The Hospital Safety scores are in, while overall State safety standard have improved moving NJ in fourth in national rankings, it’s a mixed bag for Newark. While the State safety score have improved, safety scores in Newark continue to lag. So you ask what is a Hospital safety Score? Hospital Safety Scores are assigned to more than 2,500 hospitals across the nation twice annually. The nonprofit Leapfrog Group, which gives safety letter grades of “A” to “F” to 2,500 hospitals nationwide. The Hospital Safety Score is becoming the gold standard measure of patient safety, cited recently in MSNBC, The New York Times, and AARP The Magazine.
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), the Centers for Medicare and Medicaid Services (CMS), and the American Hospital Association’s Annual Survey and Health Information Technology Supplement.
Taken together, those performance measures produce a single score representing a hospital’s overall performance in keeping patients safe from preventable harm and medical errors. The Hospital Safety Score includes 28 measures, all currently in use by national measurement and reporting programs. The Hospital Safety Score methodology has been peer reviewed and published in the Journal of Patient Safety.
New Jersey’s Hospital Safety Score, with 52 percent of the state’s acute care general hospitals getting an “A” grade for safety, Leapfrog said the goal of its hospital safety report card is to promote patient safety by providing consumers and employers with information on how well hospitals are keeping patients safe from adverse events like infections and falls, as well as medication and surgical errors.
Leapfrog issues its hospital safety report card twice a year. New Jersey moved up from seventh in the nation in April to fourth in the fall survey, now available online atwww.hospitalsafetyscore.org.
New Jersey, with 52.23 percent of its 67 hospitals getting an “A,” ranked below only Maine, at 67 percent; Massachusetts, at 63 percent; and Virginia, with 52.38 percent of its hospitals getting an “A.”
In New Jersey, 35 hospitals got an “A,” up from 30 in April.
“We’re delighted to see New Jersey setting a national model for safety and transparency,” said Linda Schwimmer, vice president of the New Jersey Health Care Quality Institute and a member of the Leapfrog board. “We especially congratulate the hospitals who worked to improve their quality by raising their Safety Score to an ‘A.’”
Although the State overall saw improvement, the hospitals within the Newark area showed lagging scores. Schwimmer pointed out that, despite New Jersey’s overall high performance, regional variation still persists. She said that, in Newark, with the exception of Newark Beth Israel Medical Center, hospitals have consistently received “Cs” and “Ds” in the last three rounds of scoring, including this most recent round. Newark Beth Israel received a “B” score both in the current report and in April.
The breakout is as follows:
Saint Michael’s Medical Center, Newark, received the lowest grade score of “D”
University Hospital, Newark, received a grade score of “C”
East Orange General Hospital, East Orange, received a grade score of “C”
Newark Beth Israel Medical Center, Newark, received the highest score in Newark of “B”
Clara Maass Medical Center, in Belleville near Newark’s border received the highest score of “A”
Dr. Suzanne Atkin, chief medical officer, of Newark University Hospital said, “There are many measures of quality and safety that assist hospitals with establishing effective standards for quality patient care and safety. University Hospital has been consistently recognized by many programs for its excellence and high-quality care. Our success and recognition in the areas of advanced heart failure and stroke care, along with our full accreditation from the Joint Commission, which remains the Gold Standard for hospital and quality safety, speaks to our ongoing commitment to providing a high quality and safe environment for our patients. The Leapfrog Hospital Safety Score is another one of those measures that we regard highly, and therefore have incorporated the findings into our ongoing patient safety plan.”
Cathy Toscano, director of communications at Saint Michael’s, said: “Some of the data used to calculate hospital grades is dated and does not reflect more recent performance improvement efforts. We are consistently measuring, monitoring and taking action to ensure the safety of our patients through our patient safety and performance improvements committees and other hospital programs.”
Leapfrog said Saint Michael’s scored below the national average in a number of areas. One issues, Leapfrog said, is that Saint Michael’s indicated it does not have intensivists treating patients in its intensive care unit. According to Leapfrog, staffing an ICU with intensivists who are specially trained in critical care medicine is shown to reduce patient mortality 40 percent.
Toscano replied: “We have a medical intensive care unit and a cardiac recovery room. Both areas are staffed by rigorously credentialed physicians who are board-certified in the appropriate specialties to provide care for these patients. We also have advanced practitioners and fellows in support of the operations 24/7.”
Further analyses of the detail report of Saint Michaels, revealed two section in the score categories were unreported, “Right Staffing to Prevent Safety Problems”, “Hospital Uses Standard Safety Procedure” resulting in reducing the overall score. Within the category of “Right Staffing to Prevent Safety Problems, seek leadership involvement to insure quality improvements. We were able to reach a board member from St. Michael’s, and they informed us, that the leadership is involved with quality measure and meet regularly with staff to discuss quality issues, and improvement measures. Additionally, if these sections were reported it would most likely increase their overall score.
Aline Holmes, a registered nurse and senior vice president of clinical affairs and director of the New Jersey Hospital Association Institute for Quality and Patient Safety, said all of New Jersey’s hospitals are part of the nationwide Partnership for Patients effort, which is led by the Centers for Medicare and Medicaid Services and is focused on quality and patient safety.
“That work is now in its third year, and I think it has created a very robust, very active culture of safety in our hospitals that is reflected in many ways — not only in reports like this one from the Leapfrog Group, but also in our own findings in the NJHA Institute for Quality and Patient Safety,” Holmes said. She said NJHA data for 2013 show that hospitals’ improvements in reducing complications like infections saved an estimated $125 million in health care costs and averted 9,206 adverse patient events.
“It’s important that we make this information easily accessible to consumers so that the public, employers and policymakers can pressure them to do better,” Schwimmer said.
And she added: “It’s also important to note that, while Leapfrog assesses and publicly reports on hospital safety, they do not and cannot assess any hospital’s preparedness for the threat of Ebola. Ebola requires the highest level of preparedness from the American health care system and public health authorities, including sophisticated methods of infection control, training, triage and isolation. These means of preparedness are far outside the scope of the routine safe practices that Leapfrog monitors in American hospitals.”
In fact, the Dallas hospital where two nurses contracted Ebola from a patient — Texas Health Presbyterian — received an “A” grade from Leapfrog, based on its past performance on safety metrics.
Leah Binder, chief executive of Leapfrog, said: “Even ‘A’ hospitals make mistakes, and sometimes patients are harmed. Based on the data Leapfrog used in the Hospital Safety Score, Texas Presbyterian is among the safer hospitals in the nation. The recent mishandling of Ebola cases proves that as a country, our hospitals must work harder to become prepared for this and any future threats.”
Leapfrog said the Hospital Safety Score is designed to give the public information it can use to choose a hospital.
“We want to turn patients into savvy health care shoppers by enabling them to take an active role in selecting a hospital,” Binder said. “By evaluating hospitals based on important safety measures and grading them accordingly, we can help consumers make smarter choices for themselves and their families.”
“New Jersey citizens should use every resource available when planning for a hospital visit, including the Hospital Safety Score,” Schwimmer said. “At the Quality Institute, we will continue to work with policymakers and employers on implementing value-based purchasing to spur safety improvements in our hospitals.”