Meningococcal Vaccine: Protection, Risk, Schedule
Former Physician Asks Commissioners To Hold Novant Accountable To 'five-star' Rating
A retired physician and health administrator is introducing a resolution to county commissioners in the hopes it will incentivize Novant to improve its two-star federal hospital rating. This comes as a new national report from a separate healthcare organization downgraded the county hospital's safety score. (Courtesy Port City Daily) NEW HANOVER COUNTY — A retired physician and health administrator is introducing a resolution to county commissioners in the hopes it will incentivize Novant to improve its two-star federal hospital rating. This comes as a new national report from a separate healthcare organization downgraded the county hospital's safety score.
READ MORE: Novant NHRMC gets 'B' safety grade per new report
Novant Health is one of the largest nonprofit hospital networks in the southeastern United States. It acquired the county-owned New Hanover Regional Medical Center in 2021 through an Asset Purchase Agreement executed by then county commissioners Julia Olson-Boseman, Woody White, Pat Kusek, and Jonathan Barfield Jr; Rob Zapple was the only commissioner to dissent. The contract includes a provision requiring Novant to use reasonable best efforts to position its healthcare in the top 10% of national quality metrics.
But three years after the acquisition, the Center for Medicare and Medicaid Services ranks Novant's New Hanover Regional Medical Center in the bottom 30% of hospitals nationwide for quality. CMS ranks Novant NHRMC two-out-of-five stars for its overall rating; CMS reviews are considered an authoritative source for ranking 2,847 hospitals nationwide on metrics including safety, mortality, and timeliness of care.
NHRMC had three stars in 2019, the last year it was ranked before its sale to Novant. It has maintained a two-star ranking since 2021.
Jon Martell — a retired physician and healthcare administrator with four decades of experience in the health sector — started the Cape Fear Five Star Project with the mission of pushing Novant to fulfill its contractual commitment.
Martell desires to see Novant achieve a five-star rating. He will present a resolution at Monday's county commissioner meeting requesting the adoption of a resolution to address quality improvement:
"The citizens of New Hanover County deserve transparency and accountability regarding the execution of Section 5.16(e) [of the Asset Purchase Agreement]," the resolution states.
It would request Novant to present a comprehensive public report within three months of adoption, including:
Port City Daily reached out to New Hanover County commissioners for their views on Martell's proposed resolution but did not receive a response from anyone by press.
A Novant spokesperson said the hospital network had no comment on Martell's proposed resolution at this time. They shared Novant's 2024 playbook to demonstrate Novant's plans to improve its care.
The playbook notes five key metrics Novant focused on in 2024, including: colorectal cancer screening, blood pressure control, A1C testing, chlamydia screening, and Medicare wellness visits. It also highlights Novant's use of patient safety coaches to train and mentor staff to prevent harmful events. The healthcare network conducts safety culture surveys for staff at regular intervals to identify means of improvement.
Martell emphasized he did not want to antagonize Novant and sought to speak with its representatives to collaborate on solutions. However, the former physician argued the healthcare network has not effectively implemented its playbook to achieve improvements in measurable benchmarks.
"A two star rating for a hospital is not like a Yelp rating," Martell said during public comment at September's city council meeting. "It's not like you go and get poor service but it's no big deal and you'll never go back. The measure of a two-star hospital is in suffering and death."
He provided several examples of differences between Novant NHRMC and five-star hospitals, such as Duke and UNC Chapel Hill, according to CMS data:
"My family now has a plan in place that if anyone gets seriously ill here, we will have a go-bag and we will get them to Duke or UNC, if it is at all feasible," Martell said at the meeting.
Mayor Bill Saffo asked Martell at the meeting if he'd shared his findings with county commissioners; Martell responded he'd been in contact with some of them and believed they should lead the effort since they sold the hospital. He noted he was crafting the proposed commissioner resolution at the time.
PCD reached out to Saffo to ask if he would support a similar resolution for city council; a response was not received by press.
However, at the meeting Saffo told Martell: "I agree with you wholeheartedly that medical care in this community has got to improve. Based on the comments that we have heard from people over and over again that have had experiences at New Hanover."
Council member Kevin Spears concurred and recommended Martell provide a public information session to commissioners.
"I think we all can tell the difference in what's taking place now versus what was taking place before," Spears said. "And it feels really bad."
City council member Charlie Rivenbark added that Martell should similarly provide his testimony to Novant's board of trustees.
Martell told Port City Daily he'd spoken with all of the commissioners but only Zapple and LeAnn Pierce expressed interest in supporting his efforts.
Martell most recently served as chief medical officer at Hilo Benioff Medical Center in Hawaii — which had a five star CMS rating at the time of Martell's 2022 retirement before declining to two stars in 2024 — and medical director of physician network TeamHealth's inpatient care program. He started the Cape Fear Five Star Project in May after a near-death experience at Novant NHRMC, first detailed in an hour-long interview that aired on WHQR.
Martell received treatment at Novant NHRMC for a gallbladder surgery in March. He said the surgery went as expected, but the hospital repeatedly failed to respond after he went into postoperative shock.
"When it was clear that I had a major incident, somebody from the quality team should have been at my bedside the next day," he said. "The [quality care team] did not know about my episode until I told them about it the day of my discharge. They are not being proactive about identifying critical episodes of care."
Martell said a new resident reaches out to him with anecdotes of poor care at the hospital every two weeks.
In a June email to local elected officials, Landon Fauber, a resident Martell said he often speaks with, described the care her boyfriend received in the months before his October 2022 death as "inexcusable." Ian Moseley was a local entrepreneur who, for more than two decades, owned well-known citywide establishments, including Level 5, City Stage, Husk, YoSake, Fibber McGee's, Dram and Morsel, Market Street Saloon, Slice of Life, and The Ivey.
"If Novant doesn't take accountability for their poor level of care, it is up to our community to advocate for significant improvements in patient outcomes and overall healthcare quality," Fauber wrote in the email. "Please consider this issue as a critical priority for the future of Wilmington."
Councilman Rivenbark forwarded Fauber's email to his brother, Bill, a county commissioner.
"I hear stories like this more often of late!" he wrote in the email.
Five months later Leapfrog group — a national healthcare watchdog organization — updated its hospital safety ratings. Leapfrog releases hospital ratings every six months. On Friday, its report indicated Novant NHRMC was downgraded from its "B" rating in May to "C."
"There's been slippage in the tangible quality events that are reported," Martell said.
NHRMC's 2024 Leapfrog rating includes below-average scores for death from serious treatable complications, responsiveness of staff, surgical split wounds left open, dangerous objects left in a patient's body, and surgical site infection after colon surgery.
Martell added there were some positive outcomes in the new LeapFrog report, such as Novant NHRMC's above-average score for staff's efforts to prevent errors. The local hospital also scored above average for safe administration of drugs, tube insertions causing collapsed lungs, preventing falls causing broken hips, and preventing accidental cuts and tears during surgery.
"But just because you have the process doesn't mean you get the results," he said. "It's how you implement that process and carry through that process. It's the safety culture that they just haven't gotten."
Novant Brunswick Medical Center also dropped from A — a rank it's held since 2021 — to a B in Leapfrog's report.
Ernie Bovio, president of Novant Health Coastal Region and NHRMC, expressed disappointment in the Leapfrog report.
"I am confident — based on real-time tracking — that our performance for the past year would not receive this grade," he wrote in a statement to Port City Daily. "One drawback in external ratings is they rely on old data, basing the rating on performance from years ago, dating as far back as 2020."
Bovio referred to a different score provided by health care firm Vizient — four out of five stars — as a more accurate depiction of Novant's performance. Novant uses the Vizient Quality & Accountability Score to track outcomes and quality in its facilities.
Martell countered that Leapfrog's updated Novant rating came from newly integrated data. He advocated for Novant to show its Vizient data and explain discrepancies with Leapfrog and Medicare ratings.
Aside from providing healthcare data services, Vizient is the country's largest "group purchasing organization," or GPO, which provides bulk purchasing of medical supplies for hospitals.
Novant CEO Carl Armato is on Vizient's board of directors and the companies are in a group purchasing organization together.
[Correction: This article has been updated to clarify Hilo Medical Center had a five star CMS rating at the time of Martell's retirement. A previous version of this article incorrectly stated Hilo Medical Center currently has a five star rating. PCD regrets this error.]
Tips or comments? Email info@portcitydaily.Com
Want to read more from PCD? Subscribe now and then sign up for our morning newsletter, Wilmington Wire, and get the headlines delivered to your inbox every morning.
History With 'Hud': James Walker Memorial Hospital's Role Before NHRMC Arrived
NEW HANOVER COUNTY, NC (WWAY) — Patients in New Hanover County rely heavily on New Hanover Regional Medical Center for health care. But before that was an option, there was James Walker Memorial Hospital.
The structure was named after a Scottish builder, contractor and brick mason who traveled to the United States at age 12. He came to Wilmington in 1857 to supervise the construction of the United States Marine Hospital for his brother, John Walker, who was the contractor.
James Walker never married and amassed a large amount of money over his successful career. As a result, he donated nearly $30,000 of his own money to build a new hospital around the turn of the century, with the first bricks being laid on May 22, 1900. He supervised the construction, but unfortunately died on March 15, 1901, just 10 weeks before it was finished.
Upon completion, the James Walker Memorial Hospital was the largest hospital in southeastern North Carolina, containing 50 beds and separate wards for men and women. Following the events of the Wilmington Massacre a few years earlier, the hospital was heavily segregated, opening a separate ward for African Americans in 1904, but not allowing African American physicians.
The hospital's school of nursing was one of the largest nursing schools in North Carolina. It offered women to be trained in the most recent medical advancements, tools and hands-on techniques.
A contagious ward was added in 1915 with a maternity and children's ward also being built, with a horse-drawn ambulance helping bring in patients quickly from far and wide.
The hospital was vital for decades and continued to serve the area until New Hanover Regional Medical Center opened its doors in 1967.
The very first patients to the new hospital were several premature babies brought in by ambulance from James Walker. Their arrival marked an achievement in the civil rights movement in the area, as the babies were accepted to the hospital regardless of the race, sex, or even ability to pay for medical attention.
With a declining need for James Walker Memorial hospital, the majority of the buildings were torn down in the late 1960s. All that remained following demolition was a 1921, 4-story brick structure, which still houses people today.
The grounds were listed on the National Register of Historic Places in 1989. A park now stands on the grounds which were once used to treat those in need around the community.
Meteorologist Matthew Huddleston ('Hud') has always had two major loves – weather and history. While you can watch him talk about weather each morning on WWAY, he looks forward to bringing you a little piece of history each Thursday on WWAY's website.To read other History with 'Hud' segments, click HERE.
New Report Shows Two Local Hospitals Dropping A Grade
(Photo: Novant Health NHRMC) CAPE FEAR, NC (WWAY) — Novant Health New Hanover Regional Medical Center and Novant Health Brunswick Medical Center receive a lower grade in a new report from the Leapfrog Group.
The Leapfrog Group is a national watchdog organization that collects data on hospitals in several categories, including safety problems, infections, problems with surgery, and practices to prevent errors.
Novant Health New Hanover Regional Medical Center received a C rating this fall, the worst grade it has received since Novant took over the facility in 2021. It received a B in the spring report.
Novant Health Brunswick Medical Center received a B rating, a decrease from the A it's had since 2021.
Columbus Regional Healthcare System remained at a C rating, the rating it had for the past four years.
Comments
Post a Comment