Post-surgery deaths above norm at Penticton Regional Hospital

New database of performance indicators shows Penticton on pace with peers in most of the 26 categories

Penticton Regional Hospital is keeping pace with most B.C. acute-care facilities its size, according to a new database of performance indicators compiled by the Canadian Institute for Health Information.

While it outperformed its peers in the area of patient safety, PRH lagged on 30-day readmission rates. And one surgical statistic was of particular concern.

The rate of patients at PRH who died in hospital within five days of having major surgery was 15.73 per 1,000, well above its peer group’s average rate of 10.52.

That particular statistic is “not as good as others,” allowed Allan Sinclair, Interior Health’s vice-president of acute services, “and we want to find out more about that.”

The hospital also trailed on the 30-day pediatric readmission rate, which was 9.51 per 100, versus a peer average of 5.92

In contrast, the 30-day in-hospital mortality rate for heart attack victims was 6.47 per 100, below the peer average of 7.79.

And the 28-day readmission rate for stroke victims at PRH was 5.87 per 100, well under its peers’ average of 7.22.

On the 26 most recent available indicators for the years 2009 to 2011, PRH outperformed its 16 peers, including hospitals in Fort St. John and Campbell River, on half of them and fared worse on the balance.

“Overall, we’re doing well,” Sinclair said.

It should be noted, however, that the numbers provided in the Canadian Hospital Reporting Project are not absolutes, but rather risk-adjusted rates. The risk adjustments take into account such things as a patient’s age and underlying conditions.

That’s an important equalizer for hospitals like PRH that see a lot of seniors, Sinclair said, “but it’s more an art than a science. So the comparisons get better, but they never get perfect.”

He also pointed out that the risk adjustments depend on doctors properly “coding” patients’ charts, to make sure their specifics are correctly categorized and included in the calculations.

The hospital reporting project, which is available online, contains information on 600 facilities across Canada and took two years to assemble, said CIHI’s manager of hospital reports, Jeanie Lacroix.

Her team garnered the statistics from discharge abstract databases that aren’t ordinarily available to the public. CIHI secured access through agreements with provincial health ministries.

“This isn’t a ranking tool; it’s more about comparing hospitals so they can share best practices and improve,” Lacroix said.

“Obviously there are some hospitals that will take this and say, ‘The data are wrong,’ or, ‘The data are bad,’ but for the most part we’re getting constructive comments.”

It’s most important for hospitals to look at the data as a whole and examine year-to-year trends, Lacroix said, and PRH is “moving in the right direction.”

Sinclair said Interior Health will now analyze the figures in the reporting project and use them to improve both performance and reporting methods at PRH and its other sites.

On a purely financial note, PRH spent $4,518.15 per patient in 2009-10, putting it safely under the peer average of $4,950.88.