The Regional Medical Center's leaders say they’re working to address the failing safety grade the hospital received last month from a national health care watchdog group.
"Where we are, we didn't get there overnight. We didn't. When we get an A, we won't get there overnight," RMC President Charles Williams told people who gathered for Tuesday’s public forum at Orangeburg-Calhoun Technical College’s Roquemore Auditorium.
“I am asking that we pull together, learn from the past, build on the present and grow in the future," he said.
The Leapfrog Group gave RMC an F in its fall 2018 survey of hospital safety across nation. The nonprofit looked at about 2,600 hospitals.
Leapfrog’s survey says the hospital performed below average in 23 out of 28 patient safety measures, above average in four safety measures and average in one safety measure.
RMC was the only hospital out of the 46 surveyed in the state to receive an F. It was also just one of 22 hospitals to receive an F grade in the nation.
Hospital officials say they’ve implemented a number of measures to address the concerns, including developing annual safety surveys, a new patient safety committee, quarterly staffing plans for nursing and quarterly hand hygiene improvement plans.
"Our trajectory is in the right direction," RMC board Chairman the Rev. Dr. Caesar Richburg told those gathered. "If you can imagine the institution as the Titanic in open waters, the reason it hit that iceberg is because it can't turn on a dime. It takes time to turn a culture. It takes time to make that paradigm shift, but it is consistently being done."
The Leapfrog data primarily covered a time period from 2015 until 2017. Data from 2018 was submitted by RMC in June.
Hospital officials noted the lag time between publicly reported data and what happens on the ground.
"It will take some time for the improvements we are making today to be reflected in our score," RMC Interim Director of Quality Medical Staff Services Mickey Whisenhunt said.
Williams said despite the fact that the Leapfrog survey covered from 2015 until 2017, the hospital did see successes during that time period.
The hospital won the Blue Cross Blue Shield Blue Distinction award for its maternity care unit.
The South Carolina Hospital Association presented RMC with three zero-harm awards for no central line-associated bloodstream infections in intensive care, zero knee replacement surgical site infections and zero abdominal hysterectomy surgical site infections.
Also, the hospital's "Get with the Guidelines" program received a gold honors for stroke and congestive heart failure and silver honors for recitation.
The gold recognizes 24 months of performance in quality areas and silver recognizes 12 months of performance in quality areas. In 2018, all three will become gold, Whisenhunt said.
Both Whisenhunt and Williams said the hospital's failing grade does not tell the whole story.
The Leapfrog score is divided into two sections, with half its score related to process and structural measures. The other half covers what actually happens to the patients when they receive care.
"Between an F and an A score, there is only 1.5 point difference in the scoring," Whisenhunt said. "It is a very narrow range."
While certain Leapfrog benchmarks may not have been addressed before he arrived, Williams said the survey will be done as required by Leapfrog under his leadership.
"If there is something out there that we are going to be graded on and the public is going to see it, we shouldn’t say it is not valid," Williams said. "We need to step up to the plate and ask ourselves the question: What is the recommendation and try to live up to that test."
Williams said the Leapfrog survey is one of many.
"The reason why Leapfrog is given so much attention is it is funded by the big employers and the big payers. The insurance companies, the Fortune 500 companies. Their goal was, ‘We want to find a way to save on our health care costs,’" he said.
Williams noted the hospital is fully accredited by the Joint Commission.
"All of our programs are accredited and approved by the highest accrediting agency there is,” he said.
Orangeburg County Councilwoman-elect Deloris Frazier praised the care she has received at RMC and asked how the community can help the hospital.
"Begin to build us up," Williams said. "We need to start saying the good things that are happening at RMC. When you hear someone bashing your health care system, call them out. Think about what happens if the RMC is not successful to this community."
"If there is something that is wrong, report it in a way to the people who can make a change," Williams said. "Don't slap it on Facebook. Don't put it on Twitter. Guess what? Twitter is not going to help you. Twitter is not going to see one patient. Twitter is not going to make one change."
Orangeburg resident Leona Brewer said she went to the RMC's emergency department during her three transient ischemic attacks. The attacks have stroke-like symptoms and require immediate medical attention since they can precede strokes, according to the Mayo Clinic website.
"I waited 45 minutes," Brewer said. She said children with bloody noises and coughs went before her.
She left the hospital with her husband and he drove her to Charleston's Medical University of South Carolina.
"I rather drive 10 miles than 100 miles, but I will take what I can at 100 miles because I have nothing good to say about this hospital because of my experiences," Brewer said. "I think if I would have stayed over that 45 minutes, I would be dead."
Williams said, "We are going to work to improve those processes. I want to talk to you. We want to talk to other people in the community."
Because emergency rooms are increasingly being used as primary care offices, Williams said the hospital is looking to build an urgent care center within the next 15 months to 18 months to help reduce the emergency room load.
Georgia resident Sonya Avery said she also has received care at RMC emergency room.
"They immediately triaged me, they did an EKG, they saw I was not suffering from heart-related issues, then they treated me," Avery said. "I cannot say enough good things about the way the emergency department treated me."
"I live in the Atlanta area and I have access to a lot of large health care organizations and I can say the treatment I received at RMC was on par with any of the excellent organizations in that area," she said.