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National report cites Southern Hills, MountainView hospitals as top performers

Two Las Vegas hospitals, Southern Hills and MountainView, are among 405 medical centers in the nation achieving recognition as top performers in five key quality measures, according to a report released Wednesday by The Joint Commission, the nation’s oldest and largest standards-setting and accrediting body in health care.

It is the first time the commission has listed hospitals it says are the best at using evidence-based processes linked to positive patient outcomes.

The Joint Commission report, “Improving America’s Hospitals,” singles out hospitals from 45 states and more than 3,000 medical centers across the country based on performance related to heart attack, heart failure, pneumonia, surgical care and children’s asthma care.

Two other hospitals in Nevada, Elko’s Northeastern Nevada Regional Hospital and the VA Sierra Nevada Health Care System in Reno, also were honored.

To be selected, a hospital had to maintain two 95 percent performance thresholds on accountability measures set by The Joint Commission.

Not on the list are some of the most celebrated hospitals in American medical care, including: Johns Hopkins Hospital in Maryland, the Mayo Clinic in Minnesota, Stanford Hospital and Clinics in California, and the Cleveland Clinic in Ohio, but a satellite, Cleveland Clinic Florida, received recognition.

In a teleconference with journalists across the nation, Dr. Mark Chassin, president of the commission, said a lot of what goes into reputations of large academic medical centers has to do with research and new treatments rather than following basic quality process measures.

To be in compliance with Joint Commission standards in regard to heart attacks, the basic process standards a hospital must meet include aspirin at arrival, the use of special drugs within 30 minutes that work to break up blood clots that are blocking a major artery, an angioplasty procedure within 90 minutes to open blocked or narrowed coronary arteries, aspirin at discharge and drugs issued at discharge for controlling high blood pressure and treating heart failure.

While timeliness is very important, Dr. Michael Henderson, quality control officer of the Cleveland Clinic, said what should be done in complex medical cases is not always immediately clear.

“I’m not being defensive about this,” Henderson said of the standards set by the commission.

“These processes are very important and have helped hospitals. But I think outcomes should be stressed far more to be helpful to the consumer. People need to know mortality and complication rates, and they need to know how many procedures a surgeon has done.”

In 2010, both Southern Hills and MountainView maintained a 95 percent performance level on measures related to surgical care, heart attack, pneumonia and heart failure, only falling below the high standard on children’s asthma care.

“Our ability to sustain top performance in key quality measures has been a team effort involving every department in the hospital,” said Will Wagnon, MountainView’s chief executive officer. “This level of quality requires constant diligence and enables us to provide the best possible care for every patient, every time.”

Southern Hills CEO Kimball Anderson reacted in similar fashion, saying, “Consistently focusing on the needs of our patients and their families is the core of our mission.”

Gary Stephenson, a spokesman for Johns Hopkins Hospital, which generally leads the nation in a variety of rankings on the nation’s hospitals, said it is important to note that the sickest patients, as well as the largest volume of patients, go to large urban hospitals.

Chassin said while it may be true that academic medical centers do see greater numbers of sick patients, he also noted that large hospitals have far greater resources, which should enable them to follow tried-and-true processes.

According to The Joint Commission, proper pneumonia care at a hospital should include a pneumococcal vaccination, a blood culture in the emergency department, an influenza vaccination and antibiotics to immunocompetent patients.

“They want antibiotics given within a few hours, but sometimes it takes longer than that to diagnose someone with pneumonia,” said Henderson of the Cleveland Clinic.

“You don’t want to just give everyone antibiotics.”

Surgical care measures include antibiotics within one hour before the first surgical cut, appropriate prophylactic antibiotics and stopping antibiotics within 24 hours.

Hospital measures for children’s asthma care include relievers for inpatient asthma, corticosteroids for inpatient asthma and a home management plan of care.

Measures for heart failure care include issuing smoking cessation advice and issuing drugs at discharge for both controlling high blood pressure and helping the heart to function normally.

Contact reporter Paul Harasim at pharasim@reviewjournal.com or 702-387-2908.

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