U. of U. health system is best in U.S., medical group says
It's not as flashy as joining the Pac-10 or nabbing the Nobel Prize.
But the University of Utah's latest claim to fame is a significant mark of excellence, say university officials.
A three-year effort to improve patient care, safety and satisfaction earned University of Utah Health Care the top spot in the University HealthSystem Consortium's 2010 Quality and Accountability Study, one of the most rigorous hospital rankings in the country.
"This is a big deal," said U. Hospital CEO David Entwistle. "It says to the citizens of Utah that you can get the same care here as you can get at the Mayos and the Hopkins and the Brigham and Women's of the world."
There are a lot of hospital score cards out there, some of them mere marketing tools, acknowledges Entwistle.
But the consortium's report judged the university's health system its hospital, clinics and medical school, Moran Eye Center and Huntsman Cancer Institute against 98 of the nation's elite academic medical centers. Unlike the popular U.S. News & World Report ranking, which is largely a reflection of a hospital's reputation, the consortium's is based on verifiable, federal data. It ranks institutions on patient safety and satisfaction, mortality rates and re-admissions using benchmarks endorsed by the Institute of Medicine.
The data are current, as of July 1. The consortium doesn't release data gathered from institutions; it instead uses a five-star system to rank health centers.
Just three years ago, the U. was given three stars, ranking 50th out of 88 hospital systems. This year, the university catapulted to five stars and the coveted No. 1 spot.
For Thomas Miller, the university's chief medical officer, the U.'s meteoric rise signals a renewed focus on patient-centered, data-driven medicine.
Getting there meant researching and adopting new and improved clinical practices. It entailed building a computer system to cull data from each patient record to better understand where the university excelled and where it fell short.
And it took aligning everyone around the same goals, from vice presidents to doctors, nurses and medical students, Miller said.
The exercise led to improvements, including new protocols in the maternity ward limiting the use forceps and suction and reducing injury to the mother, said Matthew Peterson, obstetric and gynecology chairman. "It was a collaborative effort. We made sure everybody knew what was expected, what we were measuring. We would report on outcomes every month, noting issues and addressing them with practitioners. And we trained all our residents on the new protocol."
In other cases, data and case reviews revealed faults in coding and documentation, not patient care.
In 2007, for example, the U. showed a mortality rate of 1.8 times the national average, said Carol Hadlock, U. Health Care's director of quality and patient safety. But upon closer look, it became apparent that physicians and nurses were neglecting to document the fact that patients were transferring to the U. for end-of-life care.
The mortality index is meant to show how often reasonably healthy patients die due to complications in their treatment.
Now, after accurately coding transfers, the U.'s mortality score rests at 0.6 times the national average, Hadlock said.
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