National survey grades Triangle hospitals on patient safety

Preventable errors, patient data assessed

kgarloch@charlotteobserver.com June 6, 2012 

  • Triangle hospital grades • Rex Hospital, Raleigh: A • UNC Hospitals, Chapel Hill: A • Duke University Hospital, Durham: B • WakeMed Raleigh Campus: C • WakeMed Cary Hospital: B • Betsy Johnson Regional Hospital, Dunn: C Source: Hospital Safety Score, www.hospitalsafetyscore.org

Just as diners compare restaurants by their sanitation scores, patients can now compare hospitals’ safety by letter grades compiled by a group of national medical experts.

The first annual Hospital Safety Score was released Wednesday, grading more than 2,600 U.S. hospitals based on data tracking preventable errors and medical complications, such as hospital-acquired infections and medication mix-ups.

Triangle hospitals received a range of scores, from A for UNC Hospitals and Rex Hospital to B for Duke University Hospital and C for WakeMed Raleigh Campus and Betsy Johnson Regional Hospital in Dunn.

“We are looking at how safe it is for you at various hospitals relative to each other,” said David Knowlton, CEO of New Jersey Health Care Quality Institute and an advocate for the new patient safety score. “We’re not saying that somebody who got a B or a C is a horrible hospital. But we want everybody to get A’s.”

The Hospital Safety Score is based on recent publicly available data and was developed by an expert panel led by the Leapfrog Group, a group of large employers that is pressuring hospitals to improve quality and reduce errors.

Knowlton said patients can get a good doctor and good care at hospitals with a C grade, but said the likelihood of harm being done to you at a hospital that received an A grade is “significantly less.” “There is a significant difference between the various letter grades,” he said. “We want people to start questioning their doctor: ‘I’m uncomfortable that you’re sending me to a C hospital.’ ”

If doctors hear these concerns and take them to administrators, Knowlton said, hospital CEOs will pay attention.

How grading is done

The Hospital Safety Score uses 26 national performance measures from the Leapfrog Hospital Survey, the Agency for Healthcare Research and Quality, the Centers for Disease Control and Prevention, and the Centers for Medicare and Medicaid Services.

Those measures were used to produce a single score that represents a hospital’s overall performance in keeping patients safe.

Although consumers won’t be able to identify a hospital’s specific problems, Knowlton said the score is still useful.

Not all Triangle hospital systems participated in Leapfrog’s survey, and its methodology was not universally embraced.

UNC and Rex did participate, and they said their grades reflected the significant investments they’ve made in patient safety.

“These high grades reflect great efforts from employees and physicians throughout both institutions,” said Linda Buter, Rex’s chief medical officer. “Everyone at Rex (owned by UNC Hospitals) and UNC recognizes the importance of safety and quality, and we strive to be counted among the top hospitals nationwide.”

Neither WakeMed’s Raleigh campus or WakeMed Cary have participated in Leapfrog’s survey for several years, said Meera Kelley, WakeMed’s vice president for quality and patient safety.

“We do admire and support all efforts to provide good, meaningful information to the public about quality and patient safety and transparency we think is essential,” she said.

Some dislike procedure

But she said the hospital system felt the way the Leapfrog was evaluating hospitals wasn’t the best way to measure quality and safety, and she said many peers had stopped participating before WakeMed dropped out.

Kelley said WakeMed’s Raleigh campus narrowly missed earning a B grade, and one strike against it was being cited for having five patients who developed pressure ulcers over a 20-month period. She said the Raleigh campus had 70,000 patient admissions over that period, and that a significant portion of WakeMed Raleigh’s patients are referred to the hospital because they are very sick.

“Those patients tend to stay in a bed longer and to be sicker, so they’re more at risk for pressure ulcers than people who, for example, get admitted to WakeMed Cary or some other hospital,” Kelley said. “We think that when we’re looking at very small numbers, it can be risky to jump to conclusions.”

No D’s and F’s were reported for now. Hospitals that received those grades are listed as “score pending” and will have six months to improve, Knowlton said. The lower scores will be published in September.

Of 59 hospitals graded in North Carolina, eight received A’s, and only Johnston Memorial in Smithfield got a “score pending.” Staff writer David Bracken and Ames Alexander of The Charlotte Observer contributed.

Garloch: 704-358-5078

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