S T A T E  O F  V E R M O N T
Department of Banking, Insurance, Securities
& Health Care Administration (BISHCA)
89 Main St.  Montpelier, VT 05620-3101    Main Phone:  802-828-3301  
Paulette J. Thabault, Commissioner

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Vermont Department of Banking, Insurance, Securities & Health Care Administration
DIVISION OF HEALTH CARE ADMINISTRATION 

 

Note: This is an archived report site. External links in archived sites are not maintained for currency,
and the data is current  only for the year of the report.   Click here for the most current data available .

2005 BISHCA Comparative Report

QUALITY MEASURES  I  FINANCIAL MEASURES  I  TO PRINT SUMMARY   I  ACT 53/HRAP PAGE

 


1. QUALITY MEASURES

 

Introduction

In 2003, the Vermont Legislature passed Act 53, “An Act Relating to Hospital and Health System Accountability…” Under this new law, each hospital in Vermont will produce an annual community report to show community members how the hospital performs on a variety of quality, safety and financial measures.  The report also will describe ways that community members can learn about and become involved in hospital activities. 

 

This is a summary of the quality, safety and financial measures contained in the first Act 53 Hospital Community Reports, published in January of 2005.

 

In 2001, the Institute of Medicine outlined six key goals for improving American health care.  The Institute’s book, Crossing the Quality Chasm, states that health care should be:

Hospitals organized their Act 53 reports around these goals.

 

Health Care Should be Effective

The Institute of Medicine defines effective care as “providing services based on scientific knowledge to all who could benefit and refraining from providing services to those not likely to benefit (avoiding underuse and overuse).”

 

The nine measures of effective care presented here have been developed and thoroughly tested by the Centers for Medicare & Medicaid Services (CMS) with a number of other health care quality organizations.  These measures are voluntarily reported by hundreds of hospitals throughout the country.  They were picked for public reporting for many reasons, including

  • They reflect widely accepted standards of practice for good health care;

  • They are well understood by health care providers and the public;

  • Hospitals can collect the data

For Vermont’s hospital community reports, experts decided that data should not be publicly reported unless there were at least eleven cases during the reporting period, which was January 1 through June 30 of 2004.  If a hospital did not have at least eleven cases during that time period for a particular measure, it is noted as “insufficient data to protect patient confidentiality” in the charts below.

 

For the measures reported below, each hospital is compared to the average of all other hospitals in the CMS national database.  The measures are divided into three parts in the following table: care for people with heart attacks, care for people with heart failure, and care for people with pneumonia.

KEY FOR TABLE BELOW:     

¨¨¨  Means that the score for the hospital is significantly above the national hospital average
(by at least 2 standard deviations above the national average)

¨¨  Means that the score for the hospital is not significantly different than the national average
(within 2 standard deviations of the national average)

      ¨   Means that the score for the hospital is significantly below the national hospital average
                 (by at least 2 standard deviations from the national average)

 *    Means that there was insufficient data to protect patient confidentiality 
 

Health Care Should Be Effective





Hospitals

Heart Attack Care

 Heart Patient Care Pneumonia Care
Aspirin at Arrival

 		 Aspirin at Discharge

 		 ACEI for LVSD Beta Blocker at Arrival Beta Blocker at Discharge
 		 LVF Assessment

 		 Antibiotic Timing

 		 Pneumo-coccal Vaccination Oxygenation Assessment
Hover cursor over question mark for definition of measure Reports what percent of heart attack patients received aspirin within 24 hours before or after they arrived at the hospital. Aspirin is beneficial because it reduces the tendency of blood to clot in blood vessels of the heart and improves survival rates. Reports how often aspirin was prescribed to heart attack patients when they were leaving a hospital. Long-term use of aspirin after a heart attack can significantly reduce the chance of another heart attack, stroke or death. Reports what percent of heart attack patients who have problems with the heart pumping enough blood to the body were prescribed medicines to improve the heart's ability to pump blood. Reports what percent of heart attack patients, within 24 hours after arrival at the hospital, were prescribed a special type of medicine that reduces heart damage. Reports what percent of heart attack patients were prescribed a special medicine when leaving the hospital that has been shown to reduce further heart damage. Reports what percent of patients with heart failure received an in-depth evaluation of heart muscle function in order to get the right treatment for their heart failure. Reports how long a pneumonia patient was in the hospital before they were given antibiotics. Reports what percent of patients 65 years and older were screened and vaccinated to prevent pneumonia. Reports what percent of patients with pneumonia had the amount of oxygen in the bloodstream measured. Pneumonia reduces the amount of oxygen carried in a patient's blood.
Brattleboro Memorial Hospital * * * * * ¨¨ ¨¨ ¨ ¨¨¨
Central Vermont Medical Center ¨¨¨ * * * * ¨¨¨ ¨¨ ¨¨ ¨¨¨
Copley Hospital * * * * * ¨¨ ¨¨ ¨ ¨¨¨
Fletcher Allen Health Care ¨¨¨ ¨¨ ¨¨ ¨¨¨ ¨¨ ¨¨ ¨¨ ¨ ¨¨
Gifford Medical Center * * * * * ¨¨ ¨¨¨ * ¨¨¨
Grace Cottage Hospital * * * * * * * * *
Mt. Ascutney Hospital * * * * * ¨¨ * * *
North Country Hospital ¨¨ * * ¨¨ * ¨¨ ¨¨ ¨¨ ¨¨¨
Northeastern Vermont Regional Hospital * * * * * ¨¨ ¨¨¨ ¨¨¨ ¨¨¨
Northwestern Medical Center ¨¨ * * ¨¨ * ¨ ¨¨ ¨¨ ¨¨
Porter Hospital ¨¨¨ ¨¨ ¨¨ ¨ ¨¨¨ ¨¨ ¨¨¨ ¨ ¨¨
Rutland Regional Medical Center ¨¨¨ ¨¨ * ¨¨¨ ¨¨ ¨¨ ¨¨ ¨¨ ¨¨
Southwestern Vermont
Medical Center		 ¨¨¨ ¨¨¨ * ¨¨¨ ¨¨¨ ¨¨ ¨¨¨ ¨¨¨ ¨¨¨
Springfield Hospital * * * * * ¨¨ ¨¨¨ ¨ ¨¨
WRJ VA Medical Center ¨¨¨ * * ¨¨¨ ¨¨ ¨¨¨ * ¨¨¨ ¨¨
To see a further breakout of the data used to generate the diamond rating above in the "Effectiveness Measures," link to the "Hospital Compare website, starting here: Step #2 for Vermont Hospital Data.*


* "Hospital Compare" was developed in conjunction with the Centers for Medicare and Medicaid Services (CMS), an agency under the U.S. Department of Health and Human Services, and the Hospital Quality Alliance (HQA). "Hospital Compare" shows measures based on data from hospitals' patient records. The data is converted to rates that measure how well hospitals care for their patients.

Health Care Should be Patient Centered

The Institute of Medicine defines patient-centered as “providing care that is respectful of and responsive to individual patient preferences, needs and values and ensuring that patient values guide all clinical decisions.”

 

The information in this section of the report comes from the opinions of patients.  Patients’opinions and experiences were collected during July, August, and September 2004 using a confidential satisfaction survey used by all hospitals in Vermont.  The survey was developed by Press Ganey, Inc., a nationally recognized, independent hospital survey company.  The survey asks patients more than 40 questions about their hospital stay.   Answers are reported in 11 categories, which are described below.   Hospitals are compared to two categories of hospitals in the Press Ganey national database: all hospitals, and similar hospitals (academic medical centers for Fletcher Allen Health Care, and hospitals of similar sizes for the other hospitals).

 

KEY FOR TABLE BELOW:     

¨¨¨  Means that the score for the hospital is significantly above the national hospital average
(by at least 2 standard deviations above the national average)

¨¨  Means that the score for the hospital is not significantly different than the national average
(within 2 standard deviations of the national average)

      ¨   Means that the score for the hospital is significantly below the national hospital average
               (by at least 2 standard deviations from the national average)     

   

Health Care Should Be Patient Centered

    



Hospitals

 *
Overall Hospital Rating		 *
 Admission Process

 		 *
Room
Satisfaction

 		 *
Meals		 *
Nurses


 		 *
Tests &
Treatments		 *
Visitors &
Family
 		 *
Physician
 		 *
Discharge
Process		 *
Personal
Issues		 *
Overall
Assessment
of Hospital

Place cursor over  question mark for  definition of  measure

 This rating averages all of the measures and gives a snapshot of how satisfied patients were with their inpatient care overall. This rating includes the time it took to complete the admission process and the courtesy of the admission staff. This rating includes questions about the appearance and cleanliness of the room, including temperature and noise levels, courtesy of the cleaning staff, and whether the TV and call button worked. Includes the temperature and quality of food, the courtesy of the food staff, and how well a restricted diet was explained. Includes nurses' friendliness, attitude, attention to patients' needs and pain, overall skill, and how well they informed the patient. Concerns the patients' experience with hospital tests and treatments, including waiting time, courtesy and skill of staff, and concern for patient comfort. Includes how well the hospital did at making visitors and family feel at ease and comfortable during the patient's stay. Concerns the patient's doctor, including how much time the doctor spent with the patient, the doctor's skill, courtesy, concern for patient questions, and responsiveness to patient pain Includes whether the patient felt ready to go home and the speed of the discharge process. Concerns how the patient was treated as a person including concern for privacy, concern for health problems, pain control, how well emotional and spiritual needs were met, and the patient's involvement with treatment plans. Concerns the patient's total in-patient experience including the hospital's cheerfulness, overall rating of care, and whether the patient would recommend the hospital to someone else.
Statistical basis for diamond ratings  (PDF) DATA DATA DATA DATA DATA DATA DATA DATA DATA DATA DATA
Brattleboro Memorial
Hospital		 ¨¨ ¨¨ ¨¨ ¨¨ ¨¨ ¨¨ ¨¨ ¨¨ ¨¨ ¨¨ ¨¨
Central Vermont
Medical Center		 ¨¨ ¨¨ ¨¨ ¨¨ ¨¨ ¨¨ ¨¨ ¨¨ ¨¨ ¨¨ ¨¨
Copley Hospital ¨¨ ¨¨ ¨¨ ¨¨ ¨¨¨ ¨¨¨ ¨¨¨ ¨¨ ¨¨¨ ¨¨¨ ¨¨
Fletcher Allen Health Care ¨¨ ¨¨ ¨¨ ¨¨ ¨¨ ¨¨ ¨¨ ¨¨ ¨¨ ¨¨ ¨¨
Gifford Medical Center ¨¨ ¨¨ ¨¨ ¨¨ ¨¨ ¨¨ ¨¨ ¨¨ ¨¨ ¨¨ ¨¨
Grace Cottage Hospital ¨¨¨ ¨¨¨ ¨¨¨ ¨¨¨ ¨¨ ¨¨¨ ¨¨ ¨¨ ¨¨¨ ¨¨ ¨¨¨
Mt. Ascutney Hospital ¨¨ ¨¨ ¨¨ ¨¨ ¨¨ ¨¨¨ ¨¨ ¨¨¨ ¨¨ ¨¨ ¨¨
North Country Hospital ¨¨ ¨¨ ¨¨ ¨¨ ¨¨ ¨¨¨ ¨¨ ¨¨¨ ¨¨ ¨¨ ¨¨
Northeastern Vermont Regional Hospital ¨¨ ¨¨ ¨¨ ¨¨¨ ¨¨ ¨¨ ¨¨ ¨¨ ¨¨ ¨¨ ¨¨
Northwestern Medical Center ¨¨ ¨¨ ¨¨ ¨¨ ¨¨ ¨¨ ¨¨ ¨¨ ¨¨ ¨¨ ¨¨
Porter Hospital ¨¨ ¨¨ ¨¨ ¨¨ ¨¨ ¨¨ ¨¨ ¨¨ ¨¨ ¨¨ ¨¨
Rutland Regional Medical Center ¨¨ ¨¨ ¨¨ ¨¨ ¨¨ ¨¨ ¨¨ ¨¨ ¨¨ ¨¨ ¨¨
Southwestern Vermont Medical Center ¨¨ ¨¨ ¨¨ ¨¨ ¨¨ ¨¨ ¨¨ ¨¨ ¨¨ ¨¨¨ ¨¨
Springfield Hospital ¨¨ ¨¨ ¨¨ ¨¨ ¨¨ ¨¨ ¨¨ ¨¨ ¨¨ ¨¨ ¨¨

 

Health Care Should be Safe

The Institute of Medicine defines safe as “avoiding injuries to patients from the care that is intended to help them.”

 

The four measures in this section come from the Press Ganey patient satisfaction survey described above.  They are based on patients’ opinions about the safety of the care they received during their hospital stay.  Each hospital is compared to the Press Ganey overall national average, which includes hospitals from across the country.

KEY FOR TABLE BELOW:     

¨¨¨  Means that the score for the hospital is significantly above the national hospital average
(by at least 2 standard deviations above the national average)

¨¨  Means that the score for the hospital is not significantly different than the national average
(within 2 standard deviations of the national average)

      ¨   Means that the score for the hospital is significantly below the national hospital average
             (by at least 2 standard deviations from the national average)
*    Means that there was insufficient data to protect patient confidentiality 

     

Health Care Should Be Safe



Hospitals

 Degree of safety and security felt in hospital
 		 Extent to which staff wore identification badges
 		 Extent to which you were informed about all the medications you received in the hospital Your confidence that O.R. staff correctly identified you and your procedure prior to surgery 

Statistical basis for diamond ratings  (opens PDF)

DATA DATA DATA DATA
Brattleboro Memorial
Hospital		 ¨¨ ¨¨ ¨¨ ¨¨
Central Vermont
Medical Center		 ¨¨ ¨¨ ¨¨ ¨¨
Copley Hospital ¨¨¨ ¨¨ ¨¨¨ ¨¨
Fletcher Allen Health Care ¨¨ ¨¨ ¨¨ ¨¨
Gifford Medical Center ¨¨ ¨¨ ¨¨ ¨
Grace Cottage Hospital ¨¨ ¨¨ ¨¨¨ *
Mt. Ascutney Hospital ¨¨ ¨¨ ¨¨ ¨¨
North Country Hospital ¨¨ ¨¨ ¨¨ ¨¨
Northeastern Vermont Regional Hospital ¨¨ ¨¨ ¨¨ ¨¨
Northwestern Medical Center ¨¨ ¨¨ ¨¨ ¨¨
Porter Hospital ¨¨ ¨¨ ¨¨ ¨¨
Rutland Regional Medical Center ¨¨ ¨¨ ¨¨ ¨¨
Southwestern Vermont Medical Center ¨¨ ¨¨ ¨¨¨ ¨¨
Springfield Hospital ¨¨ ¨¨ ¨¨ ¨¨

 

Health Care Should be Timely

The Institute of Medicine defines timely as “reducing waits and sometimes harmful delays for both those who receive and those who give care.”

 

Some of the effectiveness of care and patient centered measures presented above relate to timeliness.  Examples include the aspirin on arrival measure for heart attack patients, the timeliness of antibiotics measure for pneumonia patients, the patient satisfaction with admission process measure, and the patient satisfaction with tests and treatment measure. 

 

Health Care Should be Equitable

The Institute of Medicine defines equitable as “providing care that does not vary in quality because of personal characteristics such as gender, ethnicity, geographic location, and socioeconomic status.” Specific data is not available for this year's report.

 

In the future, Vermont hospitals might be able to report measures by gender or by type of insurance to see if there are variations in care. 

2. FINANCIAL MEASURES

Health Care Should be Efficient:

The Institute of Medicine defines efficient as “avoiding waste, in particular waste of equipment, supplies, ideas and energy.”  Efficiency can be difficult to measure. However, the financial data required by Act 53 as presented in these reports allow for some comparisons among Vermont hospitals and also for comparisons in relation to regional and national benchmarks. The financial information is divided into five areas: Pricing for Selected Services, Budget and Financial Information, Cost Shift, Financial Health Benchmarks and Indicators, and Hospital Capital Investments.  The information for the tables and charts comes from hospital budget information submitted to the Vermont Department of Banking, Insurance, Securities, and Health Care Administration, and from information that the Vermont Association of Hospitals and Health Systems collects on inpatient care and outpatient procedures. 

 

The source data for these financial tables is data that is submitted to the Vermont Department of Banking, Insurance, Securities and Health Care Administration through the annual hospital budget process.  The reporting format required for these submissions may differ from reporting formats required by the American Institute of Certified Public Accountants (AICPA).  Consequently, certain information and statistics in the Department format may vary from information and statistics reported by the hospitals in formats consistent with the AICPA. 

View Individual Financial Tables in PDF format

  Table # 1  Pricing for Selected Services - 2003 Inpatient Gross Charges
  Table # 2  Pricing for Selected Services - 2003 Outpatient Gross Charges
  Table # 3  Budget and Financial Information - Actual 2003
  Table # 4  Budget and Financial Information - Projected 2004
  Table # 5  Budget and Financial Information - Budget 2005
  Table # 6  Cost Shift - Actual 2003
  Table # 7  Financial Health Benchmarks & Indicators - Actual 2003
  Table # 8  Financial Health Benchmarks & Indicators - Projected 2004
  Table # 9  Financial Health Benchmarks & Indicators - Budget 2005
  Table # 10  Hospital Capital Investments - Actual 2003
  Table # 11  Hospital Capital Investments - Projected 2004
  Table # 12  Hospital Capital Investments - Budget 2005
  Table # 13  Hospital Capital Investments - Capital Plans
  Table # 14  Financial Glossary

 

TO PRINT OUT THE BISHCA HOSPITAL REPORT SUMMARY:

You may download a PDF version of the narrative . In the on-line version, the glossary terms appear in this page as pop-ups under the column headings. In the PDF version, they are attached at the end of the document.)   

The individual DATA charts for the Quality Measures, and the Tables for the Financial Measures, can be printed as PDF's directly from the links above, within this site.  

Go to:  ACT 53/HRAP Home Page  I  Index to Individual Hospital Reports

Links to BISHCA Reports by Year Comparing Hospital Data