Short-stay general hospitals receive safety scores

(Nurse.com) More than 2,600 U.S. hospitals have received letter grades — formally known as a Hospital Safety Score — based on patient safety through a first-of-its-kind initiative.

A blue-ribbon panel of the nation’s top patient safety experts provided guidance to The Leapfrog Group, an independent national nonprofit run by employers and other large purchasers of health benefits, to develop the Hospital Safety Score using publicly available data on patient injuries, medical and medication errors and infections.

“The Leapfrog Group’s goal is to give patients the vital information they need and deserve before even entering a hospital,” Leah Binder, president and CEO of The Leapfrog Group, said in a news release. “We hope people will use this score to talk with their doctor, make informed decisions about where to seek care and take the right precautions during a hospital stay.”

The Hospital Safety Score highlights the country’s safest and less safe hospitals in an effort to save lives and bring attention to the nation’s safety issues. According to recent studies, one in four Medicare patients will leave a hospital with a potentially fatal medical issue acquired in the hospital. On average, one medication error a day occurs for each hospitalized patient, and more than 180,000 Americans die every year from hospital accidents, errors and infections.

The Hospital Safety Score website (www.hospitalsafetyscore.org) allows visitors to search hospital scores for free, and provides information on how people can protect themselves and loved ones during a hospital stay. More information on the score can be found on Sharecare (www,sharecare.com/group/hospital-safety-score), an online resource of health questions and answers.

Results

Of the 2,652 general hospitals issued a Hospital Safety Score, 729 earned an “A,” 679 a “B” and 1,243 a “C” or below.

A variety of hospitals earned “As,” including:

• Academic medical centers such as Massachusetts General, NYU Langone Medical Center and University of California, San Francisco.

• Rural hospitals such as Grinnell Regional Medical center and Baptist Health South Florida Homestead.

• Hospitals with myriad national accolades such as Mayo Clinic, Virginia Mason Medical Center and University of Michigan Medical Center.

• Hospitals serving highly vulnerable, impoverished and/or health-challenged populations, such as Bellevue Hospital, Montefiore Hospital and Detroit Receiving Hospital.

• For-profit hospitals, including many in the HCA systems.

• Hundreds of not-for-profit and public hospitals.

• Community hospitals such as OSF St. Joseph Medical Center in Illinois.

The Leapfrog Group noted that hospitals with outstanding reputations for quality were among those earning a “B” or below. The score “exclusively measures safety — meaning errors, accidents and infections,” said Harvard University’s Ashish Jha, MD, MPH, a member of the blue-ribbon expert panel. “Even hospitals with excellent programs for surgical and medical care, state-of-the-art diagnostic equipment and dedicated physicians may still need this score as a reminder that patient safety should be a top priority.”

States had variations in performance. Massachusetts hospitals on average had the highest Hospital Safety Scores, while Washington, D.C., had the lowest average scores.

Methodology

Calculated under the guidance of The Leapfrog Group’s nine-member panel, the Hospital Safety Score uses 26 measures of publicly available hospital safety data to produce a single score representing a hospital’s overall capacity to keep patients safe from infections, injuries and medical and medication errors.

The panel designed the methodology for general short-stay hospitals, which have the most publicly available data at the national level. Critical access hospitals, specialty hospitals such as children’s hospitals and cancer hospitals, government hospitals such as VA and military hospitals and long-term care facilities were not considered.

The 26 measures cover falls and trauma, central line-associated bloodstream infections, severe pressure ulcers and preventable complications from surgery such as foreign objects retained in the body, postoperative hazards and accidental punctures or lacerations.

The score also credits hospitals on measures of the procedures and protocols known to prevent infection errors and accidents, such as strong nursing leadership and engagement, hand hygiene policies, computerized physician order entry systems, adherence to medical and medication protocols that prevent complications, safety-first organizational leadership and culture, and appropriate staffing levels in the ICU.

Not all hospitals make the full list of 26 measures publicly available, in which case the Hospital Safety Score was calculated only for the available measures. The panel required at least 14 measures to calculate a hospital’s score. Those without 14 measures were not scored, including all hospitals in Maryland and those in certain territories, including Guam and Puerto Rico, which the federal government excluded from required public reporting at the national level.

The Leapfrog Group’s membership will work to engage communities, employers, health plans and hospitals in using the Hospital Safety Score to improve safety. The score will be reissued using updated data in November 2012, with an annual score to follow in 2013 and beyond.

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