February 28, 2018

Becky Carter: How Care Quality is Defined and Measured, and What We Strive for as We Look to the Future

By Becky Carter
President and CNO, Blue Ridge Regional Hospital

The Centers for Medicaid and Medicare Services (CMS) publish an annual star-rating list that assesses hospital performance in various areas such as access to care, patient experience and clinical outcomes of care. The star ratings of all hospitals are available to the public to help the lay person choose where to go for care. We at Blue Ridge Regional Hospital (BRRH) are thrilled to announce that we earned a 5-star rating for 2017, the highest rating possible.  We, along with Mission Hospital and Mission Hospital McDowell, are one of only ten hospitals in North Carolina to earn this ranking.

Of course we’re proud and humbled to have received this rating, but more importantly, it speaks volumes about the commitment and professionalism of our staff: providers, nurses, pharmacists, laboratorians, radiology technicians, respiratory therapists and a host of others. These team members care deeply about the quality of care they provide and strive to improve continuously. Not only do our team members possess the highest level of clinical expertise, day-in-and-day-out dedication and an unwavering emphasis on safety, they never lose sight of the fact that our focus – always – is on the patient and family.

I also want to talk about a few other things that this rating indicates about BRRH, which might not be so obvious. A 5-star rating symbolizes that we focus on providing the safest environment for care. Some of the tools we use to provide this care include advanced patient monitoring systems, like a data analytic system that identifies potentially harmful trends in a patient’s condition before that patient actually experiences any decline and notifies nurses that an intervention or higher level of care may be needed. Our 5-Star rating also indicates that we offer our patients, such as an individual who enters our emergency department with chest pain or stroke symptoms receives the same standard of care as any excellent state-of-the-art ED.  Simply put, our ability to meet these high standards means faster, safer care that results in better patient outcomes.

Other factors that contribute to our high rating are low numbers of readmitted patients, positive patient experience results from patients themselves and low mortality or death rates. These factors include, for example, how quickly we can give patients the right care. If a patient walks in with chest pains, he or she receives an EKG promptly and that tracing can be seen by physicians and cardiologists anywhere in the Mission system. If a patient enters with stroke symptoms, we can provide a state-of-the-art, fast, low-radiation-dose CT scan within minutes which can be viewed by 24 hour stroke specialists at Mission Hospital in Asheville. At BRRH, it’s all about meeting and exceeding treatment standards that include thoroughness, precision and speed. When we meet these, lives are saved and families are reunited.

The CMS is constantly refining the measures they use to determine hospital care quality and safety. This ensures that the star-rating system stays reliable and that we do too. For example, several years ago, the CMS made stroke and heart attack measures “all or none.” If a facility doesn’t meet every single standard set forth, they don’t get any credit for performance in that type of care. The stakes are high, and they must be.

To ensure that BRRH remains a 5-star-caliber hospital, we look at the care we provide not as a broad task, but a mission that is delivered mindfully, daily. Our success means that those who come to BRRH for care can be sure that they are in the best hands possible, no matter what kind of care they need.


Rebecca W. Carter, MSN, RN, FACHE is President and Chief Nursing Officer of Blue Ridge Regional Hospital in Spruce Pine. Carter has served in senior hospital management for over 20 years and previously served as Chief Operating Officer and Chief Nursing Officer of Transylvania Regional Hospital in Brevard, also a part of the Mission Health system.

Ms. Carter is board certified in healthcare management and is a Fellow of the American College of Healthcare Executives (FACHE).  A native of North Carolina, she holds undergraduate and graduate degrees in nursing from the University of North Carolina at Chapel Hill. Ms. Carter is currently a resident of Burnsville.

For more information on Blue Ridge Regional Hospital, visit brrhospital.org.

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