Which Israeli hospitals provide the best quality care?

The annual National Program for Quality Indicators report, which aims to assess and examine drug quality in the nation’s hospitals, also showed that although the volume of activity of most of the indices it measured in 2020 had decreased, the compliance rate There was no massive decline – and in some cases even improvement.

“Coronavirus changed the face of the health care system in 2020 with a focus on fighting the virus without compromise and without fear,” Prof Chezzi Levy, former Director General of the Ministry of Health, wrote in a letter opening the report. “Although there was a marked reduction in elective and walking activity at the start of the pandemic, this was not the case with the achievements of hospitals, maternal and child centers or ambulance companies, which maintained the targets of the indices and even He used to upgrade.”

He added that the quality “targets are updated every year and service providers are challenged to maintain an annual quality improvement programme. The measure is comparative between different institutions and is a source of positive and constructive competition, for excellence and achievement.” is an incentive.”

The report ranked Meir Medical Center in Kfar Sabah and Carmel Medical Center in Haifa as No. 1 for large hospitals and the Mount Scopus branch of Hadassah as No. 1 for smaller hospitals.

Hospitals are ranked on a scale of one to 10, with 10 being the highest score. Institutes can get fractions of marks. All general hospitals in the country got scores above nine.

The report also ranked geriatric centers, psychiatric facilities, and mother and child programs, known in Israel as Tipat Chalav.

In Israel, the program was maintained despite the crisis and has therefore made it possible to analyze the impact of the coronavirus on dozens of broad and specific quality indicators.

Some of what has been found in the report are as follows:

The rate of compliance with the catheterization index within 90 minutes in an acute cardiac event and the mean time until the patient’s triage in the emergency room remained constant.

Improvements were seen in the rate of compliance with the index for hip fracture repair within 48 hours, as well as prophylactic antibiotics administered early during colon, cesarean and hip fracture surgeries.

Also, the average time until a CT scan is performed on a patient who is suspected of having a stroke has improved by a full minute, from 28 minutes in 2019 to 27 in 2020.

On the other hand, there was a 21% reduction in performing risk assessments for vein thrombosis, something that is done in internal medicine departments, and a 14% reduction in performing diagnostic imaging evaluations of a patient with transient ischemia at high. Stroke risk.

The possible reasons for this are the reduction in the number of hospital referrals and the number of hospitalizations, the report said.

Given how much the elderly population is affected by severe COVID-19, geriatric hospitals were hit hard by the pandemic. In 2020, the volume of activities across all indices decreased significantly by 10% to 25%, while these facilities focused on keeping their residents and patients safe from the virus.

For example, there were significant reductions in assessments of nutrition, diabetic foot and depression. In addition, there was a significant reduction in the amount of rehabilitative interventions in these hospitals, including functional assessment, vitamin D recommendation, and delirium assessment. Here too, this is probably due to the priority of rehabilitating outside the hospital setting as much as possible during the pandemic.

In psychiatric and mental health hospitals, activity was also on the decline. Risk assessments for psychiatric emergency violence fell 7%; Meetings between a doctor and the hospitalized child’s family were reduced by 10% within five days of admission, and follow-up appointments in the community after release were also reduced by 7%.

Apparently, the decrease in the activity of these indices is primarily due to a decrease in requests for psychiatric emergency care and consequently to a decrease in the number of hospitalizations in mental health hospitals during the pandemic, the report noted.

The most intense was setting up a meeting between a doctor and the family of a hospitalized mental health patient, which fell 16% because the index requires a face-to-face meeting, which sometimes involves close family members. It was not possible due to existence or separation.

However, the Tipat movement program saw only a small drop in activity—about 3%. And, the rate of compliance remained stable or better.

Indices showing improvement: Administration of pertussis vaccine – 2% improvement; (% 2), administration of pentavalent vaccines including diphtheria, pertussis, tetanus,

Hepatitis B and Haemophilus influenzae type B improved by 1%; and there is a 1% increase in mothers maintaining exclusive breastfeeding.

The rate of compliance remained stable, ensuring that a mother brought her child for an initial assessment within two weeks of birth.