Minnesota has the nation's best health care system, according to a federal analysis of hospitals, clinics, nursing homes and other medical providers.
The state ranked first in care at medical clinics, fourth in care at hospitals and eighth in nursing homes but 43rd in home health care — the state's lowest rank and a category that has puzzled state officials for years.
The state snapshots are part of an annual report by the federal Agency for Healthcare Research and Quality designed to improve medical care while providing information to consumers.
Overall, Minnesota ranks third for care of patients with acute conditions, seventh for chronic care and 11th for preventive care.
"For more than five years we've had an intense collaboration among providers, health plans, state officials and others to tackle both quality and cost issues," said Jennifer Lundblad, president of Stratis Health, a nonprofit organization that has contracts with government and industry to provide home health care. "That's hard work, ... and this report confirms where we're doing well and where we still need to improve."
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Minnesota hospitals convinced the Legislature to require health providers to report "never event" medical errors so that patterns can be caught and addressed. For example, patient movement during spinal surgery became an obvious problem when data began to come in. So the state asked hospitals to verify patient position by taking images of the spine.
In Rochester, a federally backed "BEACON" grant has funded a Community Collaborative Asthma Project, a collaboration between Olmsted Medical Center, Mayo Clinic, Olmsted Public Health and the Rochester school district "to identify and manage asthma cases using a shared asthma action plan." Winona Health also is collaborating with BEACON partners.
At Olmsted Medical Center in Rochester, medical surgical nursing staff used a program called "Aligning Forces for Quality Transforming Care at the Bedside" to increase their time-at-bedside to 57 percent during the day shift and 37 percent at night by May 2011 (compared to an overall 31 percent nationally) by making simple changes like storing needed supplies in patient rooms. That decreased the need for "hunting and gathering."
Mayo Clinic in Rochester recently unfurled its new Mayo Clinic Health System, standardizing care throughout multiple Minnesota communities. It added Red Wing to its network recently.
Mayo in Rochester is typically ranked by U.S. News & World Report as one of the top hospitals in the country for specialties such as neurology, cancer treatment and emergency care.
Wisconsin, which ranked first last year, fell to second — trading places with Minnesota. Iowa ranked sixth, North Dakota eighth and South Dakota 11th. At the bottom was Texas, coming in behind West Virginia, Arkansas, Oklahoma and New Mexico.
The report grades providers using measures such as the percentage of heart attack patients who receive recommended care at the hospital and the percentage of children who receive recommended vaccinations. Since it was first issued in 2006, the report has placed Minnesota among the top three states.
Many types of care in Minnesota improved last year, and many rank in the top categories of "strong" or "very strong," although the report shows the state is weak in home health care and maternal and child care.
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The report found that care improved for patients with diabetes and with heart and respiratory diseases but fell slightly for cancer patients.
Minnesota's score at 67.31, out of a possible 100, is the highest any state has achieved. Last year it scored 64.46. Some of the data is available online at the Medicare.gov website, with tools that help people compare nursing homes, home health care agencies and dialysis centers.
"Minnesota and the federal government are getting better and more sophisticated at gathering and analyzing this kind of information," Lundblad said. "The more open and effective we can be at sharing this information, the better job we all will do."
