Stephanie Dickrell

sdickrell@stcloudtimes.com

You can trust St. Cloud Hospital with your heart.

At least that's what data released by Consumer Reports on Thursday show. St. Cloud Hospital is one of only 17 hospitals nationwide to earn top scores in quality data for two common heart surgeries: heart bypass and aortic valve replacement.

St. Cloud Hospital received "better than expected" ratings, the highest given, for overall heart bypass surgery performance and overall aortic valve replacement surgery.

It is also the only hospital in Minnesota to earn that distinction, said Doris Peter , director of the Health Rating Center for Consumer Health Choices, a part of Consumer Reports. Nearly 500 hospital nationwide submitted data on heart surgery performance. That's about 60 percent of all hospitals nationwide.

Despite the less than 100 percent reporting rate, the scores are significant, explained Peter.

"A small percentage of hospitals get the highest ratings," Peter said. "The fact that St. Cloud has it is really great. Most hospitals are in the middle in this method. ... Outliers on either end are rare. (St. Cloud Hospital is) a solid, good performer."

When Consumer Reports first published this database, about 30 percent of hospitals had sent in data. While the Mayo Clinic missed the deadline on this report, it plans to participate in the next round, Peter said.

In Minnesota, 12 hospitals had relevant data they submitted, including North Memorial Medical Center, Hennepin County Medical Center and University of Minnesota Medical Center. All others received average, or "as expected," ratings in most categories. Of the 145 hospitals in Minnesota, 16 report having an adult cardiac surgery service, Peter said.

St. Cloud Hospital performed 311 bypass operations within the data's time frame, July 2015 through June 2016. Surgeons performed 152 valve operations within the time frame, from July 2013 through June 2016.

Consumer Reports produced the Healthy Heart Report in partnership with the Society of Thoracic Surgeons (STS). The society collects data directly from hospitals on several key measures.

Here's how St. Cloud Hospital did and what the measurements mean:

Both bypass surgery and aortic valve replacement:

Patient survival: Percent of patients who leave the hospital and survive at least 30 days after surgery. ​ Bypass rating: As expected. Valve rating: As expected.

Complications: Percent of patients who avoid the most serious complications, such as a second operation, a deep chest infection, stroke, kidney failure and prolonged ventilation. Bypass rating: As expected. Valve rating: Better than expectations.



Bypass:

Best surgical technique: Percent of patients who receive at least one graft from a certain artery under the breastbone, which improves survival. Rating: As expected.

Use of right drugs: Percent of patients who receive beta-blockers before and after surgery to control blood pressure and heart rhythm, aspirin or similar drugs to prevent blood clots and a drug to lower cholesterol. Rating: Better than expected.



CentraCare's Heart and Vascular Center Executive Director Phil Martin said the group gets a report quarterly from STS with much more detail and depth than this one. Dr. John Teskey said the data allows you to see the big picture. He is the most senior cardiovascular surgeon at St. Cloud Hospital and has been practicing nearly 40 years.

"Here, we don't tend to focus on how we can try to look good in results. Our approach is really to try and focus on doing the best for each patient," he said. "We assume by doing that ... we'll be giving the best possible care and in the end, that produces overall good results."

The heart surgeon community was forward thinking when it started collecting these results decades ago, Teskey said. It's paying off now, as they have a depth and breadth of data that is reliable and very useful for improving care.

"It's powerful. Instead of just looking at one experience or a single institution, you can now look at hundreds of thousands of patients across many institutions," he said.

Quality ratings like this can't be attributed to one team or one surgeon, Martin and Teskey agreed said.

"It has to be high quality and heavily committed to all the way through. ... Everybody along the way has to be on board," Martin said, from the first sign of mild chest pain to the post-surgery followup call.

It includes everyone from nurses and surgeons to the people who clean the operating room, prepare the patient's food and sterilize the equipment.

"This reflects the efforts of literally hundreds of people of all kinds," Teskey said. "This is not one or two people. ... Every person in that team is mission critical. ... And don't forget the patient and the families. ... In the end, it's the patient and the family that have the hard part."

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In the past, quality data for health care outcomes was hard to come by. Hospitals and individual doctors were reluctant to share their data. But that is starting to change.

"It's becoming more normalized to become more transparent," Peter said. This isn't happening with individual doctors yet, but she thinks they will as the data becomes more reliable and trusted by doctors.

More hospitals are participating, even lower performing ones.

For Teskey, patients are coming to him more informed in general, thanks a lot to the internet.

"The relationship between the physician surgeon and the patient is one that's collaboration, isn't it?" he said. "This enhances that collaboration. ... It can make it tougher on us. ... But it's good to be challenged."

Teskey says to be a little careful when looking at results like these because they can paint with a broad brush and statistically. It's always better to look at something over a longer period of time. Nor is heart surgery a competitive sport.

"I'd personally hate for it to degenerate into that ... like competing auto dealers," he said. "We're doing this ... so that everybody gets better at it. That's the purpose. That's what the STS data base really represents. ...With a rising tide, all boats float."

Ultimately, Consumer Reports hopes patients can be more empowered consumers when it comes to their health care.

"There this huge imbalance," Peter said, in power between doctors and patients. Patients are slow to question decisions or even to ask how expensive something is. It's uncomfortable, she said.

Peter hopes to make conversations about quality, possible side effects, necessity, risk reduction, alternatives and cost a more normal one, for both consumers and doctors.

Martin hopes that reports like this help patients decide where they'll go for major health care decisions.

"We continue to build a reputation and a reputation is built on facts," he said. "These kinds of reports definitely steer people in this direction, knowing they'll get a good outcome, close to home."

Follow Stephanie Dickrell on Twitter @SctimesSteph, like her on Facebook at www.facebook.com/sctimessteph, call her at 255-8749 or find more stories at www.sctimes.com/sdickrell.

More online

To find out more about St. Cloud Hospital's rating, as well as nearly 500 hospitals around the nation, visit www.consumerreports.org/health/hospitals/ratings.