the whole story, but it’s the beginning of a story,” he reasoned.
The CBC’s report also provided additional information about Riverside, noting it admitted 1,875 patients in the most recent year, that the average length of stay was 5.26 days, and that 18 percent of the 33 beds at La Verendrye are in single-bed rooms.
In addition, CBC assessed the hospitals in three more categories to show the initiatives Riverside is taking to improve care and safety.
One point was awarded for each answer that meets or exceeds standards for best practice, or meets or exceeds the median.
Under “safety,” it received one point out of four for its regular pain assessment (since best practice guidelines recommend nurses screen patients at risk for pain at least once a shift).
Uncontrolled pain is considered an adverse event.
In this category, Riverside was graded 70 percent for medication reconciliation on admission, where the median compliance rate among hospitals CBC assessed was 84.2 percent.
And it had an 81 percent for hand hygiene compliance, where the median was 86.45 percent.
Under the “patient-friendly” category, Riverside received two points out of four—one for its flexible visiting hours and another for conducting and reporting formal patient surveys.
The two points unearned were for families being unable to stay overnight and for full meal service not being available until 6 p.m. daily.
Meanwhile, for quality of care, Riverside earned one point out of four for 100 percent of its care being provided by registered nurses.
“Studies have linked higher levels of care provided by RNs, versus nurses with less training, to better patient outcomes,” CBC noted, citing RNs provide 70 percent of all nursing care at a typical hospital it assessed.
Katz reiterated that Riverside is satisfied with the rating it received, but they are not just going to sit and be a ‘B’ hospital.
“On the other hand, we’re not going to go in search of the allusive ‘A’ just to get the elusive ‘A’,” he stressed.
“If we’re going to improve our quality of care, we’re going to do it for the residents of Rainy River District, not to get a letter grade.”
