Canadian Hospitals rated for first time. How did yours do?


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Two months ago, I was thrilled to hear that my New Brunswick hospital where I practiced for 3 years has received an A+ rating in CBC’s Rate My Hospital report card. CBC graded nearly 240 acute-care Canadian hospitals, providing a snapshot of how hospitals across the country are performing.

The ratings are based on information collected at 4 levels:

  • Data supplied by hospitals and published by the Canadian Institute for Health Information
  • Information on initiatives to improve quality and safety was collected through a unique survey of hospital administrators
  • Basic statistics that reflect a hospital’s size and performance (emergency room wait times, rates of hospital-acquired infections…)
  • Feedback from patients who have recently been in a hospital

This initiative is a first of its kind in Canada given that it is neither designed nor executed by the government or health authorities, hospital managers or policy-makers. It fills an essential gap in our healthcare system evaluation. In Canada, limited information about the quality of hospital care is available to the public.

If you want to check how a hospital did, click here.

Surprising results were:

Chaleur Regional Hospital in Bathurst, New Brunswick received the only A+ rating east of Ontario. This made the hospital one of the top hospitals in Canada with the highest ranking. Watch CBC video report here.

Only 8 hospitals in Canada received the lowest grade of D. Five of these are in British Columbia: UBC Hospital, Vancouver General Hospital (VGH), Burnaby Hospital, Surrey Memorial Hospital, and Ridge Meadows Hospital. All are in the Metro Vancouver area.

Alberta had four hospitals among the top 10 in Canada. New Brunswick had one and British Columbia had none according to this report.

Methods:

The report graded hospitals based on:

  1. Mortality after major surgery
  2. Nursing-sensitive adverse events, surgical patients
  3. Nursing-sensitive adverse events, medical patients
  4. Readmission after surgery
  5. Readmission after medical treatment

Other indicators measured included safety (like compliance with hand hygiene, regular and reliable pain assessment, medication reconciliation upon admission, availability of single-bed rooms), patient-friendliness (like availability of extended meal services and cots for family members to stay overnight, flexibility of visiting hours, review of patient surveys), and quality of care (like the use of electronic medical records, availability of interpreter services, care provided by registered nurses, hospital board of directors discussion of patient stories.)

Limitations:

This study have limitations that should be taken into consideration when interpreting such results. “A stay at a hospital with a good grade will not necessarily be problem-free. A hospital with a lower grade might do well on measures that CBC has not considered” CBC mentions in a disclaimer.

Whereas the above indicators could be good at reflecting the quality of patient care, there are many other indicators of hospital performance that were not taken into account or measured.

You also have to be careful to compare hospital demographics when comparing ratings. One may argue it is unfair to compare a teaching hospitals to a community hospitals or hospitals covering a large area to those covering a smaller one. On the other hand, shouldn’t we expect best patient care regardless of what resources or demographics are available?

Finally, not all hospitals were rated and this might limit the generalizability of the results.

Regardless of such limitations, I anticipate a larger participation in next year’s report as the media coverage for this report has already stirred controversy, opened the eyes of the public and motivated hospital administrations to improve their performance. The report appears to have served its primary goal: it opened the debate.



Categories: Health

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