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U.S. News and World Report released their 2015/2016 ranking for hospitals. From over 50 hospitals in Idaho, four meet their "National High Performing" standard. These are:
1.) Kootenai Medical Center, CdA
2. tie) St. Alphonsus Regional Medical Center, Boise
2. tie) St. Luke's Regional Medical Center, Boise
4.) Pontneuf Medical Center, Pocatello
From a selfish standpoint, I'm happy to hear this and will have confidence that KMC will satisfy my medical needs during my retirement years.
U.S. News and World Report released their 2015/2016 ranking for hospitals. From over 50 hospitals in Idaho, four meet their "National High Performing" standard. These are:
1.) Kootenai Medical Center, CdA
2. tie) St. Alphonsus Regional Medical Center, Boise
2. tie) St. Luke's Regional Medical Center, Boise
4.) Pontneuf Medical Center, Pocatello
From a selfish standpoint, I'm happy to hear this and will have confidence that KMC will satisfy my medical needs during my retirement years.
Volosong,
I certainly have used past U.S. News Hospital rankings in the past for myself. But I was comparing the top 10 programs in the U.S. when looking for the best Ortho programs for a congenital, by-name real wrist problem I have. I combined the U.S. News report with basic science papers, who was publishing the most and what clinicians were considered the thought leaders when making my choices of where to be seen and have surgeries. I was seen by the #1 and #2 in the U.S. for that condition. Probably it was waiting in Iowa to be seen by the #2 surgeon, that a resident, an attending who traveled with me, and someone else, like OP and I discussed the U.S. News rankings in particular. I never used them the same after that noticing what was omitted, and who was being questioned etc.
One has to understand, especially this year, the patient safety data wasn't included the same way. If you want a totally different look at Idaho hospitals, look up the Safety Ratings. But read that methodology before totally panicking. Also, look at the methodology of how data was obtained for three years for U.S.News. Hospitals adding new service lines drop compared to hospitals that don't even offer a third of the services. The data may be slightly more useful in Urban areas, but look at the Idaho list and SLOW down!
I don't know many who even know where Montpelier is let alone travel there for care. Nine physicians are there half to full time. Probably four are older than 65, as Bear Lake can't recruit enough replacements yet. Radiology services are provided by the power group in eastern Idaho, Medical Imaging Associates in Idaho Falls. They send some great sub-specialists to Bear Lake a couple of days each week or every other week.
Idaho hospitals range from 10 acute care beds to 400+ beds. I personally dislike this rating system as so much is left out. For people relocating who are from major metro areas, they could easily say the list means the same thing in Idaho that it does in NYC or Miami or Houston. No, it doesn't. Not even close.
Kootenai goes in and out of being a verified Trauma Center I can't keep it straight two months in a row. Look for information that actually matters: Who has Verified Trauma Services and what does that really mean? I would trust that single ranking more than probably any other, given what a hospital has to have both in equipment, staff, physicians and money spent improving. Other important measures that matter are: 1. Primary Stroke Certification, 2. The American Cardiology "Door to Balloon (D2B) time...does your hospital meet national standards of 90 minutes or less (check that one out for ID!), 3. Comprehensive Cancer Center rating and in Idaho, are there inpatient psychiatric facilities, among other questions are the real measures.
Certainly facilities that score high here like to market it. That's a nice plus, until patients check further. Are the same doctors still practicing at the facility as two years ago? Yes, I know that one hurts a few hospitals. Be wise and educated consumers.
I half cringe and half laugh anytime I see Bingham Memorial listed. It is #1 in Idaho, having a convicted criminal continue on as CEO. He and some of his IT employees were doing some illegal things, like wire tapping doctors and more, but his conviction was on the wire taps. He was convicted and probably didn't miss three days of work. He does some very underhanded things to other regional hospitals. But, that's not a big deal to him, as long as he can generate $. And he does from the multiple organizations and businesses he runs from the hospital. He has four neurosurgeons who have privileges. It doesn't mean any of them do anything beyond a sacral or lumbar procedure at least six times/ yearly. None of them live in Blackfoot. And oh, btw, he can't keep a pediatrician at his hospital and recently most of the Family doctors have left as well.. Bingham and its "sister hospital" across the street, Doctors' Hospital might be ranked high, but sick babies, strokes, traumas, cardiac, cancer and most everything else complex are transferred via ambulance or helicopter to Idaho Falls, when the patients have lost critical time. His E.R. docs left as well.
Lists are one tool to use, when one understands how the data sets were obtained.
Thanks for posting this. I stopped factoring this list in for my personal care that morning in Iowa when the very well published, knowledgeable surgeon who was seeing me went in and out of exam rooms essentially giving every patient he saw a similar diagnosis as he slammed every door shut. His fellow was helpful, but it was his fellow, while he examined me and talking with both the MD who went with me and myself that said, " You don't want to ask him that question this morning," convinced me lists are just that. That surgeon was a jerk. But U.S. reports had his department as #2 in the U.S. that year.
MSR
Last edited by Mtn. States Resident; 07-22-2015 at 07:01 AM..
Other important measures that matter are: 1. Primary Stroke Certification, 2. The American Cardiology "Door to Balloon (D2B) time...does your hospital meet national standards of 90 minutes or less (check that one out for ID!), 3. Comprehensive Cancer Center rating and in Idaho, are there inpatient psychiatric facilities, among other questions are the real measures.
MSR -
Do you have any tips on where you would look to find these ratings for specific hospitals? I haven't done an exhaustive search, but a little time on Google didn't turn anything up.
St. Luke's here in Ketchum is supposed to be very good. I was sorry to see that it was not on the list. I know that hospital's reputation is one of the reasons people like to retire here.
Do you have any tips on where you would look to find these ratings for specific hospitals? I haven't done an exhaustive search, but a little time on Google didn't turn anything up.
Thx,
Dave
Dave,
I've thought about and researched your question some since I first read it. That was during a self imposed break from CDF and certain threads in ID in particular.
Every measurement of healthcare provides some useful information. However, many don't bother to read how data was collected. That is one of the biggest problems. When one reads the methodology, one automatically is a far better informed patient and consumer of health information. USH &WR changed the safety data usage this year. Safety data is available quarterly by itself. But take that factor along with the % of physicians contacted each year. Then ask yourself, what physicians are going to respond? My quick answer for that is those in academia and those who aren't as busy, plus probably housestaff (interns, residents and fellows). Of course there are exceptions.
As for cancer care, I've written before I know the director of Kootenai's cancer care. Anytime you get someone who did a fellowship at one of the major programs (Sloan-Kettering, M.D. Anderson and NIH for example), you've got a thought leader in charge. Clinically, that is good. But other top notch training programs train competent physicians too.
Usually, contacting the local or regional non-profits, like the American Cancer Institute or American Heart Association is one of the best ways to really get information about who "has the touch," as some say. Those organizations are there to educate and help the public. However, they know where patients get procedures done and outcomes.
I have no qualms asking a physician or director of a hospital service line, but few have had my training, work experience, and "personal physician" explaining how systems work as I did. By personal physician, I don't mean bug your primary care daily. I mean in my life, my late, closest friend for ~ 20 yrs. was one of those who did an NIH fellowship as a first with others to follow. Using the right combination of names, one can pull up something we published in the U.S. as the first piblished info about a certain medication and a couple of diseases. So I'm not intimidated to ask anyone, unless a Hand Fellow at Carver Medical School in Iowa tells me I'd better not ask the hand surgeon I saw in Iowa those questions (See my first post). If I am seeing someone who can be so moody I can't ask questions, that person is of zero benefit to me.
The door to Balloon time (D2T) is part of information from the American Heart Association. Stroke information has been added. It's called Stemi. You can search for those results or learn the basic concepts from the link I'm adding here https://en.m.wikipedia.org/wiki/Door-to-balloon Your local American Heart Association again is the place to find additional info, if any physician or hospital director won't give you more info.
I do understand we all need to feel right about who is caring for us or family members and that we'really getting good care. C'd'A is a difficult place in that it's reasonably close to Spokane. My bottom line is find a primary care you really trust and ask. And be flexible. We all need different things. A lot of care is the same, but the volume of patients seen with that diagnosis and staff familiarity with the treatment is what one really wants to know and what symptoms or complications would make Spokane a better choice for whatever conditions.
At one time in my life I lived in the 4th highest capitated state in the U.S. A co-worker one day asked me what hospital system I used. My 100% honest answer was, "It depends on what is wrong." Any hospital should be able to rehydrate someone. But not all have the personnel and physicians trained to use the clot-busting drugs. Some times I think we make things harder than they have to be. In Idaho, care does not have to be received at one hospital vs. more than one. If tests are needed to see a specialist later, get the tests done only at the facility that physician utilizes. All MRIS are not the same based on the subspecialists who interpret them, or techs who help with them.
We have one group of interventional cardiologists in Idaho Falls who offer radial (wrist) cats for heart catherization. The other group is equally as good but some of their interventional cardiologists prefer groin only access. The realit is patients get good care from both groups. One has the average d2b time down to about 55 min. vs. 90 min. But 90 min is the national standard. It's learning more about what you have to be the expert: your health and any family members who have ongoing medical conditions.
I found this link this morning, which is why I'm finally adding it
Some of the terminology goes over my head, but it seems the primary challange for those of us living in Bonner county is the transport time to a hospital that can perform a heart catheterization. Apparently Bonner General can't perform that procedure, so patients need to be transported to Kootenai Medical Center, or I suppose alternatively to Spokane. By changing their protocol and transporting many patients directly to KMC without stopping at Bonner General they were able to reduce the average D2B time significantly. That said, it's still well above the 90 minute target. I'd guess all this goes in spades for people living in Boundary county.
It's an interesting reality check for people who live in rural areas.
Some of the terminology goes over my head, but it seems the primary challange for those of us living in Bonner county is the transport time to a hospital that can perform a heart catheterization. Apparently Bonner General can't perform that procedure, so patients need to be transported to Kootenai Medical Center, or I suppose alternatively to Spokane. By changing their protocol and transporting many patients directly to KMC without stopping at Bonner General they were able to reduce the average D2B time significantly. That said, it's still well above the 90 minute target. I'd guess all this goes in spades for people living in Boundary county.
It's an interesting reality check for people who live in rural areas.
Dave
Anyone know anything or have had an experience or opinions about the Life Flight Network Service? Curious on how their program works? Appears it would be a great service to those folks living in NID.
Some of the terminology goes over my head, but it seems the primary challange for those of us living in Bonner county is the transport time to a hospital that can perform a heart catheterization. Apparently Bonner General can't perform that procedure, so patients need to be transported to Kootenai Medical Center, or I suppose alternatively to Spokane. By changing their protocol and transporting many patients directly to KMC without stopping at Bonner General they were able to reduce the average D2B time significantly. That said, it's still well above the 90 minute target. I'd guess all this goes in spades for people living in Boundary county.
It's an interesting reality check for people who live in rural areas.
Dave
You're welcome Dave. If nothing else, I'd focus on Stemi and Trauma verification. Kootenai was a Trauma III the last I looked. Trauma Verification matters to me as again it speaks not only to the physician's who must have privileges at a hospital, but also how much does the hospital spend to keep staff current and trained in their respective areas? In a Trauma I case, even if it's a car collision on the roads, Trauma II hospitals have a Cardiac RN as part of the group awaiting a severely injured patient, who is not injured in the heart. Why? Because cardiac could have been an undiagnosed cause of something happening, or a secondary result. Trauma patients who have lost a lot of blood can have cardiac damage and failure. There are more those RNS screen, but that's the point. Instead of saying this is a head injury, neurosurgery will go to the O.R. to relieve pressure or remove debris etc., the patient is assessed by the general Trauma surgeon with a crew of about 15 - 20 supporting docs, RNS and other health experts. That information alone tells you a lot about the hospital. In Pocatello's case, they had to make several deals with different Idaho Falls physicians. Once they finally did that, they got their Level II verification and the first rating as primary stroke center.
Cardiac Catherizations labs are expensive to build, staff and keep updated. Only the biggest hospitals in ID have them. Bonner is a general acute care. Cardiac Caths are beyond what they should be doing. Part of good outcomes is having a high enough volume of procedures done that the hospital staff is as competent at their jobs as the interventional cardiologists are at theirs. Numbers are hard to come by, for many hospitals. Last year, EIRMC in Idaho Falls did 1,800 cardiac caths/procedures. That's a high number which is usually found in hospitals in major urban centers like Portland, Seattle, Salt Lake City and Denver etc. But there are reasons those numbers are high: population served, high # of Visitors to Yellowstone National Park, The Tetons and Jackson Hole who have either undiagnosed cardiac problems and have a cardiac event while visiting a high altitude location, or those with known cardiac or cardiopulmonary problems that also don't tolerate high altitude plus other factors.
Kootenai is kind of complex as my understanding is cardiologists from Spokane do daily clinics in Cd'A and Lewiston. How many of those cardiologists have done interventional fellowships compared to other or just do general cardiology, IDK. But if I were living there and wondering, I'd call Kootenai and talk to the service line director for cardiac or vascular services and ask. I'd also ask two or three different cardiologists.
Time really does matter. If a procedure which could save one's life or prevent brain damage could be done well at Kootenai, why waste the time going to Spokane?
I'm going to read what you posted and will post again later if there is something that stands out. Just being aware of Stemi and d2b makes anyone a better consumer of health information. Some in hospitals bristle to think patients can question times and the number of cases annually etc. They'll get over it. Hospitals improve when patients know more of what to ask. I like clean hospital rooms with cheerful or funny nurses too. Given the choice between a room that may not have had a window or mirror cleaned perfectly because the staff had done so many procedures of what I needed done, the past week, I'm not going to complain if there is a streak on the mirror and I'm alive to see it. I think ratings from telephone directories etc. have to be viewed in light of the big picture.
I had an anesthesiologist yell obscenities at the blood bank once. Not something I'd desire to have. But, he yelled what he did to get enough blood into that O.R. so my brain was still getting oxygen from the transfusions, while my surgeon tried to find the bleeder. Everything is relative and I'm so grateful not only for my surgeon and those who had donated blood, I was grateful in that extreme emergency to have had the anesthesiologist who cursed enough and said a few other thinks, that I lived during that two hour emergency surgery.
Anyone know anything or have had an experience or opinions about the Life Flight Network Service? Curious on how their program works? Appears it would be a great service to those folks living in NID.
Thanks!
What questions do you have? Do you have a choice of helicopter services?
Life Flight from a specific hospital or the Life Flight Network in general?
What questions do you have? Do you have a choice of helicopter services?
Life Flight from a specific hospital or the Life Flight Network in general?
MSR
I was told that if you lived in a remote area you can enroll as member of the Life Flight service and if you were in a life threatening medical situation they would respond and transport you to the appropriate medical facility.
This would be wonderful in a heart attack/stroke type situation.
Is this how it could work?
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