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Below-average scores in several areas no surprise to health-authority administrators

Apr 07 2012

Patients should not be concerned about the care and treatment they receive at any hospital on Vancouver Island, health authorities say, despite new statistics showing they are performing below average in some areas.

"While some facilities are performing below the B.C. or Canadian average in some areas, the rates are still generally good," says Shannon Marshall, spokeswoman for the Vancouver Island Health Authority.

This week, the Canadian Institute for Health Information released a new website tool - the first of its kind in Canada - that includes more than 600 acute-care hospitals across the country and four years' worth of data.

The data were used to create a comparison tool called a performance allocation. Hospitals were rated as below performance range (performing below the 50th percentile), within the performance range (between the 50th and 75th percentile), or above the performance range (at or above 75th percentile).

Overall, no one hospital performed consistently above average on all measures of patient care.

Victoria General and Royal Jubilee hospitals were lumped together statistically as a large community hospital. According to CIHI's statistics, the two hospitals are underperforming when it comes to the number of people who die in hospital - of any cause - within 30 days of being admitted for a first stroke. The hospitals' adjusted rate is 19.06 deaths per 100 people, compared to a Canadian average of 15.22.

Marilyn Copes, VIHA executive medical director for acute interventional services, said health authority administrators and physicians are not surprised by the statistics.

"It's a known result, and of course we continue to work on improving that," Copes said.

The administrator suggests the success of Victoria General Hospital's stroke rapid assessment unit - which does prevention work and early intervention, identifying stroke symptoms and getting victims CT scans and drugs within the first hour - means that those who end up in hospital are often more acute patients, resulting in skewed statistics.

"And with that increasing severity comes, in some cases, increased mortality," Copes said. "It is a fine point."

Victoria General and Royal Jubilee hospitals are above the performance range with regard to the 28-day readmission rate after an acute myocardial infarction - a heart attack - and the 90-day readmission rate after a knee replacement.

Nanaimo Regional General Hospital, considered a large community hospital, is underperforming with regard to the 28-day readmission rate after acute heart attacks, and the 90-day readmission rates after both hip and knee replacements.

"I would say it's because we don't have the same level of cardiac rehabilitation in Nanaimo as we do in Victoria," Copes said. "That's something we've put some investment toward but we don't have the same degree as we do in Victoria."

The fact there are fewer rehabilitation services in Nanaimo than in Victoria might also account for why Nanaimo's hospital is underperforming with respect to readmission rates after hip and knee replacements.

Nanaimo Regional General hospital has improved with regard to the five-day mortality rate following major surgery and is above average in the 28-day readmission rate after stroke and 30-day in-hospital mortality rate following stroke.

For more information, see www.cihi.ca.

MIXED RESULTS FOR ISLAND HOSPITALS IN REPORT

The Canadian Institute for Health Information performance allocation is intended to help hospitals evaluate their levels of care. By comparing hospitals objectively, administrators can identify areas where improvement is needed, and track the success of improvement efforts.

ceharnett@timescolonist.com

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