Island hospital's ER ranks high in patient satisfaction
The Martha's Vineyard Hospital (MVH) emergency room (ER) got high marks for patient satisfaction and finished in the top ranks in all categories, when compared with other ERs in several hospital groupings, according to a survey of patients over a six-month period.
The overall facility rating for the emergency room at MVH was 93, meaning that the Island hospital's ER scored better than 93 percent of ERs among the survey group of 136 hospitals that handle 20,000 or fewer patient visits or fewer each year. The overall facility rating for the emergency room at MVH was in the 99th percentile of 923 hospitals surveyed nationwide, according to a report by Press Ganey Associates, a national firm headquartered in South Bend, Indiana, specializing in quality care measurement and the improvement of health-care institutions.
The rankings are based on the results of surveys completed and returned by patients who visited the ER between Nov. 1, 2006 and April 30, 2007. Visitors seeking emergency treatment were most pleased with nurses and doctors and less pleased with their arrival and processing.
Press Ganey measured MVH against three categories of hospitals, according to MVH chief executive officer Tim Walsh - all 923 hospitals in the company's database, 79 hospitals in the Northeast region, and 136 hospitals with 20,000 or fewer ER visits.
A national survey firm examined hospital emergency room performances and ranked the Island ER favorably among its peers. Photos by Ben Scott
MVH had approximately 16,000 ER visits last year, said Mr. Walsh. Every patient was mailed a survey form. The survey collects information and asks questions in several patient care areas.
A total of 404 patients, or approximately 10 percent of the patients treated during the six-month survey period, responded. Those results provided the basis for a mean overall score that was then measured against the results from other hospitals and used as the basis for separate rankings.
For example, the Vineyard hospital ER doctors received an overall mean score of 92.1, based on patient responses. When measured against all hospitals in the database, the doctors ranked 99 for all categories, meaning that 99 percent of all hospitals in the database had lower overall scores in that category. The rank was 96 in the 20,000 or fewer patient category and 97 for the northeast region.
The 145-page Press Ganey report (available here) provides a detailed breakdown of patient responses to a variety of questions. For example patients were asked about waiting time, nurse courtesy, nurse concern for privacy, and whether doctors took time to listen.
The hospital ER received a mean score of 88.2 in the category of how well pain was controlled, with rankings of 99 for the entire database (20,000 or fewer), 97 for patient loads, and 98 for the Northeast region. The rankings for waiting time to see a doctor were 96, 89, and 95, respectively, for the three categories.
The Vineyard ER's time-worn and confined space will be expanded and modernized with the construction of the new $42 million hospital building.
The lowest rankings received were in the categories of tests and personal/insurance information, when the Vineyard hospital was compared to hospitals in the 20,000 or less category. The hospital received a mean score of 91.1 for the courtesy of the radiology staff, but scored a 50 ranking when compared to other small hospitals.
The hospital received a mean score of 89 for protecting privacy when collecting personal/insurance information and a 59 percentile ranking.
In almost all other categories, the hospital scored 90 and above. Mr. Walsh said some patient complaints, such as noise and room temperature control, are directly attributable to the conditions in the 33-year-old facility that is about to be replaced. Despite those issues, he said the ER "is always right up there."
Commenting on the latest survey results, Mr. Walsh said the ER staff does a fabulous job in a facility that is too small and inadequate. "That is borne out by the survey results," he said. "Just wait until we get that new hospital."
The ER, now 10 small rooms in a wing of the outdated facility, will be 16 full-size rooms with the newest equipment in the $42 million hospital about to be built.
Validation for ER personnel
Hospital emergency services director Dr. Tim Tsai worked in some busy ERs prior to arriving on the Vineyard, including a stint in the Bronx in New York City.
"I would put this department up against any in the country when it comes to skill, compassion, esprit de corps or any other measure of success you could care to choose," said Dr. Tsai. "The latest Press Ganey scores simply validate what I've known all along about the people I work with."
The nature of a resort community like the Vineyard requires the hospital ER to be ready to deal with many types of emergencies. Dr. Tsai said people come from all over the world to get sick on Martha's Vineyard. And unlike a large city hospital, there are not specialists waiting in the wings to assist.
"We care for the sickest patients presenting to the hospital and do so without benefit of a trauma team, in-house neurosurgeon, cardiology team or even an extra set of hands at times," said Dr. Tsai, "and we do so with compassion and caring, and we never take our role in the community for granted."
While high Press Ganey scores provide positive feedback on the MVH emergency room performance, lower scores are used to improve deficiencies highlighted in the report. Mr. Walsh said the Press Ganey survey is shared with hospital managers and is an excellent tool for focusing resources where improvement is needed. He said a previous survey of overall patient satisfaction highlighted the need to improve food service. He said it took a lot of work but the results have been good.
Mr. Walsh said that when the hospital receives critical comments from patients, "it hurts and it bothers people, but at the same time it provides an opportunity to improve."