LHIN CEO Paul Huras

Behind the results of the NRCC study that ranks PECMH as the top performing community hospital in the province.

The folks of Prince Edward County have always known their hospital was special—that the care they received there was unlike anywhere else. Now it’s official. Now everyone knows it.

According to an authoritative survey conducted by National Research Corporation Canada and sponsored by the Ontario Hospital Association, Prince Edward County Memorial Hospital is the top performing community hospital in the province, as measured by patient satisfaction. PECMH’s emergency department also ranked in the 90th percentile—among the very best in the province.

ABOUT THE STUDY
Between April 1, 2011 and March 31, 2012 patients across Ontario were asked to complete experience surveys ranking their overall care and likelihood to recommend the care provider.

National Research Corporation Canada (NRCC) is the Canadian arm of National Research Corporation a three-decade-old-U.S.- based consultancy focused on measuring health care experience and quality. NRCC’s website preaches the notion of patient-centric health care across the spectrum of services—that patient outcomes improve when people feel good about the care they receive.

NRCC’s report on Ontario hospitals identifies only the top performers and those delivering care within the 90th percentile of all hospitals. Both PECMH and Trenton Memorial are recognized in the report for high patient satisfaction. There is no mention of Belleville General or North Hastings hospitals in the report.

Statistics provided by QHC, though not from the NRCC report, indicate significantly higher patient satisfaction with PECMH’s inpatient care and emergency department compared with BGH and North Hastings. But QHC spokesperson Susan Rowe notes that “patient satisfaction for inpatient acute care is very consistent across QHC hospitals.”

One common thread, when examining the NRCC report, is immediately apparent. That is that the best hospitals in Ontario tend to be smaller and serve a rural community. That finding is echoed by QHC’s Susan Rowe.

In this issue of the Times we ask what the results mean about healthcare in general and specifically what it tells us about healthcare in Prince Edward County.

Dr. Elizabeth Christie is the chair of the Prince Edward County Family Health Team. Paul Huras is CEO of the South- East Local Health Integration Network and Peter Mertens is mayor of Prince Edward County.

Mary Clare Egberts, cheif executive officer of QHC was invited to share her views on the NRCC findings but declined.

DR. ELIZABETH CHRISTIE
It is obvious something special is happening at PECMH to Dr. Elizabeth Christie.

“When you walk around the Picton hospital you get a sense the team is pulling together,” said Christie. “From the kitchen staff, to the cleaning staff, the maintenance staff, the clerks, the nurses and doctors. People are pulling together on behalf of their patients.”

She describes a sense of collaboration and teamwork that courses through the Picton hospital. It is a way of working and thinking that patients see and feel.

“What this survey shows is that small hospitals offer a personal touch that can get lost in a large setting,” said Christie.

Not all care is suited for a community hospital. But, she argues, this and other research shows patients prefer specialized hospitals “because it is small again.”

“Large hospitals have lot to learn from their smaller cousins in terms of patient satisfaction and quality care,” said Christie.

But how important is patient satisfaction? Isn’t patient outcomes the only measure of a health care system? It may be nice that people feel good about their care but, in the end, isn’t it just about getting better, sooner?

Dr. Christie says satisfaction and outcomes are interlinked. They can’t be taken apart.

“A lot of research has been done over the past few years about how to best measure quality of care,” explained Christie. “Time and again—patient satisfaction has risen to the fore as a true measure of quality care.”

Dr. Christie notes that this survey is an “extremely credible and important result.”

“It is extremely satisfying to know you are working within a fantastic team. And it is very satisfying to have that formally recognized in this way.”

“Our hospital is a model—I don’t think anyone can deny that now.”

Great news story

But financial pressures on healthcare are unrelenting

Paul Huras heads the SouthEast Local Health Integration Network (LHIN), the provincial organization that delivers health care funding and pushes deeper integration between health care providers in the southeast region of the province, a triangular patchwork stretching roughly from Brighton to Bancroft and Cardinal.

“It’s a great news story,” Huras told the Times.

“In Prince Edward County we are so fortunate to have 24 physicians there who work well with each other and the staff and volunteers. They have created a community, almost family atmosphere at the site. And when patients feel good about their care—they have better outcomes.”

Huras said he wasn’t surprised by the NRCC findings.

“Small hospitals, like PECMH, have groups of physicians who are very, very tightly connected to the organization. Larger hospitals, on the other hand, often deal with more complex cases with more opportunities for things to go sour.”

But Huras says this small hospital atmosphere can’t be replicated in every hospital setting, nor, says the LHIN chief, is patient satisfaction the only measure of quality care. Indeed, he suggests it might indicate inappropriate care and lead to the inefficient use of hospital resources.

“Patients may have a high level of satisfaction staying in a hospital bed longer than they should but that is inappropriate care,” said Huras. “The patient may walk out the door saying ‘that was pretty good care’. But it is not a reflection of the hospital using the resources available to them the best they can.”

Huras and the LHIN focus on nurturing ways to move patients to the most appropriate setting quickly and seamlessly.

“Integration doesn’t necessarily mean amalgamation or centralization of services. Integration means the system works together, and that patients move from one level of care to another, efficiently and without risk. We want to constantly improve that.”

Nevertheless Huras is pleased that hospitals in the SouthEast like PECMH are being recognized for patient satisfaction. It doesn’t alter the LHIN’s determination to extract savings and drive greater integration of the system. Nor is it a guarantee that more service cuts won’t befall PECMH or Trenton Memorial.

“It doesn’t change the financial pressures on every single hospital in this province,” said Huras. “What we are trying to do is build an integrated system of care. When you do that, you free up resources— sometimes that leads to redirection of resources and closure of beds.”

“It is great that Picton has done so well and we need to share those lessons. We have strong people. Strong hospitals. Strong services. Now we must make the system work better. That is what the LHIN is focused on.

“Together we have more capacity than our individual hospitals,” concluded Huras.