A national watchdog group recently found that Maine had some of the safest hospitals in the country, based on data mostly collected in 2018. But of the 17 Maine hospitals that were evaluated this fall by the Leapfrog Group, one big facility stood out for its low grade.
Northern Light Eastern Maine Medical Center in Bangor, the state’s second largest hospital, was the only one to receive a C. That was better than the lowest possible scores of D and F, but worse than every other Maine hospital.
More than half of them received A’s, including three that belong to the same hospital group as EMMC: Northern Light Maine Coast Hospital in Ellsworth, Northern Light Inland Hospital in Waterville and Northern Light Mercy Hospital in Portland.
Among the half-dozen Maine hospitals to receive B’s from Leapfrog were St. Joseph Hospital in Bangor and Maine Medical Center in Portland, the largest hospital in the state. (Leapfrog did not evaluate all Maine hospitals.)
EMMC has previously received B’s and one A from Leapfrog in the last four years. Now, as a new president prepares to start working at the Bangor hospital on Monday, interim president Timothy Dentry said that the 411-bed facility has already been implementing initiatives that address the concerns raised by Leapfrog and another prominent rating system.
EMMC is one of five Maine hospitals that currently have two out of five stars — the lowest rating in the state — from the federal Centers for Medicare and Medicaid, which scores hospitals on a range of quality and performance measures.
Dentry, who is the chief operating officer of EMMC’s parent, Northern Light Health, said those ratings don’t reflect improvements the hospital has made in the last year because they are largely based on data from 2018. He said the Bangor hospital tracks its performance and would receive a B on the Leapfrog assessment if it used more recent metrics, but he added that the hospital still needs to do more to improve its safety.
“We also know where we’re heading toward: an A,” Dentry said. “The same goes for the CMS star-rating: the two-star. We are not pleased, and that’s good to not be pleased. We know which elements we need to improve upon and in which areas we have made those improvements.”
The recent Leapfrog evaluation noted several areas where EMMC performed poorly, including the responsiveness of hospital staff and the prevention of surgical complications, bed sores, patient falls and hospital-acquired infections.
The Leapfrog and CMS ratings incorporate such a broad range of measures that they are generally a good indicator of a hospital’s overall quality, according to Dr. Amy Boutwell, a physician who leads Collaborative Healthcare Strategies, a Massachusetts-based organization that works to improve the delivery of health care across the country.
To an extent, the ratings can help people make informed decisions about where to seek care or give them a reason to advocate for improvements at their local hospital, according to Boutwell. But they are calculated in complicated ways that do not necessarily predict the actual experience a patient will receive.
“It’s really meant to be a snapshot,” she said. “If you walk through the doors of this hospital, does this hospital have processes in place to manage high-quality care across this snapshot?”
The scores are more useful to hospital leaders themselves, Boutwell said, because they signal how well they have been meeting established standards.
“They reflect the expectation of hospitals across the country that they should be able to perform well across this particular set of patient quality and safety domains,” she said. “If a hospital is showing up with not great scores or mediocre scores on Leapfrog or CMS star ratings, at the very least they should articulate that they are aware of and actively working on it.”
Dentry said that more work is still needed to improve the quality that patients can expect from EMMC, particularly because it is Northern Light Health’s flagship institution. The system includes nine hospitals stretching from Portland to Presque Isle and is close to merging with a 10th, Mayo Regional Hospital in Dover-Foxcroft. EMMC employs about 4,200 of the system’s nearly 13,000 workers.
Rand O’Leary, a former Oregon healthcare executive, will become the president of EMMC on Monday. He will replace former president Donna Russell-Cook, who stepped down in April, and report to Dentry. Northern Light officials did not make O’Leary available for an interview, but Dentry said he was hired, in part, because of his focus on hospital quality.
During Dentry’s term as interim president, he said the hospital has been creating designated teams of administrators and providers to ensure that different departments are properly caring for patients and preventing problems. He said that approach has contributed to various improvements, including a steep drop in the number of infections that have occurred after surgeries.
“That was an area that had a rise in the prior year,” Dentry said. “Our physician leadership and our nursing leadership, they have taken this on with a vengeance.”
The hospital has also been conducting surveys of staff to increase their focus on safety, and it has been trying to learn lessons from a clinical affiliation that it formed in 2018 with Massachusetts General Hospital in Boston, according to Dentry.
Boutwell said that CMS, the agency that oversees Medicare and Medicaid, readily offers free technical assistance to hospitals that want to improve their star ratings. But Suzanne Spruce, a spokesperson for Northern Light Health, said EMMC is not currently taking advantage of those resources.