UT Health and Christus

Stars were gained and lost across East Texas in new, updated annual hospital ratings from the Center for Medicare and Medicaid Services.

Tyler’s Christus Trinity Mother Frances and UT Health North Campus Tyler (UT Health Science Center at Tyler) led the way with four-star ratings, while Longview Regional Medical Center gained a star to join UT Health East Texas Tyler at three stars. In Longview, Christus Good Shepherd fell from three stars to two in the most recent report.

CMS rates hospitals nationwide annually on a variety of factors, such as timely and effective care, complications and deaths, unplanned hospital visits, psychiatric unit services and payment and value of care. Hospitals are rated on a scale of one to five stars, with five stars being the best.

According to CMS, data included in the report goes as far back as 2016 and includes results from as recent as the end of 2019.

Longview Regional said in a statement it is proud of its improved rating.

“In the past two years, our clinical teams have made tremendous strides in controlling infection and reducing hospital-acquired complications. With their focus we’ve decreased the number of central line-associated bloodstream infections, catheter-associated urinary tract infections and clostridium difficile,” said Libby Bryson, director of marketing for Longview Regional Medical Center.

According to Longview Regional, the hospital reports weekly on its ratings for categories which include infections, readmissions, patient experiences, safety indicators and emergency department indicators. From the reports, the executive leadership team is able to identify key areas where hospitals can improve.

“We have adopted numerous best practices related to communications and service to enhance our patients’ experiences, through leader rounding, and we emphasize the importance of using patient whiteboards to offer information about who is caring for patients and their pain and fall score. Longview Regional remains committed to providing safe, quality care for every patient. Our physicians, nurses, and other clinicians work to continually improve care, and measurement helps us identify progress and opportunities to further improve,” the LRMC statement read.

UT Health East Texas also said it is proud of its North Campus Tyler’s four-star rating, and expects to see continued success at hospitals across the division as quality improvements implemented are reflected in the ratings.

“It’s important to remember that the data is not a reflection of the current state. For example, the most recent release for CMS is based on data that reaches as far back as 2016, previous to the formation of the health system. UT Health has implemented frameworks for driving quality, safety and experience, which improve patient outcomes in a comprehensive, methodical and systematic manner,” UT Health said in a statement.

In the statement, hospital officials said quality, safety and experience are priorities of their mission to care for patients, families and each other. The work UT Health is doing will be reflected in future CMS star reporting.

Executive Vice President and Chief Clinical Officer for Christus Health Sam Bagchi said in a statement both Christus Trinity Mother Frances Health System and Christus Good Shepherd are committed to providing for patients and their family members and the commitment was further heightened during the past year due to COVID-19 as teams across the organization worked to serve the community.

“We support the concept of providing an easier way for patients and communities to understand and access (CMS) data. However, in doing so, the rating system can oversimplify the complexities of delivering high-quality care based on data that is being collected during different time frames by multiple health care agencies, often lagging behind for up to five years,” Bagchi said.

Bagchi added both Christus health systems have received numerous quality and safety awards and accreditations from national organizations, such as the American Heart Association, the American College of Surgeons and the Joint Commission. He said the recognitions single out excellence in heart and stroke care, patient safety and overall quality, among more services.

“In every ministry, Christus is focused on providing patient care, and we are allocating our resources and staff to ensure we continue to deliver high-quality, faith-based care,” Bagchi said. “That involves bringing more caregivers from different areas of the organization to the bedside, including clinicians from our quality teams, who are responsible for preparing and entering data for surveys and consideration for awards and recognitions. We anticipate reporting our updated health system information for the years of 2020 to 2021 by the end of this year.”

The overall star rating for hospitals summarizes quality information on important topics, like readmissions and deaths after heart attacks or pneumonia. The overall rating, between one and five stars, summarizes a variety of measures across seven areas of quality into a single star rating for each hospital. The seven measure groups include mortality, the safety of care, readmission, patient experience, the effectiveness of care, timeliness of care and efficient use of medical imaging.

At the Hospital Compare website, people can look up the overall rating of hospitals by location or zip code. They also can compare hospitals based on criteria such as clinical outcomes, customer satisfaction and patient safety.

Individual measures of hospital performance — such as how often patients get infections after surgery, how long patients wait in the emergency department before seeing a doctor or nurse and how likely patients are to get readmitted to the hospital after a heart attack — are used to create a snapshot of the hospital’s overall quality of care.

Significant changes among the hospitals include UT Health’s death rates for COPD patients. They were rated worse than the national rate and Christus Mother Frances rated better than the national value in serious complications.

Longview Regional and Christus Mother Frances Hospital’s central line-associated bloodstream infections (CLABSI) in ICUs and select wards was rated worse than the national benchmark.

All hospital’s catheter-associated urinary tract infections (CAUTI) in ICUs were rated better than the benchmark, while Christus Mother Frances rated no different than the national benchmark. Clostridium difficile (C. diff) intestinal infections ratings were better than the national benchmark across all hospitals.

In surgical site infections (SSI) from colon surgery, UT Health rated better than the national average, and Longview Regional had no data available. Data of SSI from abdominal hysterectomy was not available for all hospitals. In methicillin-resistant staphylococcus aureus (MRSA) blood infections, Christus Good Shepherd and Christus Mother Frances rated worse than the national benchmark.

In death rates, UT Health and Christus Mother Frances Hospital rated worse in COPD patients.

In their rating for timely and effective care, the CMS looked at how often or quickly the hospital was able to provide care that research shows, gets the best result for patients with certain situations, and how the hospital used outpatient medical imaging tests, like CT scans or MRIs.

Longview Regional, UT Health and Christus Mother Frances did well in colonoscopy follow-ups, earning an above average rate than the national and Texas average, while Christus Good Shepherd fell below. Christus Good Shepherd hospital rated no different.

The percentage of patients who left the emergency department before being seen at Longview Regional was better than the national average, while UT Health, Christus Mother Frances and Christus Good Shepherd’s percentage was higher than the average.

Emergency department volume rated high in Longview Regional and UT Health, seeing an average of 40,000 to 59,999 patients annually, while Christus Mother Frances and Christus Good Shepherd rated very high, meaning they see over 60,000 patients annually.

The average time patients spent in the emergency department before leaving from their visit resulted in above average waits at Longview Regional and at UT Health, while Christus Mother Frances and Christus Good Shepherd’s average time was below average.

The percentage of healthcare workers given influenza vaccination at Longview Regional resulted better than the national and Texas average, while UT Health’s was below the national average. Data was not available for Christus Mother Frances and Christus Good Shepherd’s influenza vaccination averages.

Longview Regional got an above average for percentage of mothers whose deliveries were scheduled too early, (one to two weeks early) when a scheduled delivery wasn’t medically necessary. UT Health and Christus Good Shepherd and Christus Mother Frances stayed below the national average.

Longview Regional, UT Health and Christus Good resulted in below average in outpatient CT scans of the abdomen that were double scans, while Christus Mother Frances’ was above the average. The percentage of outpatients who got cardiac imaging stress tests before low-risk outpatient surgery was below average for Longview Regional, while UT Health, Christus Mother Frances and Christus Good Shepherd, above average.

The percentage of outpatients with low-back pain who had an MRI without trying recommended treatments (like physical therapy) was not available for Longview Regional and UT Health, while Christus Good Shepherd and Christus Mother Frances rated above average.

In unplanned hospital visits, Christus Mother Frances’ rate was better than the national rate while other hospitals rated no different than the national rate.

The rate of readmission for chronic obstructive pulmonary disease (COPD) patients at Christus Good Shepherd rated worse than the national rate, while other hospitals rated no different than the national rate.

For readmission of heart attack patients, Christus Mother Frances rated better than the national rate while other hospitals rated no different than the national rate.

The average hospital return days for heart attack patients averaged lower at Longview Regional, UT Health and Christus Mother Frances, and 25.8 days at Christus Good Shepherd.

In heart failure, Christus Good Shepherd rated worse than the national rate at 26.9% while all hospitals rated no different than the national rate. The hospital return days for heart failure patients resulted in 47.7 days at Longview Regional, -14.1 days at UT Health, 6.2 days at Christus Mother Frances, and 19.8 days at Christus Good Shepherd.

The rate of readmission for pneumonia patients was no different than the national average across all hospitals, and the hospital return days for pneumonia patients resulted in the lowest number of days at UT Health and Christus Mother Frances, and 8.8 days at Longview Regional and 16.6 days at Christus Good Shepherd.

For unplanned hospital visits by procedure, Christus Mother Frances rated better than the national rate in unplanned hospital visits after outpatient colonoscopy, while in coronary artery bypass graft surgery and the rate of readmission for CABG surgery patients was no different than the national average across all hospitals, as well as hip and knee replacement readmissions and the rate of unplanned hospital visits after an outpatient colonoscopy.

The ratio of unplanned hospital visits after hospital outpatient surgery at Christus Mother Frances and Christus Good Shepherd rated better than expected while the other two hospitals rated no different than the national rate.

Data for all hospitals’ psychiatric unit services is not available.

The hospital’s payment and value of care shows whether Medicare spends more, less, or about the same on an episode of care for a Medicare patient treated in a specific inpatient hospital compared to how much Medicare spends on an episode of care across all inpatient hospitals nationally. A ratio that is more than the national average means that Medicare spends more per patient for an episode of care initiated at this hospital than it does per episode of care across all inpatient hospitals nationally.

The medicare spending average per beneficiary was above the national average at all four hospitals.

The payment for heart attack patients at Christus Mother Frances and Christus Good Shepherd are greater than the national average payment, while the other two hospitals rated no different than the national rate.

The payment for heart failure patients Christus Mother Frances was greater than the national average, and in payment for hip and knee replacement patients, less than the national average payment, while the other three hospitals rated no different than the national average in both procedures.

The payment for pneumonia patients was greater than the national average at UT Health and at Christus Good Shepherd, while the remaining two hospitals rated no different than the average.

The death rate for both heart attack and heart failure patients across all hospitals are no different than the national rate, as well as the complications for hip and knee replacement patients.

Payments for hip and knee replacement patients were less than the national average at Christus Mother Frances, whereas remaining hospitals rated no different than the average.