May 28, 2013

Hospital Safety

On May 21, we discussed hospital costs. Today, it’s hospital safety.

As Consumer Reports described in its May 2013 issue, the story isn’t especially positive. Its latest survey includes data from 2,031 hospitals, focusing on five key measures:
  • Readmissions 
  • Complications 
  • Communication 
  • Overuse of CT scans, and 
  • Infections 
The highest-scorer – at only 74 out of 100 – was Bellin Memorial Hospital in Green Bay, Wisconsin. At the bottom – a distinction that must certainly have created a PR nightmare for the facility’s administrators – is Clinch Valley Medical Center in Richlands, Virginia. Their score? 14.

The average score for all hospitals was 49 – a failing grade in most assessments I know that are based on a possible 100. Said Dr. John Santa, director of the Consumer Reports Health Ratings Center: “When it comes to health care, average should never be good enough, and this average is not even close.”

Even more alarming was the performance of the nation’s teaching hospitals, where doctors are trained. In that “elite” category, nearly two thirds of the scored hospitals fell BELOW that average (49). The CR article calls out the 28 teaching facilities in and around New York City, of which only ONE scored above the already-sketchy national average.

The top three teaching hospitals were:
  • Mayo Clinic Hospital in Phoenix, Arizona (69) 
  • Mayo Clinic Jacksonville in Jacksonville, Florida (68) 
  • Gundersen Lutheran Medical Center in La Crosse, Wisconsin (66) 
Gundersen (#3 above) enhanced its national reputation last year with its special, sensitive handling of hospice, death and dying. I wrote about that facility in a post titled The Best Way to Die.

CR’s report is available only to subscribers. But there are other ratings resources. One is Hospital Safety Score. (It's ratings cause me to question the Consumer Reports rating system, as I'll explain at the end of this post.)

Here’s how this resource describes its methodology:
The Hospital Safety Score uses national performance measures from the Leapfrog Hospital Survey, the Agency for Healthcare Research and Quality (AHRQ), the Centers for Disease Control and Prevention (CDC), and the Centers for Medicare and Medicaid Services (CMS) to produce a single score representing a hospital’s overall performance in keeping patients safe from preventable harm and medical errors. 
In addition, secondary data from the American Hospital Association’s Annual Survey was used to give hospitals as much credit as possible toward their safety score. The Hospital Safety Score includes 26 measures, all currently in use by national measurement and reporting programs. 
So . . . how did my Washington, D.C. area hospitals perform? These hospitals earned the top “A” grade:
  • Sibley 
  • Inova Fair Oaks 
  • Inova Alexandria 
  • Inova Loudon 
  • Prince William 
  • Virginia Hospital Center 
These facilities earned a “B” grade:
  • Inova Fairfax 
  • Inova Mount Vernon 
  • Reston Hospital Center 
These hospitals scored a “C” grade:
  • George Washington University Hospital 
  • Georgetown University Hospital 
  • Sentara Northern Virginia Medical Center 
  • Washington Hospital Center 
Two hospitals earned a “D” grade:
  • Howard University Hospital 
  • United Medical Center 
One failed, with an “F” mark:
  • Providence Hospital of Washington 
This resource allows you to see the hospitals’ full, detailed scores. To check facilities near you, simply go to the site (link above) and enter your zip code in the search bar.

Comparison with Consumer Reports Ratings
As a Consumer Reports subscriber, I can access its rating of individual hospitals. Unfortunately, it lets you search only by city or county, so it doesn't have a separate listing for the Washington metropolitan area. I could only call up their ratings for DC itself. Here are their overall safety scores. Remember, the average score for all hospitals was 49.
  • United Medical Center  -- 54
  • Sibley Memorial Hospital -- 50
  • Georgetown University Hospital -- 45
  • Howard University Hospital -- 43
  • George Washington University Hospital -- 42
  • Washington Hospital Center -- 42
  • Providence -- 34
The big surprise here is giving the top rating to the United Medical Center, which scored a "D" grade in the Hospital Safety Score rating. This rating also comes as a surprise to this longtime Washington resident. The United Medical Center is a successor to the Greater Southeast Community Hospital, which nearly went bankrupt in 1999 and had a couple of reincarnations before it underwent major renovations in 2008, when it became the United Medical Center.

With this major exception, the other ratings by Consumer Reports track those of the Hospital Safety Score.

Just another example of how difficult it is for the medical-care consumer to get reliable information.

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