Conventional wisdom would suggest that the bigger the city, the better the quality of health care.
But a new study by Consumer Reports magazine found that being a bigger city hospital didn't necessarily mean being the safest for patients.
Kadlec Regional Medical Center in Richland topped hospitals in Seattle and Tacoma to earn the distinction of being the safest hospital in Washington -- and ranked within the top 10 safest hospitals in the country, according to a Consumer Reports survey.
"It's definitely an honor," Kirk Harper, Kadlec's vice president of nursing, told the Herald. "It's something we're definitely appreciative of. It's a demonstration of our organization's culture and how we really focus on the process, and not the person, so we can improve the process for every patient."
The survey included 1,159 hospitals in 44 states, or about 18 percent of hospitals in the United States. Kennewick General Hospital and Lourdes Medical Center in Pasco weren't on the list.
Dr. John Santa, director of the Consumer Reports Health Rating Center, said in a statement that the survey included a relatively small percentage of American hospitals because patient safety measures aren't reported fully or consistently nationwide.
"The fact that consumers can't get a full picture of most hospitals in the U.S. underscores the need for more public reporting," Santa said.
The report, which is published in the magazine's August issue, scored hospitals on a 100-point scale measuring hospitals in categories such as the number of deadly infections, re-admissions, communication about new medications and discharge plans, overuse of radiation scanning and patient mortality.
The scores came from a variety of government and independent sources, a news release stated.
Of the hospitals surveyed, Billings Clinic in Billings, Mont., ranked No. 1 with a score of 72 out of 100.
Kadlec was ranked No. 5 with a score of 71. Nos. 2 through 4 -- Saint Clare's Hospital, Weston, Wis.; Alton Memorial Hospital, Alton, Ill.; and Central Vermont Medical Center, Berlin, Vt.; also had scores of 71.
Rounding out the top 10 were St. John's Hospital in Springfield, Mo.; Mayo Clinic Hospital in Phoenix; Northern Michigan Regional Hospital in Petoskey, Mich.; Bon Secours St. Francis Health System in Greenville, S.C.; and Memorial Hospital of Union County in Marysville, Ohio.
The lowest-scoring hospital in the nation was Sacred Heart Hospital in Chicago, with a safety score of 16 out of 100.
Other hospitals in the bottom 10, with scores between 20 and 25, were Harlem Hospital Center in New York; Lake Regional Health System in Osage Beach, Mo.; Kings County Hospital Center in Brooklyn, N.Y.; Our Lady of the Resurrection Medical Center in Chicago; Kimball Medical Center in Lakewood, N.J.; St. Rose Dominican Hospitals-San Martin Campus, Las Vegas; Clinical Valley Medical Center in Richlands, Va.; Westchester Medical Center in Valhalla, N.Y.; and Hanford Community Medical Center in Hanford, Calif.
The majority of hospitals in the nation -- 51 percent -- scored below 50.
"It says bigger is not necessarily better," said Becky Fuller, Kadlec's patient safety officer. "Because we're a bit smaller, we're able to adapt a little more quickly to things like best practices. We are able to more readily test, try, improve and retest, and try something on a smaller scale."
Fuller said Kadlec has focused for several years on improving patient safety through the use of teams, each working on a particular issue to collect evidence about what works and then implement a model.
Teams have worked on health care issues such as lowering the rate of septic shock, reducing incidences of pneumonia in people on ventilators and prevention of hospital-acquired infections.
The Consumer Reports article notes that even the top-scoring hospitals failed to get high marks when it comes to re-admissions -- the chance that a patient who has had a heart attack, heart failure or pneumonia will end up back in the hospital within 30 days of being discharged -- and communications -- how clearly staff explain new medications and discharge planning to patients.
"I don't think there are a lot of surprises in that," Fuller said.
Communication is a challenging piece of the health care puzzle for most hospitals, and how well patients understand or follow through with those communications isn't always within the hospital's control, she said.
"It takes buy-in from the patients and the community and the physicians in the community," she said.
But Kadlec is exploring ways to improve its communication efforts, Fuller added.
Susan Senner of Richland is a member of Kadlec's volunteer patient advisory council and said the hospital has made great strides in educating patients over the last several years.
Senner, who has a heart condition that has resulted in stays at Kadlec, said she thinks the hospital does a good job at the most important thing -- listening to patients.
"I feel like through forums like the patient advisory council, Kadlec is doing just that," she said.