Is my hospital good enough?

Patients' opinions will be taken into consideration in new set of hospital tests

21 April 2010

OFFICIAL hospital evaluations are to get tougher following pressure from privately-produced league tables and consumer groups.

For the first time patient satisfaction and how efficiently medical records are kept, among other new criteria, will be monitored. However consumer groups say that while progress is being made, it is still only a starting point.

The Ministry of Health does not produce league tables but has previously published grades for five indicators linked to hospital superbugs (maladies nosocomiales). The latest results are available hospital by hospital on its superbugs site www.icalin.sante.gouv.fr

Only one relates to actual incidence of superbug infections the rest to prevention procedures, like the amount of antiseptic handwash a hospital uses.

From this year these superbug indicators plus five new ones relating to quality of patient care are to be published annually by all hospitals. It is expected this will be on their websites and in their patient brochures (called a livret d’accueil).

It will also be possible to check on a hospital’s grades for the ten indicators on the government’s hospital evaluations website Platines www.platines.sante.gouv.fr (This already has some information but much of it is outdated and it is due for an update this year.)

The new indicators monitor the keeping of the patient’s dossier (records), spotting nutritional problems, pain management, how quickly the account of the hospital stay is produced (compte-rendu d’hospitalisation - required for follow-up care) and correct keeping of anaesthetic records.

The ten indicators will be self-assessed by the hospitals but local health bodies the direction des affaires sanitaires et sociales (drass) can carry out follow-up checks.

An extra indicator on patient satisfaction is being trialled. It is expected that results will be published from next year. Another element, mortality figures, is under discussion and these may also be published from next year.

Health spokesman for consumer group UFC-Que Choisir Christophe Le Guéhennec said that, despite improvements, the official government data for the public did not give enough hard facts about hospitals results.

“I’d rather know how many deaths occurred linked to superbugs than how much soap is used. We would also like information on treatment of specific illnesses. We are only really at the start of proper communication to the public about hospital performance,” he said.

Mr Le Guéhennec said it was good that patients’ satisfaction was to be assessed but this aspect must be supplemented with more medical facts. “Just because a patient liked the way he was treated doesn’t necessarily mean the medical treatment was effective,” he said.

The Haute Autorité de Santé

Separately from these ten indicators, every four years hospitals have to be certified by health watchdog the Haute Autorité de Santé (HAS), which includes looking at elements such as food and treatment of patients.

The latest results are being published in user-friendly digests for the public for the first time.

Recent reports can be found at http:// tinyurl.com/hasreports by clicking for the rapport synthétique. In these, hospitals are graded on ten key factors - such as food, hygiene and respect of patients’ rights.

They are compared to national averages and you can see areas that caused concern.

Brief details on HAS reports are also on the Platines site, such as whether a given hospital was certified with or without “recommendations,” or “with reserves” or “with major reserves” (meaning it was asked to work on significant areas of concern).

Unoffical league tables

Some national newspapers and magazines publish annual palmarès (league tables) - for example Le Nouvel Observateur (http://tinyurl.com/nouvelobspalmares and Le Point (http: //tinyurl.com/lepointpalmares). These mark hospitals by specific illnesses and allow you to see rankings locally or nationally. Le Point also ranks the best hospitals overall by combining their scores.

These studies use varying assessment methods but are usually partly based on anonymous patient patients’ medical records data which can be applied for to use in research. A recent study by L’Express, showing the “safest” hospitals, however was based on the latest round of the five superbug indicators.

Mr Le Guéhennec said while the magazine studies are unofficial they had been a positive influence. “They force hospitals to be more open. If they get bad marks they clarify how they work and review what they do,” he said.

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