Maine Hospital Association,

The following Opinion Editorial appeared in the Oct. 14, 2005, edition of the Kennebec Journal.

Healthy hospitals

by Steven R. Michaud, President, Maine Hospital Association

The newspaper's editorial of Sept. 21 reports that hospitals "had better have a good answer" for not participating in the state's new Safety Star program.

Besides its hostile and threatening tone, this statement also shows profound ignorance as to how Maine hospitals already rate in the quality of care they provide and what they are continuing to do as they pursue quality excellence.

In two recent studies conducted by the federal government and published in the Journal of the American Medical Association, Maine hospitals rated third-best in the nation on the quality of care provided to Medicare patients. But Maine hospitals do not rest on that stunning achievement. They continue to pursue excellent quality and assure patient safety without being asked or required to by the state or anyone else.

Maine hospitals have been at the forefront of evaluating, improving and reporting the quality of care they provide. In the areas of heart-attack and heart-failure treatments, Maine hospitals overall scored in the top 16 percent of the hospitals in the federal government database. And in patient satisfaction, Maine hospitals scored above the norm 191 times in 16 categories.

The newspaper writes that it "cannot imagine why (hospitals) would not participate in a program that recognizes hospitals for safe practices." Nor can we. Even before the Safety Star program was launched, Maine hospitals reported quality indicators to a dizzying array of organizations, including the federal Centers for Medicare and Medicaid Services, the Joint Commission on Accreditation of Healthcare Organizations, the Maine Health Management Coalition, the Maine Hospital Association and the Maine Quality Forum.

All of the organizations I have just listed have a public reporting component. In fact, the Maine Quality Forum already requires that hospitals report on more than 50 measures. And if that were not enough, earlier this year the Maine Hospital Association joined an effort sponsored by the Institute for Healthcare Improvement's 100,000 Lives Campaign, which focuses on improving patient care.

We believe it is more than obvious that Maine hospitals already excel and continue to pursue excellence in the area of quality care. However, before the newspaper suspects that hospitals might "dodge" a program such as Safety Star, it is important to note there might come a point of diminishing returns in participating in every initiative that comes down the road. Participating in a particular program and its specific requirements and interpretations might divert vital resources away from areas that actually will improve patient care.

We wish hospitals in Maine could say without hesitation they have the resources to participate in every quality-reporting program that comes along. But we need to take into account that many of these are redundant, with administrative burdens that are crushing. Hospitals have an equal responsibility to ensure that the quality care they deliver is affordable. Needlessly increasing administrative costs is hardly consistent with the goals of affordable health care. We believe state government and this newspaper should allow hospitals to make that judgment and to be deliberative as to how they spend precious resources.

We are also surprised the newspaper would unilaterally assume that a quality program started by state government should automatically be held in such high regard. The state of Maine has its own hospital here in Augusta that functions under a 15-year-old court order and court takeover of the state's management of that hospital because of poor quality and safety. Are we now to assume state officials should sit in judgment of the quality and safety in Maine's 39 hospitals that are community-governed and that are ranked third in the country? State and federal money that cannot be accounted for, computer system debacles and the inability to pay health-care providers on a timely basis only scratch the surface of the quality problems within state government itself.

Hospitals have to make tough choices. We support the goals of the Safety Star Program, and many of our members may participate. Our hospitals practice the standards that the program will measure. But some might choose to direct the focus of their safety efforts to programs they already participate in, and they should be proud to do so. Consumers should not assume that lack of a star from state government means unsafe or poor quality just because state government and newspapers lead them to believe so.

Steven R. Michaud of Topsham is president of the Maine Hospital Association in Augusta.

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