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Friday, April 29, 2011
By Shaun Sutner TELEGRAM & GAZETTE STAFF
ssutner@telegram.com
WORCESTER — While the nurses’ union at St. Vincent Hospital says unsafe conditions exist at the hospital due to not enough nurses, the state’s public health commissioner recently informed two city lawmakers there is no evidence of quality or safety problems at the hospital.
“At this time, we do not have evidence indicating that a dangerous circumstance exists at St. Vincent Hospital,” John Auerbach, the health commissioner, wrote in an April 25 letter to state Sen. Harriette L. Chandler, D-Worcester, and Rep. Vincent A. Pedone, D-Worcester. “We have no reason to believe that St. Vincent Hospital has disproportionate quality or safety problems.”
The union, in a contract dispute with the hospital, has scheduled a one-day strike May 6. Patient safety and adequate staffing levels have been at the core of the union’s dispute with the for-profit hospital.
The union contends the hospital is understaffed, while hospital executives say the union has used the staffing issue to gain sympathy from the public and to distract attention from wage hikes it is seeking.
In his letter, Mr. Auerbach made no mention of staffing concerns. Instead, he focused on the incidence of major medical problems reported to the state and patient satisfaction as measured by surveys.
“Their serious reportable event incidence is relatively low for a hospital its size,” the commissioner wrote to the two Worcester lawmakers. “Patient satisfaction surveys place it in the average statewide, with 70 percent of patients giving the hospital a 9 or 10 rating on a scale of 1 to 10 and 76 percent stating that they would definitely recommend the hospital.”
But Marlena J. Pellegrino, chairman of the Massachusetts Nurses Association St. Vincent Hospital bargaining unit, said surveys and state public health reports on the most serious incidents involving mismanaged medical care — or serious reportable events — do not accurately reflect the situation inside the hospital.
She said conditions at the hospital are more accurately reflected by the approximately 1,000 reports nurses have filed with the state within the last 16 months alleging unsafe staffing.
“We care for the patients,” said Ms. Pellegrino, a medical-surgical nurse. “The DPH is not going to know my assignment or if I’m not able to give my patient a pain medication for an hour and a half. That’s the reality of working when you’re caring for six or seven patients at once.
“They’re giving you surveys. I’m giving you first-hand experience,” she added.
In 2009, the most recent year for the state’s serious reportable events survey, St. Vincent recorded five serious reportable events during 79,027 patient days, for a rate of 0.63 per 10,000 patient days — well below the statewide average of 0.95 serious reportable events per 10,000 days.
By comparison, UMass Memorial Medical Center – Memorial Campus had the same rate of 0.63 while UMass Memorial’s University campus registered a rate of 0.81.
A national survey of patients’ hospital experiences by the U.S. Dept. of Health and Human Services from July 2009 to June 2010 showed that 73 percent of 300 St. Vincent patients surveyed said nurses always communicated well. The national average was 76 percent, and the Massachusetts average was 78 percent.
In the survey, 59 percent of St. Vincent patients said patients always received help as soon as they wanted, compared to 64 percent statewide and nationally, and 55 percent at UMass Memorial Medical Center.
In a measure of overall satisfaction, 70 percent of St. Vincent patients gave the hospital a 9 or 10, or “high,” rating, compared to 66 percent at UMass Memorial, 68 percent for all reporting hospitals in Massachusetts, and 67 percent for all reporting hospitals in the United States.
St. Vincent executives said the letter from Mr. Auerbach, the state health commissioner, confirmed that the hospital provides high quality health care while accommodating many of the state’s most acutely ill and poor patients. Meanwhile the nurses’ unsafe staffing reports are self-reported and not independently verified, they said.
“The state validated what we have always said, that St. Vincent has an excellent record,” said Joseph J. Mullany, president and chief executive officer of the hospital.
The nurses’ assertions about unsafe conditions are “disturbing,” Mr. Mullany said.
“It’s self-serving rhetoric that I think is reflective of the MNA leadership and not of the employees at St. Vincent Hospital. It’s pure propaganda,” he said .
Mr. Pedone, one of the legislators who wrote to the state health commissioner, said he did so because of questions raised by nurses about safety at the hospital.
He said the letter was “a snapshot in time,” and warned that if the hospital moves forward with a plan to reduce the size of its intensive care unit and move acutely ill patients into regular units, “patient safety might become an issue.”
“These negotiations should continue at the bargaining table,” Mr. Pedone said.
Contact Shaun Sutner by e-mail at ssutner@telegram.com.
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