New York’s Hospitals: A Disgrace?

New York’s principal health official – Commissioner Dr. Nirav Shah – is in a battle against one of America’s best known watchdogs – the Consumer Reports Health Ratings Center – on the matter of safety in hospitals.  In response to the Consumer Reports’ safety ratings undertaken in February assessing 1,100 hospitals in America, various problems were found with local institutions.  But Shah argued that the information and methods used were “incomplete and flawed.” Indeed, in Shah’s favor, while various hospitals in the region – such as Beth Israel and Harlem Hospital – received these disappointing reports, America’s Department of Health and Human Services had credited them as being “better than the national average.”

Over the years, Consumer Reports has been conducting its investigations on all matters, form infection rates to health outcomes and patient satisfaction.  However, in response to the attack, the Consumer Reports Health Ratings Center director, Dr. John Santa, argued that New York State’s hospital infection data is more thorough than most other states and the federal government.

Origins of the Data

Santa said New York State’s hospital infection data is more thorough than most other states and the federal government. He also said that Shah used numbers for the ratings from his own department.   In New York’s favor, it has been taking the investigation much more seriously than other states and even the federal government has been.  As well, several of the state’s hospitals are much safer than others in the five boroughs.

The main issue is a comparative one.  If two hospitals are dealing with very similar issues and one is doing much better than the other, for no apparent reason, one has to question this. For example, Detroit’s Henry Ford is doing much better than NY’s urban hospitals where those investigated argued they are encountering many low-income patients with more challenging health problems than those in suburban areas.  But Henry Ford doesn’t seem to be struggling, despite dealing with the same issues.  Why?

Still, regardless of this, according to Baystate Medical Center’s Dr. Peter Lindenauer, these results aren’t having any impact on people’s choice of treatment/surgery facility.  This is probably due to the fact that there is so much conflicting information.  It is going to take time until the kinks are ironed out and such reports can be properly trusted as a true, helpful resource.

Adverse Events in NY Hospitals

However, there are other sources of information that are perhaps more accurate.  These also bemoan the poor state of hospitals in New York.  For example, there have been 40,000 adverse events recorded in hospitals since 2007.  These include: unexpected deaths; delays in treatment; wrong-patient surgeries (including a woman being given a C-section who wasn’t even pregnant) and a variety of other mistakes throughout the state’s hospitals.  As well, it seems like these are being covered up in a database that is hidden from public records, since only a small minority of these can be accessed at the NY Health Department website.

The reason this is allowed to happen – hiding the facts from the public – is due to the state law that lets hospitals report such problems through the New York Patient Occurrence Reporting and Tracking System (NYPOTS) which are kept confidential.  One of these was the case noted above of a mistaken C-section, regardless of the fact that such surgical errors be reported to the Health Department within 24 hours, although the claim was, that it was processed through NYPORTS. Further, there were 14 cases of unexpected deaths not recorded for public access.  Indeed, perhaps not surprisingly therefore, NYPOTS has undergone substantial criticism from patient safety advocates, given that there is no procedure for giving patients the assurance that hospitals are reporting what they should be reporting.

Clearly, patients in New York deserve better access to accurate data about hospital treatment and care and at the same time, there needs to be greater checks and balances on the system in its entirety, as everyone should be working toward the same goal – improved care in NY health care facilities.