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Maine's Rural Hospitals Win Accolades from Grading Group
12/06/2012   Reported By: Jay Field

Maine's rural hospitals have gotten a big vote of confidence from a national organization that ranks hospitals according to safety, quality and how they use resources. Of the 13 hospitals on the Leapfrog Group's annual Top Hospital's list, five come from Maine. The state also has two hospitals on the larger list of top urban medical centers. Hospital administrators say the rankings are proof of a commitment to patient quality, despite limited resources. But one health researcher cautions against taking the rankings too seriously. Jay Field has more.

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Maine's Rural Hospitals Win Accolades from Grading Listen
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The Leapfrog Group graded nearly 1,200 urban, rural and children's hospitals on a range of safety measures, like preventing medical errors, reducing motality for high-risk procedures and limiting re-admissions once patients have been treated. Missy Danforth is Leapfrog's senior director of communications and membership.

"So I think what we're seeing out of these five top hospitals is that they've been reporting now on these measures for a few years in a row, and they've been improving," she says. "And they've reached a point now where they really represent some of the best rural hospitals in America, we think."

The five that made the list are Calais Regional Hospital, Rumford Hospital, Mt. Desert Island Hospital Organization, Sebasticook Valley Health in Pittsfield and Inland Hospital in Waterville. This year, in addition to the standard review, Leapfrog required all of its top facilites to get an "A" on a new hospital safety exam. Danforth says the group also pays a lot of attention to quality of care.

"So one of the amazing things about the majority of the hospitals in Maine that receive this designation is one of the quality ratings we focus on is the rate of early elective deliveries," she says. "Four of the five hospitals fully met our target for early elective deliveries, which is really outstanding."

Danforth says much credit for these hospitals' strong performance goes to a Portland-based non-profit. For years, the Maine Health Management Coalition has been pushing hospitals large and small throughout the state to take Leapfrog's annual survery and make their data public. Elizabeth Mitchell is president of the coalition, which includes health insurers, unions and employers.

"The employer members of our coalition have made it very clear that they want their employees to be able to know if there are variations in safety and quality," Mitchell says. "So they have insisted that, whenever possible and appropriate, that that information be made public."

In Maine, all eligible hospitals completed the Leapfrog survey, giving the state the best rate of compliance in the country. Laird Covey runs Central Maine Medical Center, which oversees Rumford Hospital. In addition to Rumford's honor, Central Maine was named one of the top 67 urban hospitals. Covey says getting here hasn't been easy.

"We've been working hard for years on all of the quality measures, and everything we can do to provide a safe environment and exceptional quality," he says. "And to get this level of national recognition from a group like Leapfrog - the whole organization is just really pleased, excited. It validates the work we've been doing."

While the accolades are one measure of the rural hospitals' performance, they don't change the financial realities that make it difficult to deliver top-flight care. Declining Medicaid reimbursements and higher costs continue to force them to do more with less.

And John Gale, a health policy researcher at the University of Southern Maine's Muskie School of Public Service, says national surveys don't always touch on these challenges.

"I think everyone supports the idea behind transparency of quality indicators. They can be misleading on occasion," Gale says. "Really, one of the big concerns about any of the quality systems is whether you look at them as one point in time or as a trend."

Gale says national rankings like Leapfrog's frequently use methods for measuring quality that are more geared to big urban hospitals than small rural ones. And that, he says, can make it hard to to know just what a top-flight rating actially means.



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