Pen Bay Healthcare officials said they are still trying to understand why, despite the local hospital’s top notch performance ratings for its medical care, patients rate their experiences there lower than people do at most other Maine hospitals.

The administration said it is launching a cultural change on how patients and their families are treated in order to address those lower patient satisfaction survey results.

The practical effect of the lower-than-average patient satisfaction scores means that Penobscot Bay Medical Center in Rockport has lost its tier one ranking from the Maine Health Management Coalition. The loss of that designation means state employees will have to pay a higher deductible when receiving services at PBMC.

“We keep trying to get our arms around why we get these scores,” said Pen Bay Healthcare Chief Operating Officer Eric Waters.

Waters said one factor is that this is a sophisticated community with high standards.

Chris Burke, director of marketing and communications at Pen Bay Healthcare, said survey results are higher during the summer when seasonal residents are patients.

“For instance, people from out of state will comment how pleased they were that they only had to wait 30 minutes to be seen in the emergency department but local residents will say ‘we had to wait 30 minutes to be seen,'” Burke said, noting that in many other states people often wait for hours.

Burke said he believes the lower scores are also due to a residual effect from patient experiences many years ago.

The surveys results are published by the Centers for Medicare and Medicaid. The federal agency issues the reports annually to allow consumers to compare hospitals.

The agency contracts with outside companies that receive discharge information from hospitals and then the companies send standardized questionnaires to patients. The outside companies collect and compile the survey results.

Survey results

When asked whether they would definitely recommend the hospital to their friends and family, 62 percent of PBMC patients surveyed said they would. This is less than the 75 percent state average and the 68 percent national average.

More than 300 patients from PBMC were surveyed between April 2008 and March 2009.

For Miles Memorial Hospital in Damariscotta, 80 percent said they would definitely recommend the hospital while for Waldo County General Hospital in Belfast the percentage was 79 percent.

The lowest percentage among the 36 hospitals in the state was received by Downeast Community Hospital in Machias where only 58 percent said they would definitely recommend the hospital to friends or family. The highest percentage was earned by York Hospital in York with 89 percent.

Six percent of PBMC patients said they would not recommend the hospital. This is the same as the national average but greater than the 4 percent state average. At Miles Memorial Hospital, 2 percent said they would not recommend the facility and at Waldo County General Hospital, 3 percent said they would not recommend it.

Another question posed to patients was about how high they would rate the hospital on a scale of 0 (lowest) to 10 (highest). On this question, 59 percent of patients from PBMC gave the hospital a 9 or 10 rating.

The state average was 70 percent. The national average was 65 percent. Miles Memorial Hospital received a 9 or 10 rating from 77 percent of patients surveyed and Waldo County General Hospital received a 9 or 10 rating from 75 percent of patients.

Aroostook Medical Center in Presque Isle had the lowest percentage of patients who rated the hospital at a 9 or 10, at 57 percent. York Hospital had the highest percentage at 83 percent.

The survey was of patients who spent at least one night in the hospital.

Despite the lower than average patient satisfaction survey results, Medicare’s hospital quality report showed that PBMC was at or above the state and national average in the care it provided patients. Both the mortality rate and the readmission rate were the same as the national rates.

Waters said the disparity between the high ratings for care and the lower ratings for patient experiences is what makes it difficult to get a handle on the reason for the lower scores.

He said he has started making daily rounds at the hospital to talk to patients and hear from them directly.

The hospital has also started what officials said is a cultural change through a program called Safe Patient and Family Centered Care. As part of that program, a patient and family advisory council is being created. This will consist of former patients and community members who will advise the hospital on how to provide the best possible patient experience.

The hospital has designated a new patient care coordinator to better focus on overall care, satisfaction and discharge planning.

Pen Bay Healthcare is also producing a brochure to explain the role of hospitalists at PBMC. PBMC has seven to eight physicians based at the hospital who coordinate care with patients’ primary physicians. Waters said patients could be disappointed and give lower ratings because they see their primary care doctors at the hospital less due to the use of hospitalists.