So your hospital got an 'A' in safety, but how useful is the report card?
A survey aimed at helping patients choose a hospital with solid safety standards finds three of Western New York’s medical institutions to be among the best in the state. But how useful is a report card for prospective patients if it doesn’t cover all of the area hospitals?
Twice a year, hospital safety ratings from the Leapfrog Group assess 30 measures of how well hospitals protect their patients from accidents and errors. Those measures are split evenly between the processes and procedures a hospital takes towards safety, and the outcomes they influence. The results are then graded on a scale of ‘A’ through ‘F.’
On the Spring 2017 list, Western New York’s Kenmore Mercy, Sisters of Charity in South Buffalo, and the Erie County Medical Center all scored top grades of ‘A.’
“We see some very low infection rates. We see low rates of what we call the ‘hospital acquired conditions’ – so things like falls, blood clots, a collapsed lung,” explained Leapfrog Group Director of Communications Erica Mobley. “And overall these are hospitals that still have some mistakes – no hospital is perfect – but are generally doing very well and scoring ahead of their peers.
Eight more hospitals in the Western New York Area were graded ‘C.’ Mobley said hospitals with those average grades generally have problems on both the processes and procedures side, as well as patient outcomes.
“By all means, no patient should avoid those hospitals entirely, but it is important to be extra vigilant when going to those hospitals, and ask the doctors and nurses and other caregivers what steps are being taken to protect them and ensure that an error doesn’t harm them during their hospital stay,” said Mobley.
With 11 Western New York hospitals ranked, what about the rest of the 27 listed by the New York State Department of Health?
Mobley explained that the Leapfrog rating focuses on general acute care facilities.
“Unfortunately, the majority of the data that we use comes from the federal government through Medicare,” said Mobley. “And that information is only available for hospitals that are licensed as general acute-care hospitals.”
But major hospitals such as Niagara Falls Memorial – which is an acute care facility – are not included in the ranking, along with many more. Mobley said Leapfrog isn’t able to grade all the hospitals that are eligible because, for many, there is too much missing data.
“We use 30 different measures of patient safety in calculating the safety grades, and if a hospital is missing too many of those 30 measures, we’re unable to give them a grade,” said Mobley. “Hospitals may be missing data for a variety of reasons. Probably the most common is having volumes that are too low to report on certain measures.”
In addition to using Medicare as a source of data, Leapfrog also uses two voluntary surveys – one from Leapfrog, and another from the American Hospital Association. But if a hospital does not participate in either survey, Leapfrog can’t assign a grade.
“What we really want to do is to educate patients using a simple letter grade system – using A, B, C, D, or F to which hospitals are safer than others,” said Mobley. “But also to really drive a market for improvement and encourage hospitals to improve their safety record.”
That drive for improvement has become a reality for some hospitals that have taken poor grades seriously, admitted their shortcomings, and worked towards change. While hospitals like ECMC and Sisters have been on fairly decent grading curves for the past few years, their latest ‘A’ grades were a step up from Fall 2016 ‘B’s.’ Leapfrog is also looking for other data sources that can be used to expand the list of graded hospitals.
But with so many hospitals left un-ranked, the question remains – is Leapfrog a useful tool for prospective patients?
“Absolutely,” according to Mobley. But she noted that it isn’t the only tool for a patient to use. The first step is finding a hospital with a grade you’re comfortable with, then look for additional information about the hospital.
“For example, if they are going to have a knee replacement, look for a hospital that has good outcomes with knee replacements, to find a surgeon that performs a high volume of those procedures, and collectively use that information to choose the hospital that’s right for them and their family,” said Mobley.
Mobley also encourages patients to do their part to ensure a safe stay by bringing lists of current medications to the hospital, as well as a family member or loved one who can speak up if anything is wrong. And last, but not least, ask everyone who walks into a hospital room to wash their hands and prevent the spread of unsafe infection.