Northwest hospital officials say conditions have improved after one-star federal rating

Northwest Medical Center in Tucson
received a one-star rating from the Centers for Medicare and Medicaid
Services in July, but hospital officials said staff have done a
phenomenal job in improving conditions at the hospital.

The
CMS updated its Overall Hospital Quality Star Ratings based on 46
hospital quality measures in five categories: safety of care, mortality,
patient experience, readmission rates and timely and effective care.

Northwest
Medical Center in Tucson received a one-star rating out of five, just
one of five hospitals in Arizona to receive the low rating.

The
others were Abrazo Scottsdale Campus in Phoenix, Western Arizona
Regional Medical Center in Bullhead City, Valley View Medical Center in
Fort Mohave and Mountain Vista Medical Center in Mesa.

According
to CMS, 4,654 hospitals were rated. Five percent received a 1 star
rating; 14% two stars; nearly 19% received three stars; and 17% received
four. Ten percent, or 483 hospitals, received five stars. Thirty-four
were classified as N/A.

Some of the data is updated quarterly, while others are updated annually.

The
data reporting period ranged from July 2018 to March 2022, so Northwest
Medical Center Sahuarita, which opened in 2020, didn’t receive a
rating.

Brian Sinotte, Northwest Medical Center’s interim chief executive
officer, said that while he didn’t want to discount the significance of
the data collected, much of it does go back roughly five years.

Sinotte,
who joined the Tucson hospital in June 2021, attributed the poor rating
to three areas. First, he said that during the pandemic many COVID-19
patients were placed on respirators and on their stomachs to assist them
in breathing.

While the hospital had “prone” people before, never to that degree and the maneuver was new to some staff, he said.

“You
would have these poor patients who started to have pressure ulcers in
very unique areas. It could be around the mouth, just things that you
really weren’t seeing before and all of a sudden you would have that,”
Sinotte said. “That certainly impacted us pretty significantly during
COVID.”

In addition,
the hospital saw a spike in patients contracting pneumonia in July 2018,
and it continued through the pandemic and up through June 2021, he
said.

Since that time, hospital-acquired pneumonia has decreased 290%, Sinotte said.

Specific
protocols and practices were adopted, including universal nasal
decolonization in high-risk populations, which involves applying a
topical antibacterial medication inside the nostrils to reduce bacteria
in the nose, Veronica Apodaca, a hospital spokeswoman, said via email.

In
addition, nurses new to the facility meet with infection preventionists
and there’s a new partnership between nursing, quality and infection
prevention departments to perform safety validation rounds, Apodaca
wrote.

Healthcare workers have a “high safety environment” playbook of sorts and Sinotte said sometimes you have to go back to it.

“(Sometimes)
you need to really revisit some aspects of the playbook that may be
falling out that might need some improvement, that might be some
refinement,” he said.

While
everyone’s passionate and has a 24/7, 365-day commitment to doing every
the right way every single time, Sinotte said people are human.

“Sometimes
things can happen, and so we review every single case where there may
have been something that we could do differently or if there was a
process deviation and we immediately correct, provide coaching and get
better and learn every single day from opportunities for improvement,”
he said.

Sinotte said the hospital’s recent data shows how well their new protocols and practices are working.

There
hasn’t been a hospital onset MRSA infection in 22 months, nor has there
been a hospital onset catheter-associated urinary tract infection in 17
months, he said. In addition, there haven’t been an hospital onset
central-line associated bloodstream infection in 15 months.

“It
really is reflective of the work that we have done over the past three
years to instill high reliability principles throughout the organization
that we all are very, very proud of,” Sinotte said. “It is…really
stunning for a hospital this size.”

Patient satisfaction rates also play a large role in hospital ratings and Northwest is working on that as well, he said.

They
are trying to create a “high reliability culture” and part of that
includes having administrators go on rounds to sure patients have
everything they need, Sinotte said.

“That’s
quite a time commitment when you think about having a 300-bed hospital
and you’re going to be having leadership out rounding to ensure the
environment’s safe, staff feel supported and they feel like they can
deliver safe care and to being able to pop in and say hello to patients
who may have some questions relative to their care real time before
they’re discharged,” Sinotte said.

The
policies and procedures that have been put in place at the Tucson
hospital have also been implemented in the Sahuarita hospital, Sinotte
said.

Thanks to Brett
Lee, the chief administrative officer for the Sahuarita hospital, and
Cari Olvera, the chief nursing officer, the hospital is seeing
outstanding results when it comes to quality, safety and patient
experience outcomes, he said.

“They’re really doing a great job,” he said.

For example, there have been no hospital-acquired MRSA infections since it opened, he said.

Pneumonia
numbers weren’t immediately available, but because the Sahuarita
hospital doesn’t have an ICU, it can’t be compared to the hospital in
Tucson, Lee said.

The future looks bright for Sahuarita’s hospital, Sinotte said.

“We
actually just got out of a meeting earlier today where Brett and I were
walking some important people through what our future plans are down
there and we’re excited,” Sinotte said. “We take our commitment very
seriously and I love what I’m seeing come out of Brent’s leadership as
it pertains to merging quality scores, patient satisfaction scores.
There’s a lot to be proud of for what’s happening down there.”

According
to Sarah Sabalos, a marketing manager for Northwest Healthcare, the
Sahuarita hospital employs close to 200 people and has 50 providers.