Saturday, June 15, 2019

These are some of the safest (and deadliest) hospitals in America

If you look at outcome measures here, not a single one contains stroke deaths so this is worthless for evaluating stroke hospitals.  I think you'll find it is safe to go to any stroke hospital in the world, just not effective, as long as you don't expect full recovery. Not one is advertising tPA full recovery better than 12%, or full recovery better than 10%.  Would you consider 10 or 12% a success in any profession?

These are some of the safest (and deadliest) hospitals in America

Naveed Saleh, MD, MS, for MDLinx | June 10, 2019
Recently, the Leapfrog Group—a national nonprofit organization that represents the country's largest and most influential employers and purchasers of health care—released its Spring 2019 Hospital Safety Grades. Do you wonder how safe the hospitals are in your state, and whether they made the Leapfrog list? If so, read on.

This independent, nonprofit grading system doles out marks to general, acute-care hospitals across the United States, with grades ranging from "A" to "F." Of more than 2,600 hospitals assessed, 32% earned "A" grades, 26% got "B" grades, 36% "C" grades, 6% "D" grades, and less than 1% received "F" grades.

The Hospital Safety Grade covers 28 quality measures, which are all used by national measurement and reporting programs. These measures include 13 "process and structural messages" (eg, hand hygiene, nursing workforce, nurse communication, and physician communication) and 15 "outcome measures" (eg, foreign object retained, air embolism, falls and trauma, and in-patient methicillin-resistant Staphylococcus aureus infection), with the two domains contributing equally to the overall score.

Leapfrog Safety Grades are informed by safety data collected from the Leapfrog Group, the Agency for He althcare Research and Quality, the CDC, the American Hospital Association, and the Centers for Medicare & Medicaid Services.

Let's take a look at some of the highlights from Leapfrog's semiannual report.


Best States

The 10 states with the highest percentage of hospitals receiving "A" safety grades included:
  1. Oregon (58.06%)
  2. Virginia (53.03%)
  3. Maine (50.00%)
  4. Massachusetts (48.28%)
  5. Utah (48.00%)
  6. New Jersey (45.59%)
  7. Rhode Island (42.86%)
  8. Ohio (42.20%)
  9. Texas (41.43%)
  10. Colorado (41.03%)

Worst states

The 10 states with the lowest percentage of hospitals receiving "A" safety grades included:
  1. South Dakota (10.00%)
  2. Iowa (9.10%)
  3. New York (7.53%)
  4. Nebraska (7.14%)
  5. Arkansas (6.90%)
  6. West Virginia (4.35%)
  7. Wyoming (0.00%)
  8. North Dakota (0.00%)
  9. Delaware (0.00%)
  10. Alaska (0.00%)
Also, 0.00% of hospitals assessed in Washington, DC, received "A" safety grades.

Avoidable fatalities

This year, the Leapfrog Group worked with the Johns Hopkins Armstrong Institute for Patient Safety and Quality to update estimates of avoidable deaths due to errors, accidents, injuries, and infections at "A", "B", "C", "D," and "F" hospitals.

When compared with "A"-rated hospitals, patients at hospitals that received "D" and "F" grades were found to have a 92% greater risk of avoidable death, patients at "C"-graded hospitals were found to face an 88% greater risk, and patients at hospitals with "B" ratings, a 35% greater risk.

According to Leapfrog, about 160,000 patients die each year due to avoidable medical errors that are accounted for in the Safety Grade. Although disconcerting, this statistic is an improvement from 2016, when there were 205,000 avoidable deaths.

Although "A" hospitals are susceptible to unnecessary deaths, too, they are improving. Indeed, "tens of thousands of lives have been saved because of progress on patient safety," remarked Leah Binder, president and CEO, the Leapfrog Group.

"The bad news is that there's still a lot of needless death and harm in American hospitals. Hospitals don't all have the same track record, so it really matters which hospital people choose, which is the purpose of our Hospital Safety Grade," she added.

Of note, if all hospitals assessed had an avoidable death rate equal to "A"-grade hospitals, 50,000 lives would have been saved compared with 33,000 lives saved in 2016.

Examples of top hospitals

Leapfrog doesn't rank individual hospitals by safety in the form of some master list. Instead, it publishes a short list of top hospitals in the states they are found. These top hospitals are categorized as either teaching, general, rural, or children's.

Let's briefly take a look at one top hospital from each of the top four states with the highest percentage of hospitals that received "A" safety grades in Leapfrog's spring report. (No top hospitals were specifically highlighted for Utah in Leapfrog's short list.)

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