Hospitals are doing a better job at avoiding preventable medical errors, injuries, accidents, and infections, according to a new report card from the Leapfrog Group.
Since 2012, average safety scores have improved by 6.3%. And nearly one-third of the more than 2,500 hospitals evaluated by the Leapfrog Group had a 10% or greater improvement in their overall safety performance since 2012.
Missy Danforth
"Hospitals are making incremental improvements indicating they are becoming safer," Leah Binder, president and CEO of the Leapfrog Group, said during a press conference.
Ms. Binder called the new data the "most important evidence to date of across-the-board improvement in patient safety."
The Leapfrog Group, a not-for-profit organization that conducts regular surveys of hospital quality, released its national report card on hospital safety on April 29.
The group calculated the grades according to performance on 28 process and outcomes measures of patient safety from the use of computerized physician order entry systems to death among surgical inpatients.
The composite safety scores are based on publicly available data from the Centers for Medicare & Medicaid Services, the Leapfrog Hospital Survey, and the American Hospital Association’s annual survey.
Hospitals were given a safety score based on those measures and the score was converted in a letter grade (A through F). Hospitals that scored 0.6 standard deviations or more above the mean earned an "A." To earn an "F," hospitals had to score more than 3.0 standard deviations below the mean.
Of the 2,523 hospitals issued a hospital safety score nationwide, 32% earned an "A," 26% earned a "B," 35% earned a "C," 6% earned a "D," and 1% earned an "F."
Maine has the highest percentage of top-rated hospitals, with 74% of its hospitals earning an "A" grade. Massachusetts was ranked second nationally, with 70% of its 64 graded hospitals earning the top grade. South Dakota, Illinois, and Hawaii rounded out the top five.
The poorest performers were in Connecticut, Idaho, Nebraska, Wyoming, and the District of Columbia. No hospital in those states or DC earned an "A" grade.
Leah Binder
The current report reflects 2012 performance, with some data from early 2013. The report ranks general acute care hospitals that had enough publicly available data to allow for scoring.
The greatest improvements were seen among the 15 process measures evaluated, said Missy Danforth, Leapfrog Group’s senior director of hospital ratings. In particular, there were across-the-board improvements in the adoption of computerized provider order entry (CPOE).
There have been incremental improvements in the Surgical Care Improvement Project (SCIP), which measures adherence on starting and stopping antibiotics, removing urinary catheters, and the use of appropriate venous thromboembolism prophylaxis, Ms. Danforth said.
"It’s clear that we’re headed in the right direction," she said during the press conference.
But improvements have been slower on the 13 outcomes measures, she said. While there have been small improvements over time in reducing central line–associated bloodstream infection rates, other measures, such as catheter-associated urinary tract infection rates, still need improvement.
Dr. Alexander R. Carbo
Dr. Alex Carbo, a hospitalist at Beth Israel Deaconess Medical Center in Boston, praised the Leapfrog Group for helping to draw attention to preventable infections.
"Any time we shine a light on something, that’s going to help drive behavior," said Dr. Carbo, who teaches quality improvement and safety to residents at Beth Israel, which received an "A" in the Leapfrog Group’s report.
Fifteen years ago, central line–associated bloodstream infections were largely considered a cost of doing business, he said, but today nearly all hospitals are focused on this problem. "Everyone is trying to reduce infections that are preventable," he said in an interview.
mschneider@frontlinemedcom.com
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