The Leapfrog Hospital Safety Grade explained
Wichita hospitals received mixed scores in the latest round of patient safety ratings handed out by a Washington-based nonprofit focused on reducing preventable medical errors, illnesses and deaths.
The Leapfrog Group last week released its Spring 2019 hospital patient safety grades for more than 2,600 general, acute-care hospitals across the country, including five in Wichita. The group evaluates and rates the hospitals twice a year on 28 measures —including blood infection and dangerous bed sore rates, injuries, medication mix-ups and other deadly errors — then assigns an overall single letter grade of A, B, C, D or F.
Two Wichita hospitals — Wesley Medical Center and Wesley Woodlawn Hospital & ER — received an A, the top score.
Ascension Via Christi St. Teresa hospital was given a B.
Two other Ascension Via Christi hospitals in Wichita, St. Joseph and St. Francis, received a slightly lower grade of C.
None of the hospitals in Wichita or the surrounding areas received a D or an F — the worst grades.
Leapfrog considers A-graded hospitals safest for patients, but the ratings aren’t the only hospital performance evaluations a person can use to decide where to seek care. Leapfrog doesn’t score critical access, specialty, government and rehabilitation hospitals or hospitals that have too little publicly reported data like small or rural hospitals.
Most of the data used comes from the Centers for Medicare and Medicaid Services and other public sources. Hospitals are also asked to complete a voluntary survey that reports other quality and safety information like handwashing habits and how staff members work together to prevent errors.
A breakdown of the overall letter grade shows how a hospital scored on individual measures, how it scored compared to other hospitals and what safer hospitals are doing to prevent problems.
Wesley Healthcare President and CEO Bill Voloch in a news release said the scores “speak directly to the initiatives we have championed to improve our patient care and safety processes.”
About a third of hospitals nationwide received an A grade.
“Exceptional outcomes based on best practices are our goal, and we are proud that those efforts have again been recognized on a national level,” he said in the release.
Wesley’s main campus, 550 N. Hillside, ranked well on most preventable infection rates measured, the number of surgery-related problems and safety issues like dangerous bed sores and falls.
But the hospital fell short on measures that evaluated how well patients thought doctors and nurses communicated with them and gave discharge orders. It also had more patients than expected who ended up with infections after colon surgery, according to the scorecards.
Wesley’s hospital and emergency room site at 2610 N. Woodlawn had similar marks.
Ascension Via Christi Chief Nursing and Quality Officer Carla Yost explained St. Francis, St. Joseph and St. Teresa’s lower grades by pointing out that part of the ratings are based on Leapfrog’s voluntary survey — which she said the hospitals don’t fill out because they’re time and resource intensive.
The hospitals think evaluations “can be valuable tools in providing a snapshot” of needed improvements, Yost said. But Ascension Via Christi hospitals choose to participate only in those they think are “most valuable in enhancing the quality and safety of the care we provide.”
Hospitals get graded whether they fill out the survey or not, but Leapfrog says opting out might impact their overall ratings.
With information missing, “it is unclear how they could rate our performance,” Yost said.
According to the latest Leapfrog scorecard, St. Teresa received above-average marks for having better than average rates of Clostridium difficile (C. diff) infections, problems with surgical wounds, dangerous blood clots, bed sores and patient falls and injuries. But it had worse than average performance when it came to patients experiencing serious breathing problems and collapsed lungs.
The hospital did not have data available for Methicillin-resistant Staphylococcus aureus (MRSA), blood, urinary tract and surgical sites infections or deaths from serious but treatable post-surgery complications.
St. Joseph and St. Francis, meanwhile, both had better than average performance when it came to rates of collapsed lungs, breathing problems and accidental cuts and tears among patients. They also had fewer MRSA, urinary tract and post-colon surgery infections than expected.
But both had more central line-associated blood infections than expected, and both performed below average on measures that looked at the number of surgical wound splits, dangerous blood clots, falls, injuries and post-surgery deaths due to complications in patients.
Asked what is being done to increase patient safety, Yost cited a more than 50% reduction in bed sores and a 5% drop in overall mortality rate at the hospitals over the past two years.
“We are extremely proud of our efforts to continuously improve patient safety and outcomes at all of our hospitals,” she said.
An estimate of deaths prepared and released by the Johns Hopkins Armstrong Institute for Patient Safety and Quality alongside Leapfrog’s grades says patients who seek care at B-rated hospitals have a 35% greater risk of dying from avoidable circumstances and those at C-rated hospitals have an 88% greater risk than patients at A-rated hospitals.
For patients at D- and F-rated hospitals the risk of death is nearly double, the estimate says.
In total, more than 400,000 people die annually from preventable medical errors, illnesses, infections and harm.