Local hospitals get good checkup results

Ottawa-area hospitals are performing well on a variety of measures compared to other hospitals in Canada, but they lag in patient safety and efficiency, according to new data from the Canadian Institute for Health Information.

The data are found in the 2013 Canadian Hospital Reporting Project, which assesses and compares more than 600 Canadian hospitals on 21 clinical and six financial indicators. The project, which first reported last April, is the first nationwide study of hospital performance.

There was plenty of encouraging news in the updated results released Wednesday.

At the Montfort and QueenswayCarleton hospitals, readmission rates following treatment for heart attacks, strokes and knee and hip replacements were all below the Ontario and national averages, sometimes substantially so.

At the Montfort, for example, the 28-day readmission rate after stroke was less than half the provincial and national averages. For heart attacks, the readmission rate fell sharply to less than one-third of average rates.

For both hospitals, the readmission numbers represent a turnaround.

Last year’s survey reported that their readmission rates, particularly for heart attack patients, had been rising steadily for four years.

The Montfort and QueenswayCarleton scored well on mortality measures. The Queensway- Carleton’s 30day in-hospital mortality rate plummeted by more than 50 per cent and sits at less than half the national average.

At the Montfort, the rate of death in hospital following a heart attack rose, but was still slightly below the national and provincial averages. The rate of death within five days of major surgery declined and is now well below average.

The news on mortality and readmission rates was also mostly positive at The Ottawa Hospital and the University of Ottawa Heart Institute, which the CIHI survey inexplicably lumped together.

Mortality rates after heart attacks, strokes and major surgery were average or below. That was also true of readmission rates after stroke, heart attack and knee replacement. But The Ottawa Hospital readmitted more patients after hip replacement surgery than the national average.

Not all the news was positive. At most local hospitals, the rate of “nursing sensitive adverse events” — urinary tract infections, pressure ulcers, in-hospital fractures and pneumonia — exceeded average rates.

On that measure, as well as its rate of caesarean sections, The Ottawa Hospital ranked in the bottom 25 per cent of Ontario teaching hospitals, officials there acknowledged.

In a news release, they noted that the data in the 2013 update are more than a year old, meaning the hospital is already aware of areas that require improvement. They said the survey data “are already being used to guide the planning and implementation of hospital-wide efforts aimed at changing staff behaviours and improving clinical processes.”

Most area hospitals also scored poorly on measures that assessed their efficiency and cost-effectiveness.

Only the Queensway-Carleton spent less per “weighted case” — a measure of the relative cost efficiency of a hospital’s ability to provide acute in-patient care — than the national average of about $5,100.

The Queensway-Carleton spent an average of $4,396 per patient, but the numbers were far higher at other hospitals — $5,965 at the Montfort, $6,748 at the Children’s Hospital of Eastern Ontario and $5,927 at The Ottawa Hospital/Heart Institute.

For the 16 acute-care hospitals within the Champlain Local Health Integration Network, the average weighted cost of treating a patient was $5,638 — nearly $500 more than the Ontario average.

The Queensway-Carleton fared less well when the survey assessed its administrative costs, which accounted for 5.53 per cent of its total expenses. That’s above the national average, though slightly below the provincial average.

The Montfort spent the largest proportion on administration at 7.12 per cent. The Ottawa Hospital/Heart Institute, at 4.57 per cent, and CHEO, at 4.59 per cent, were both near the national average, but below the provincial average of 5.75 per cent.

Nurses at the QueenswayCarleton and The Ottawa Hospital/ Heart Institute spent fewer hours providing services to patients in their hospitals than the national average. But the opposite was true of nurses at the Montfort and CHEO.

CHEO nurses provided an average of 55.1 hours of inpatient care per case — the most of any Ottawa hospital — while nurses at the Queensway-Carleton averaged just 40.39 hours.