BCH praised for accuracy in national standards

BARSTOW • Barstow Community Hospital has been placed in the top 14 percent of accredited hospitals for its adherence to national standards for pneumonia, heart failure and surgical care.

The hospital was recognized last week by the Joint Commission, the largest accrediting body for hospitals in the country. The Commission identified hospitals across the country that were over 95 percent accurate in following the national standards for one or more of five clinical services, including heart attack, heart failure, pneumonia, surgical and children’s asthma.

Specifically, BCH is recognized this year for its procedures for giving pneumonia patients antibiotics and providing the pneumonia and flu vaccine to these patients. It also scored highest in its triage procedures for heart patients, like electrocardiograms and infection prevention for surgery patients.

Marilyn Kennedy, chief quality officer for the hospital, says the staff has to record every step in the process with a patient who is being treated for one of the five areas. The Joint Commission uses these records to determine how accurately the hospital is following national standard protocols. For example, she said, if a patient comes to the emergency room with chest pains or shortness of breath, they must be set up with an electrocardiogram within ten minutes to determine the issue.

Although this was the first year for this particular recognition, hospitals have been graded on these standards for about ten years, Kennedy said. The hospital makes sure to go over the standards at orientation with all staff members, and then provides regular training as any standards change.

“Education is probably the key component,” Kennedy said.

According to the hospital’s reporting data, since 2007 it has stayed above a 93 percent accuracy for its heart failure and pneumonia procedures. The hospital measured 70 and 80 percent accuracies for surgical procedures in 2007 and 2008, but consistently improved to above 90 percent starting in 2009.

When the national standards were first being followed, Kennedy said long-time physicians were having trouble adapting to them, since they were used to their preferred medications or protocols. So the staff started looking at how each physician or nurse was following the protocols and giving them individual feedback. Now, the medical staff is starting to personally aim for better scores.

“They see the scores as being an extension of themselves,” said Diane Sheriff, risk manager and quality coordinator for the hospital.

There are also signs all over the hospital reminding staff of the procedures, such as the electrocardiogram time limit. The staff uses colored bands for the patients to expedite the care, so if a physician sees a patient wearing the band for pneumonia symptoms, he or she can quickly go through the protocol for pneumonia.

“It’s really a group effort between the nurses and clerks to make sure the time intervals are met on a daily basis,” said John Stroh, a physician in the emergency room.

The only category in which BCH scored below a 90 percent was for giving surgery patients the proper antibiotics and stopping them within the required time . The hospital scored an 89 percent.

Kennedy said that the hospital is usually graded down in the heart attack category because the hospital isn’t equipped to do angioplasties — a procedure to open a blocked artery — and a patient usually has to be transferred to a different hospital. John Rader, spokesman for the hospital, said the new hospital won’t be equipped for angioplasties at first but it is a consideration for the future.

The hospital also didn’t receive scores for areas where it didn’t apply to them or there weren’t enough cases from BCH. BCH doesn’t have a pediatrics department so it can’t be considered for the child asthma category.

There were 405 hospitals nationwide recognized, including 34 California hospitals. The only hospital to receive recognition for all five areas was the Lawnwood Regional Medical Center and Heart Institute in Florida.

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(760) 256-4126 or smitchell@desertdispatch.com