ALMC officials respond to story on heart patients
Published 11:00 am Friday, April 30, 2010
A Star Tribune story from April 18 said patients hospitalized with heart failure are twice as likely to die in Albert Lea than in Austin because of a report prepared by Medicare.
“Those numbers do not mean you’re twice as likely to die in Albert Lea than in Austin in the hospital,” Dr. Mark Ciota, CEO of ALMC, said.
The study said that heart failure patients at Austin Medical Center have an 8.3 percent death rate while patients at Albert Lea Medical Center have a death rate of 15.5 percent. Many factors go into those percentages, which count anyone who has been to the hospital and then died within 30 days of their stay.
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An excerpt from the Star Tribune article: “At the Austin Medical Center, Dr. Cynthia Dube noticed the red flags several years ago. At the time, the hospital’s own data showed that heart-failure patients weren’t doing as well as expected. Among other things, records showed, only about 80 percent were getting proper discharge instructions.”
Ciota, with administrators and cardiologist Dr. Sandra Birchem, are now working on some of the same things that helped Austin Medical Center. More recent data was available to hospitals in April that showed ALMC was improving, and this data was not included in the Star Tribune’s report. Instead of a 15.5 percent death rate for heart failure patients, it improved to 14.1 percent in the newest report.
“Since July our numbers have come to the state average now,” Ciota said. “It’s still not acceptable, but it’s a move in the right direction.”
Congestive heart failure is a chronic disease that will ultimately end a person’s life. Historically people in Albert Lea bring their family members to ALMC for end-of-life care. If they are admitted to ALMC and die, their death is recorded, while other hospitals may send that person to a hospice or nursing home. That death would then not be recorded in a hospital’s mortality report.
“There’s a lot of factors that go into that number,” Ciota said. “Heart failure is a long-term illness.”
The data the Star Tribune used was released in July 2009 and was compiled from surveys from July 2005 to June 2008, said ALMC Administrator Steve Underdahl. The data are compiled retrospectively, with the newer data from April reflecting surveys from June 2006 to July 2009. There will be even newer data available in June of this year, which will show if the hospital is still improving.
Ciota said they also didn’t like the ratings from July and have made changes since then. One change is to connect patients with comfort care like a nursing home, which doesn’t change the fact that the patient dies but changes the statistic. Another change was the hiring of case managers. If a heart failure patient leaves the hospital, they are connected with a nurse who will call them to make sure they are taking their medicine and help the patient look for warning signs.
“We want people to know they’re safe when they come here,” Underdahl said. “We do a good job of caring for cardiac disease here.”
Underdahl noted ALMC compares very favorably to other hospitals in the country in all other studies except this heart failure report.
“With this heart failure one, it hits people’s ears a little funny and sounds like people die more frequently than somewhere else, and that’s not the case,” Underdahl said.
Ciota also talked about the trend that hospitals have started being concerned about the health of their communities instead of just caring for people as they come in.
“As time goes forward, I think it will fall to the hospital to be more involved in what you do before you come and what you do after and not just while you’re here for multiple diagnoses,” Ciota said.