In terms of patient satisfaction, most South Florida hospitals are producing middle-of-the-road results, earning just under an average of three stars out of five in the federal government’s new hospital comparison system.
In an effort to make comparing hospitals more like shopping for refrigerators and restaurants, the ratings, released Thursday by the Centers for Medicare and Medicaid Services, score Medicare-certified hospitals on a five-star scale based on patient experience surveys.
Only one hospital in the tri-county area — Miami-Dade, Broward and Monroe — scored a five-star rating: Mariners Hospital in Tavernier, which is part of the Baptist Health South Florida system.
Seven others scored four stars, with four of those hospitals located in Miami-Dade County. The four in Miami-Dade are: South Miami Hospital, Baptist Hospital of Miami, West Kendall Baptist and Homestead Hospital. Baptist operates all four.
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Florida had an average patient score among the lowest in the nation, according to a Kaiser Health News analysis. Nationally, only 7 percent of the hospitals judged earned five stars.
The surveys calculate patient experiences between July 2013 and June 2014 and measure 11 different factors, including how well doctors and nurses communicated, how well patients believed their pain was addressed and whether they would recommend the hospital to others.
Following a national trend, several of the top-performing hospitals in South Florida were small specialty hospitals, like Mariners, which is a rural critical access hospital, and like Fisherman’s Community Hospital in Marathon, which scored four stars and also is considered a rural hospital. Small specialty hospitals have traditionally received more positive patient reviews than have general hospitals, where a diversity of sicknesses and chaotic emergency rooms make it more likely patients will have a difficult experience.
Locally, most of the top-performing hospitals are part of the Baptist Health South Florida system, the largest hospital network in the region.
Thinh Tran, chief medical and chief quality officer for Baptist Health South Florida, said its hospitals focus on listening to patient concerns and then readjusting care to address those concerns.
“Regardless where the patient arrives in our health system, they would have the same experience as any patient of ours,” Tran said.
Mariners Hospital’s success, he said, is a combination of implementing best practices and serving as a community resource.
“The care team down there is really embedded within the community and really serves the community well,” Tran said.
Overall, Miami-Dade’s facilities earned an average of 2.5 stars, while Broward performed slightly better at 2.7. Monroe County hospitals scored among the top in the state with an average of 3.6 stars.
The majority of South Florida hospitals scored two or three stars, while two scored only one star: Jackson Memorial Hospital and North Shore Medical Center, both in Miami.
“We are not satisfied with out HCAHPS Star Rating performance, and we are focused on improving our patients’ experience,” Shelly Weiss, a spokeswoman for North Shore, said in a statement.
She said the hospital has implemented various initiatives to improve patient experience, including hiring a team of patient experience coordinators and nurse managers who are focused on patient services.
“Our goal is for our future scores to be more reflective of our commitment to deliver high-quality, patient-centered care,” Weiss said.
Kevin Andrews, vice president of quality and patient safety at the Jackson Health System, said improving the patient experience has become an area of increased focus in the last few years. Jackson plans to implement service excellence committees in which former patients can voice ideas to improve the patient experience.
“We want to really engage members and have community members as part of our customer service,” Andrews said. “We are looking forward to that transformation.”
The Affordable Care Act, which calls for transparent and easily understandable public reporting in the healthcare system, initiated the push for a simplified patient review system.
Evaluating hospitals is becoming increasingly important as more insurance plans offer patients limited choices. Medicare already uses stars to rate nursing homes, dialysis centers and private Medicare Advantage insurance plans. While Medicare publishes more than 100 quality measures about hospitals on its Hospital Compare website, many are hard to decipher, and there is little evidence consumers use the site very much.
The hospitals are also compared against each other, meaning the ratings are based on a curve.
Medicare noted on its Hospital Compare website that “a 1-star rating does not mean that you will receive poor care from a hospital” and that “we suggest that you use the star rating along with other quality information when making decisions about choosing a hospital.”
But many in the hospital industry fear Medicare’s five-star scale won’t accurately reflect quality and may place too much weight on patient reviews, which are just one measurement of hospital quality. Medicare also reports the results of hospital care, such as how many died or got infections during their stay, but those are not yet assigned stars.
“There’s a risk of oversimplifying the complexity of quality care or misinterpreting what is important to a particular patient, especially since patients seek care for many different reasons,” the American Hospital Association said in a statement.
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This story was produced in collaboration with Kaiser Health News, an editorially independent program of the Kaiser Family Foundation