Jefferson Healthcare has earned a five-star rating from the Centers for Medicare and Medicaid Services based on patient outcomes.

The rating — the highest available in a one to five system tier — was awarded in February by the organization. This is the first time Jefferson Healthcare has received a five star rating.

“To me, I don’t think of this as an award that we won,” said Tina Toner, Jefferson Healthcare Chief Nursing Officer. “This is recognition of the quality care that we provide at Jefferson Healthcare and is earned by our team.”

Such recognition is a measurement of each encounter a patient has with every level of staffing at the hospital while receiving care, Toner said.

CMS created the Star Quality Rating Systems to help consumers, their families and caregivers compare hospitals more easily, according to a news release from Jefferson Healthcare. Medicare’s Hospital Compare, an online resource for the quality of care at over 4,000 Medicare-certified hospitals, provides quality ratings to each of the nation’s Medicare/Medicaid certified hospitals.

Medicare uses data compiled from Hospital Consumer Assessment of Healthcare Providers and Systems, a national survey asking patients about their experiences during a recent hospital stay, according to the news release.

The survey asks a random sample of recently discharged adult patients to give feedback about topics such as how well nurses and doctors communicated, how responsive hospital staff were to patient needs and the cleanliness and quietness of the hospital environment.

“The beauty of the five-star rating is that it is really very much based on your outcomes,” said Brandie Manuel, Jefferson Healthcare’s chief quality officer. “It is not something we can apply for or ask for that they can come watch. It is literally how well did your patients do? Did they have complications? Did they get readmitted for any reason to the hospital within 30 days? Did they die?”

The study also looked at how well the hospital providers adhered to what is considered evidence based medicine, Manuel continued.

“How timely was the care?” she asked. “Did (the patient) get it the way they needed it when they needed it?”

Further, the overall patient experience was studied, Manuel said.

“How did patients feel their experience was? Would they recommend this hospital to family and friends? That comes directly back from the feedback our patients themselves provide through (the) survey process.”

HCAHPS star ratings on Hospital Compare provide snapshots of 10 measures of patient experience of care, according to the news release. In addition, the HCAHPS summary star rating combines all 10 HCAHPS topic-level star ratings into a single, comprehensive metric.

“The bottom line here is there is really no one thing that is measured,”  said Dr. Tracie Harris, MD, Jefferson Healthcare chief of medicine. “It measures different domains on the care of a person and I think that is probably why that feels so good, because … you really do need to kind of hit it all and it is complex.”

Top three in state

There are a total of three five-star hospitals in Washington state, according to the news release.

“The award itself .... is a recognition of the progress that has been made at this hospital and the quality of medical care that we provide our patients here,” Harris said. “I think the biggest take home, from my perspective, is that it should convey to the community you’ve got a quality hospital.”

The rating places Jefferson Healthcare among the top eight percent of hospitals for quality patient outcomes nationwide, Harris said.

“It is OK and safe to come here,” she said. “And not just that, really. This measurement rating was from a one to five star rating system and we are not just average, we are quite a bit above average and that is a big deal in a community like this.”

Being in the top eight percent of hospitals — big and small — for patient outcomes is a distinction made possible by every staff member from certified nursing assistants all the way up to the medical doctors making their rounds each day, Manuel said.

“Really it is the work of our providers and all of our clinicians and even those in support roles who are rowing in the same direction and who have a very clear vision of taking great care of our patients in our community, and a lot of pride in doing that,” she said.

The HCAHPS results posted on Hospital Compare also allow consumers to make fair and objective comparisons between hospitals, and with state and national averages.

Bedside manner

Helping provide good patient outcomes begins from the moment a person with an injury or illness is admitted, Harris said.

“How do you approach a patient when they are first hitting the door?” she asked. “You acknowledge that most people are coming to the hospital not on their best day. When folks come to see us, this might not be their best day, and for some it might be the very worst day of their lives, especially if we are in a death and dying situation — a truly life threatening situation.”

That reality, and how to best help the patient physically and psychologically, is constantly on the minds of the hospital staff, Harris said.

The key is to rapidly develop rapport with the patients and their families and to “talk a little bit and listen a lot,” Harris said.

Serving the small and tight knit Jefferson County community means the staff often know or have relationships with their patients outside the hospital grounds.

“There is such a sense in this type of hospital that we are caring for our community,” Toner said. “We are caring for our neighbors, our family, our friends. So, there is just this commitment to valuing every person that walks in here. It is not six degrees of separation here, it is like two.”

Harris said the staff relies on each other for emotional and professional support in order to help patients dealing with “emotionally heavy” situations.

“It is having powerful leadership that acknowledges that this can be a tough field to work in, especially for the front line providers — intimate precisely because we are caring for our neighbors,” she said. “We are not only care for our neighbors, we are our neighbors. It is hard to get away from that. We are sort of one big family.”

Readmissions process

To improve patient outcomes, hospital staff has reassessed the process for discharging patients in order to help prevent them from being readmitted, Manuel said.

“We did a lot of work looking at the reasons that people might end up coming back to the hospital and trying to figure out … what brought them back here,” she said.

While readmission rates have been low in comparison with other communities over the past few years, there is still a desire to lessen them further, Manuel said.

“We really try hard to figure out what led them back here.”

Individual reasons for readmission were identified during the reassessment process, Manuel said.

“There are a couple of things that stand out to me,” she said. “One of them is just that our cancer program, our oncology program, really grew over the last couple of years, so we were really seeing these patients who are often quite ill coming back in.”

In response, the hospital has worked to add additional services, including social work, to the oncology program, Manuel said.

“We have put together a palliative care program to help better manage patients who are going through a really tough time,” she said.

Hospital staff also asked the patients why they thought they had to be readmitted to the hospital.

“The feedback that we have heard is something like they didn’t have the money to pay for their medications, or they may not have understood fully the importance of what the food in their refrigerator could mean for the trajectory of their healthcare, that kind of thing,” Manuel said. “It has been really great