Patients Give Hospitals in State Mixed Marks

Patients in California hospitals usually receive needed pain medication, do not experience long waits and are treated with respect and care before surgery, according to the first industrywide survey of the state’s hospitals to be released today.

But the survey also found that many hospitals fail to sufficiently educate patients about medication or resuming day-to-day activities after they go home.

The survey marks a turning point for an industry that has until now resisted such public comparisons. Though it may not be entirely representative of care in California hospitals, the survey is the best overall picture for consumers so far, several patients’ advocates said.

Almost a third of the hospitals--which house 42% of the licensed beds in the state--responded to the survey conducted by the philanthropic California HealthCare Foundation and the nonprofit California Institute of Health Systems Performance.

“We can’t really think of a situation where having no information is better than having some information,” said Ann Monroe, a researcher on the survey and director of the California HealthCare Foundation’s Quality Initiative. “This is somewhat of an outgrowth of the whole idea of the empowered consumer.”

The study is not intended to be a guide to “good” or “bad” hospitals, Monroe said--it was voluntary, and hospitals that participated were willing to confront their strengths and weaknesses.

Of the major medical providers in Southern California, 11 Kaiser Permanente hospitals received average or below-average overall scores from patients, while City of Hope National Medical Center in Duarte and Hoag Memorial Hospital-Presbyterian in Newport Beach received above-average marks. Cedars-Sinai and UCLA medical centers were ranked average overall.

Simi Valley to Seek Improvements

In Ventura County, only Simi Valley Hospital took part in the survey. Overall, its patients said their hospital experience was below average.

Patients gave the hospital poor ratings in six areas of care, including coordination, physical comfort and emotional support. The hospital received an average ranking in the area of respect for patient preferences.

Hospital spokeswoman Alicia Gonzales said officials decided to participate in the survey because they “care about what patients think. . . . We see this as an opportunity to make changes.”

Within the past year, the hospital has hired a new executive team that is working on a plan to improve services, she said.

“We really feel strongly about the new team and the changes they will make for the better,” Gonzales said. “We want the community to know that we are listening, we care and that we are making changes.”

Some area hospitals, including Los Robles Regional Medical Center in Thousand Oaks, chose not to participate because they conduct their own surveys.

“This was great for hospitals who never had any initiatives like this,” said Los Robles spokeswoman Kris Carraway-Bowman. “But we already do our own [survey] which we thought was a lot more in-depth. And we do it every quarter.”

Carraway-Bowman said her hospital had a 95% patient satisfaction rate in the last in-house survey.

Five out of six Los Angeles County Department of Health Services hospitals chose not to participate in the survey, citing lack of resources.

“Because of the surveys we already do [as required by the federal government], we did not put the resources into this one,” said department spokesman John Wallace. “You would be surprised at a system as large as ours, how much effort that would take.”

Some Hospitals Unaware of Survey

Hospitals that participated in the survey were required to pay a $1,500 fee per facility.

Several hospitals that did not participate complained that they were unaware of the survey.

“It would be interesting to know how they got the word out, since there was such a low response rate,” said Kim Pine, a spokeswoman for UC Irvine Medical Center in Orange County, where only three hospitals responded.

“There are more than 40 hospitals in Orange County,” she said. “It’s kind of strange.”

Statewide, 113 hospitals participated, including 14 in Los Angeles County. Surveys were sent to eligible patients who had spent at least one night in the hospital. Forty-three percent--or 21,151 patients--responded.

“This data is a really good opportunity to have a dialogue between patients and doctors, and for patients to say, ‘What are my choices among hospitals?’ ” Monroe said. “It is part of that mosaic of consumer information that we are trying to provide for people who are making a very serious decision.”

While the study is significant, it should not be the only source patients consult before choosing a hospital, said Jan Emerson, spokeswoman for the California HealthCare Foundation.

“This doesn’t measure clinical quality, this is more about what they think about the hospital,” she said. “It’s the beginning of a lot of publicly reported pieces of information on hospital care.”

Emerson said hospitals that participated and received low marks should not be criticized.

“The hospitals should definitely be commended . . . because they used a standardized tool and agreed to having this publicly reported regardless of where they ended up in terms of survey results,” she said. “This can be very useful information they can use to . . . advance their care.”

Peter Lee, president of the Pacific Business Group on Health, a nonprofit consumer group, said hospitals that participated should be seen as champions for patient care.

“It’s a sad reality that less than 20% of the hospitals in Los Angeles County participated in this survey,” he said. “I think for a long time, many in the health care profession have not been ready to be held accountable.”

All of Kaiser Permanente’s 27 hospitals in California participated, said Marilyn Chow, vice president for patient care services at Kaiser’s California division. Just one ranked above average overall, according to the patients surveyed.

“The results show that we clearly have work to do on service,” Chow said. “It shows we need to listen to our patients and what our members are saying about patient care. We are using this as a way to focus on service.”

Scores Can Be ‘Very Helpful’

James Miser, chief executive of the City of Hope National Medical Center, said the survey was helpful because it gave staff a snapshot of its performance.

“There are always opportunities to improve, and getting the views of people you serve is quite helpful,” he said. “I understand the idea of resistance [among hospitals] because some don’t want to be held up to an evaluation. But these scores can be very helpful.”

The results are available at https://www.chcf.org or by calling (510) 238-1040.

Times staff writers Jennifer Mena in Orange County and Tina Dirmann in Ventura County contributed to this report.

(BEGIN TEXT OF INFOBOX / INFOGRAPHIC)

Rating Hospitals

Overall experience of patients at California hospitals that volunteered to participate in the survey:

*** Above average

** Average

* Below average

Adventist Health/Paradise Valley Hospital: **

Adventist Health/Simi Valley Hospital & Health Care Services: *

Adventist Health/South Coast Medical Center, Laguna Beach: ***

Adventist Health/White Memorial Medical Center Los Angeles: **

Alvarado Hospital Medical Center, San Diego: **

Cedars-Sinai Medical Center: **

City of Hope National Medical Center, Duarte: ***

Desert Valley Hospital, Victorville: **

Eisenhower Medical Center, Rancho Mirage: **

Hoag Memorial Hospital Presbyterian, Newport Beach: ***

Huntington Memorial Hospital, Pasadena: **

Kaiser Foundation Hospital-Baldwin Park: *

Kaiser Foundation Hospital-Bellflower: *

Kaiser Foundation Hospital-Fontana: **

Kaiser Foundation Hospital-Harbor City: *

Kaiser Foundation Hospital-Los Angeles: *

Kaiser Foundation Hospital-Orange: **

Kaiser Foundation Hospital-Panorama City: **

Kaiser Foundation Hospital-Riverside: *

Kaiser Foundation Hospital-San Diego: *

Kaiser Foundation Hospital-West Los Angeles: **

Kaiser Foundation Hospital-Woodland Hills: *

Loma Linda University Medical Center, Loma Linda Lompoc District Hospital: **

Methodist Hospital of Southern California, Arcadia: **

Pacific Alliance Medical Center, Los Angeles: ***

Riverside County Regional Medical Center: *

Sharp Coronado Hospital and Health Care Center Coronado: **

Sharp Grossmont Hospital, La Mesa: **

Tri-City Regional Medical Center, Hawaiian Gardens: **

UCLA Medical Center: **

Note: Those surveyed were maternity, surgical and medical patients.

Sources: California HealthCare Foundation, California Institute for Health Systems Performance