When patients suffering heart attacks arrive in the emergency room at Suburban Hospital in Bethesda, they are first given aspirin because studies show this initial form of treatment decreases the chance of a heart attack being fatal by 23 percent.
When doctors at Prince George's Hospital Center in Cheverly treat patients for pneumonia, they often employ an oxygen mask because studies have found that supplemental oxygen decreases the risk of death.
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And when a patient suffers heart failure at Howard County General Hospital in Columbia, the trauma team performs a test to evaluate the heart's left ventricle because that chamber must work harder when a patient's arteries are clogged.
"We have known now for 20 years that patients who get aspirin do much better in preventing a second heart attack," said physician Eugene Passamani, senior vice president for medical affairs at Suburban, which received an A grade from the Maryland Health Care Commission last week. The commission released its first evaluation of how hospitals treat patients who experience heart attacks, heart failure or pneumonia.
"It comes down to people -- having a good staff, the nurses, the doctors and the system we have put into place," said Robert Rothstein, director of emergency medicine at Suburban.
Stephen J. Salamon, chairman of the commission, said his panel and the Maryland Health Services Cost Review Commission produced the report so that consumers can compare hospitals on the basis of how they deliver critical care to people who have severe heart and lung illnesses.
Heart ailments continue "to be a leading cause of death to Maryland residents, resulting in more than 12,000 deaths in 2003," Salamon said at a recent news conference in Baltimore. "Many of these deaths can be prevented through rapid and appropriate interventions."
The Maryland Hospital Performance Evaluation Guide, which is available online at hospitalguide.mhcc.state.md.us, results from a 1999 Maryland law that required the health care commission to develop a system by which the public could compare how hospitals delivered health care in a variety of areas.
In the past, the commission issued reports comparing nursing homes, ambulatory surgery centers, health maintenance organizations and certain health plans. The latest report looked at how hospitals treated patients with heart problems and pneumonia during the first six months of last year.
At the news conference, Salamon; Enrique Martinez-Vidal, deputy director of performance and benefits for the health care commission; and Calvin Pierson, president of the Maryland Hospital Association, praised the efforts of Maryland's hospitals to comply with industry standards in a variety of ways.
Howard County General Hospital scored in the 100th percentile for performing the recommended test for patients experiencing heart failure. Anne Arundel Medical Center ranked in the 95th percentile for performing the same test.
Two of the quality measures were whether the hospitals gave heart attack patients aspirin upon arrival and whether pneumonia patients received antibiotics in a timely manner. The statewide averages on those two care criteria were 94 percent for aspirin and 66 percent for the antibiotics.
Civista Medical Center in La Plata scored in the 92nd percentile for giving aspirin to heart attack patients, but it was in the 64th percentile when it came to giving antibiotics in a timely fashion to people being treated for pneumonia.
Calvert Memorial Hospital in Prince Frederick was in the 98th percentile for administering aspirin and the 77th percentile for giving antibiotics in pneumonia cases. At St. Mary's Hospital in Leonardtown, those scores were 97th percentile and 66th percentile, respectively.
Suburban Hospital had high scores in many areas. Medical officials at the hospital said one reason is because the hospital has been involved in a project for the past three years with the National Institutes of Health that has focused specifically on cardiac care. Suburban had 39,000 visits to its emergency room last year, and Passamani said the report bears that out. "We take pride in providing good service."
Suburban Hospital scored in the 97th percentile in dealing with heart attack victims, which is above the state average, but the hospital scored in the 53rd percentile in giving discharge instructions to heart failure patients.
"We really do support the notion of report cards," Passamani said. "This really focuses us on making sure that we are doing what we ought to do. We have been working for a very long time to ensure that people get the medicine that we know they need to help them."
