Long Island hospitals, despite some improved scores, continue to rate among the lowest nationally in how satisfied patients are with their experience.
The federal Centers for Medicare & Medicaid Services tie 25 percent of hospitals' reimbursements to 10 questions that rate how well they score on patients' perception of their care. The questions include how patients rate the hospital overall, whether they would recommend the hospital, whether doctors and nurses communicated well with them, whether their pain was controlled, whether the area around their room was quiet at night and whether their rooms were clean.
Millions of dollars of reimbursements are at stake for Long Island hospitals. But in the latest data, released in December, none of 20 Long Island hospitals scored at or above the national average in all 10 questions and six were below the national average in all 10. This is though many Long Island hospitals rank average or better in the actual quality of care.
St. Francis Hospital in Flower Hill scored the best, with eight out of 10 measures at or above the national average. Nassau University Medical Center in East Meadow and Brookhaven Memorial Hospital Medical Center in East Patchogue had the lowest scores, below the national and state averages in all 10 questions.
Compared with the rest of the state, LI hospitals also scored poorly overall. And New York's averages are comparatively low. The state scored no better than fourth from the bottom compared to other states on any of the questions.
Yet only two LI hospitals were at or better than the state average in all 10 areas: St. Francis and John T. Mather Memorial Hospital in Port Jefferson.
That is not much different from two years ago when Newsday examined the data, although there have been improvements. Fourteen of the 20 hospitals showed higher scores in two key areas: how the patients rated the hospital overall; and whether they would recommend it. The problem is that national and state averages have risen, too.
"Obviously, all hospitals have an eye on patient satisfaction, so it's more challenging to maintain your standing," said Nancy Uzo, Mather's vice president of public affairs.
Hospital officials are at a loss to explain why it has been so difficult to move the needle more.
"It's not like they're not trying to address it," said Kevin Dahill, chief executive of the Nassau-Suffolk Hospital Council. "They know where the issues are."
Older buildings blamed
Dahill speculates that older buildings play a role in overall perceptions.
"You still have some hospitals with four beds to a room," he said. "I would argue we have more outdated facilities compared to the national level. If you room with another person, chances are staff is going to come in and the noise level is going to be higher."
Although many hospitals said they have instituted quiet times when lights are dimmed and staff are encouraged to speak in low tones, the lowest scores for LI hospitals were in how quiet rooms were at night, with none scoring above the national average of 61 percent. Only nine hospitals were above the state average of 51 percent.
Dr. Victor Politi, NUMC's chief executive, said the safety-net hospital that treats many of the county's poorest simply doesn't have the money to fix its aging infrastructure. "We need more money to make rooms nicer," he said. "Where am I supposed to get the money?"
But others said older buildings can't entirely explain the discrepancy.
"I don't understand it myself. It surprises me that we're not higher up," said Susan Penque, senior vice president of patient care services at South Nassau Communities Hospital in Oceanside, referring to LI hospitals overall. Penque, a native Long Islander, spent 30 years working in hospitals in Minnesota before returning four years ago to the Island.
She said that some of it may have to do with New Yorkers themselves. "There's a lot of demanding things right now," she said. Minnesotans tended to be "more patient and forgiving," she said.
But that, she said, is not deterring her staff from working hard to engage each patient personally. "In nursing we talk about 'nursing presence,' " she said, "giving their undivided attention to the patient 15 minutes each day at the bedside."
Establishing better and ongoing communication between patients and staff is a common thread among hospitals. Mary Ann Donohue-Ryan, chief patient care services officer at Stony Brook University Hospital, said doctors are being encouraged to bring chairs into the room when they visit a patient. "It's quality time when they are actually sitting down and looking you in the eye," she said.
Dr. Patrick M. O'Shaughnessy, chief medical officer for Catholic Health Services, said each unit at each of the six CHS hospitals is aware of its patient-satisfaction scores and a friendly competition is encouraged. What's more, executives' performance evaluations are tied to the scores.
"This is hard-wired into the campuses," he said.
Many hospitals speak of learning from the hotel industry. Last year, North Shore-Long Island Jewish Health System hired Sven Gierlinger for the newly created position of vice president and chief experience officer. Gierlinger came from the Henry Ford Health System in Detroit, where he was vice president of hospitality and service culture. Before that, he worked for the Ritz-Carlton Hotel Co.
Like Penque, he has found that New Yorkers tend to have "a shorter attention span" than Midwesterners. And he, too, said aging facilities may play a role in patients' perception of their experience. But he said closely tracking and parsing each interaction will eventually improve scores.
"Every person that comes into the hospital matters, and every interaction matters," he said.
Brookhaven's chief executive Richard Margulis agreed.
"We own our scores. We may not like them, but it is something we pay attention to every day," he said. "Health care is not a commodity or a product; it's about human connection."