January 11, 2008

Franklin Hospital – For-Profit Major Quality Problems?

Posted at 5:56 PM by Adam Searing

It’s brewing into one of those epic health care industry battles.  One of the few for-profit hospitals in the state, Franklin Regional Medical Center, wants to move from sleepy Louisburg on the edge of the rural half of Franklin County down towards the Wake County line.  That’s the area where the population growth, fancy houses, and people with health insurance are located. 

After initial state rejection of the move, Franklin has now teamed with UNC Health Care System’s Rex Hospital in an undefined partnership to build in the same location.  This raises questions about how a public hospital can align its interests with the stockholders from the for-profit chain of which Franklin is a part.  However, there is another and potentially more serious issue about the quality of care patients are getting right now at Franklin.

A look at the US Department of Health and Human Services “Hospital Compare” website (www.hospitalcompare.hhs.gov) – a tool for consumers to find out how hospitals are doing on basic measures of treatment – reveals some pretty disturbing data about for-profit Franklin.  On some very basic measures of quality Franklin falls far, far short of the average scores for North Carolina hospitals.

Take surgical care.  While Franklin is around or above average on four measures, on the key measure of stopping preventative antibiotics on time they manage only 34% compliance compared to a state average of 77%.

It’s like this in the other major areas US DHHS measures.  In treating pneumonia Franklin is around average on four measures, but only gives the critical influenza and pneumococcal vaccines at about 1/3rd of the rate of the average NC hospital. (29% to state average 77% for flu and 25% to state average 76% for pneumococcal.)  They also only give pneumonia patients smoking cessation advice and counseling around 1/3rd of the time compared to the average NC hospital (31% to state average 90%).

Finally, in caring for heart patients, Franklin is slightly below average in measures other than the critical one of telling patients how to manage heart attack symptoms after they go home.  There they only manage a 10% rate of success compared to 68% at other hospitals.

When you compare these basic measures of hospital quality to a public hospital like Rex (owned by UNC Health Care), who Franklin is apparently planning to partner with in this move, there simply is not a comparison.  Rex hits around average on everyone one of the measures I’ve cited above.  Sometimes it’s a little above, sometimes it’s a little below, but they are in the ballpark every time.

Before any move of Franklin should even be considered, it seems critical that Franklin at least improve its quality of care to the state average or above.  If it were only one or two measures, perhaps that wouldn’t be so disturbing.  However, from the DHHS data, there apparently are major quality of care issues that must be addressed in multiple areas.  It makes little sense to have a huge debate over moving a hospital with all the lawyers, PR effort, politics, and state reviews when that very hospital has such major quality problems.

If our health system really put people first, we’d be figuring out how to bring Franklin and every low-performing hospital up to state standards in delivering care.  Instead, we continually have hospitals jockeying to build new facilities in the more populous and wealthier areas of the state while our rural areas continue to be left far behind in both access to care and, just as important, quality of care.

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2 Comments

2 Comments Add yours »

Token Conservative 14 Jan 2008 3:25 pm

I used to teach 7th grade English at a public school in Louisburg, NC. My students would always tell me that I should never go to FRMC to do anything but get worse. Most had family members who had very bad experiences there.

The Progressive Pulse – Franklin Hospital – Quality problems should raise red flags 21 Mar 2008 9:16 am

[...] many basic measures of hospital quality, Franklin Regional ranked far below state averages.  I wrote about the issue here at the Progressive Pulse as [...]

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