Message From Our CEO: Independent Review as a Florida Special District Asserts Parrish Medical Center Delivers the Same, or Better, Quality Care Than its Peers

August 12, 2024

QUALITY CARE

Independent Review as a Florida Special District Asserts Parrish Medical Center Delivers the Same, or Better, Quality Care Than its Peers

I am proud to continue to share with the public, in full transparency, the operational performance results achieved by North Brevard County Hospital District d/b/a Parrish Medical Center (PMC), as reported within an Independent Review conducted by nationally top-ranked CPA and hospital/health system operating performance audit firm, PYA, P.C. (PYA). The independent review covered five functional areas: access-to-care, quality, community benefit, cost, and financial performance. My previous letter to the community focused on our financial performance. Today, I will cover the functional area of quality.

Independent Review Engagement
I’ll first quickly review why we engaged PYA. In response to the 2021 Florida Legislature’s Uniform Special District Accountability Act (s. 189.0695, F.S.) (the Act), Parrish Medical Center (PMC/District) issued a request for proposals (RFP) and engaged PYA. All Florida Independent Special Districts (FISD), including public special district hospitals, like PMC, are required to comply with the Act and have conducted independent, objective third-party reviews of their operating performance.

Quality Results
To evaluate PMC’s relative quality, PYA used elements of the Institute of Medicine’s (IOM)1 domains for quality specifically using the following three (3) dimensions – safe, patient-centered, and timely. Also used were generally-accepted and comparable data elements from several sources such as: 30-day “all cause” hospital wide readmission rate; deaths among patients with serious treatable complications after surgery; Leapfrog Group safety rating; CMS/Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) star rating; and average time patients spent in the Emergency Department (ED) before leaving from the visit.

After assessing PMC relative to the quality criteria presented, PYA wrote in its report, “believe the organization is committed to providing quality care as stated in its mission, vision, and values statements as well as submitted performance data, and is delivering comparable or better quality than its peers.”

Since 2019, PMC has consistently received 2 or 3-stars from CMS2. Per CMS, a 3-Star rating means the organization provides good quality of care. A rating of 2 stars means that the organization’s performance was below the average of other organizations measured but does not necessarily mean care is poor. According to a recent article published in Becker’s Hospital Review, 60% of U.S. hospitals earned 3 stars or less.

Additionally, Becker’s reporters Erica Carbajal and Mariah Taylor, wrote on July 31, 2024, “this year, 29 more hospitals received one star than last year and of the 276 hospitals receiving a one star this year, 34 of those were from the State of Florida.

You may have seen our recent announcements and progress reports about our Emergency Department (ED) Care Partners, in collaboration with our TeamHealth physician partners, creating solutions for ED wait times. In 2023, the average time PMC patients spent in the ED before leaving the visit was 152 minutes (sometimes referred to as door-to-discharge time). This is slightly higher than, though similar to, PMC’s peers, according to the PYA report. The ED team has established a goal to reduce that time while also improving overall patient satisfaction. Earlier this month, they tested a new workflow that showed much promise. Patient surveys also are showing a steady positive trend. The enthusiasm and engagement of everyone involved shows how much they care about providing the highest quality of care possible.

We are sharply focused on the future; always testing our systems of care against the highest evidence-based standards for care quality; and inviting rigorous reviews from independent third-party agencies such as PYA, The Joint Commission, American College of Surgeons Commission on Cancer, College of American Pathologists, The LeapFrog Group, the World Health Organization, and more.

Our continuous performance improvement journey to excellence continues. I am extremely proud of our family of Parrish Healthcare Care Partners for their focus and determination to providing the highest levels of quality and patient experiences possible to every person in our care. While we acknowledge there is work yet to be done, we also acknowledge there is much for all of us to be proud—Parrish Proud.

In the coming weeks, I look forward to sharing with you the results of our performance review as it relates to Access-to-Care.

Sincerely,

George

George Mikitarian, Jr.
President/CEO