Corridor hospitals' safety score rankings released

Some area hospitals are where they should be when it comes to patient safety; others have more work to do to improve their overall patient safety standards.

That's according to recently released scores by the national not-for-profit organization the Leapfrog Group, which releases the rankings as part of its Hospital Safety Score.

Forty-seven hospitals in Iowa and Nebraska were scored. Eleven received an A, the highest rank.

According to results of the study, Mercy Medical Center in Cedar Rapids earned an A, and St. Luke's Hospital received a B. Mercy Hospital of Iowa City received a C, as did the University of Iowa Hospitals and Clinics.

The scores were assigned to hospitals based on infections, injuries and medical and medication errors. The Hospital Safety Score uses 26 measures of publicly available hospital data to produce a single score representing a hospital's overall performance in patient safety. Scores were calculated under the guidance of a nine-member panel of patient safety experts.

"We're pleased to have that particular ranking but there are a number of different quality and safety rankings that are out there," said Dr. Mark Valliere, chief medical officer at Mercy Medical Center in Cedar Rapids. "This is not the first one we have done well on. This is kind of nice to get validation from yet another organization."

Valliere said the hospital has several performance improvement teams around the areas of stroke, heart attack and heart failure, diabetes and obstetrics. Teams work on best practices in these areas, he said. There are safety teams for medications, infection control, falls, patient handoffs and readmission prevention.

"There's a lot of people doing a lot of good work that result in things like this," he said. "I'd like to think it's because people here are working very hard and trying to do their very best job they can everyday. When you have the right attitude and are working in the right direction, good things happen to patients.

"I think it just reflects people's dedication to great patient care. That's why they come in the door everyday and it shows."

The hospitals that scored less than perfect took issue with Leapfrog itself or the way the information was collected.

"We continue to support the American Hospital Association's position that much of the data derived is outdated and does not reflect hospitals' current environments," said Sarah Corizzo, media relations specialist at St. Luke's Hospital in an email statement. "The American Hospital Association has supported several good quality measures but many of the measures Leapfrog uses to grade hospitals are flawed and they do not accurately portray a picture of the safety efforts made by hospitals."

Corizzo said the hospital does not participate in the Leapfrog Group survey.

"We are continually making improvements in patient safety, which we do not feel are accurately reflected in surveys such as Leapfrog," she said.

As an example, she pointed to the hospitals computerized physician order entry (CPOE) with the implementation of its electronic medical records system in June 2012. Because Leapfrog uses data from the CPOE in 2010, this latest implementation is not reflected in the survey's recent report card, Corizzo said.

Mercy Iowa City, which received a C, uses methodology from and reports to the Center for Medicare and Medicaid Services, the Joint Commission and other organizations in its quality and patient safety indicators.

"Like many other hospitals, Mercy Iowa City has chosen not to participate with the Leapfrog Group," said Denice Connell, director of marketing and community relations in an email statement. "In our view, the Leapfrog report is incomplete without voluntarily reported information from Mercy."

Connell said Mercy Iowa City is very engaged in patient safety and ongoing quality improvement.

The use of Leapfrog is "fairly controversial," said Dr. Theresa Brennan, chief medical officer for the University of Iowa Hospitals and Clinics.

"We don't submit our data to Leapfrog," she said. "We've chosen not to participate because we feel that there are other quality and safety metrics that are better."

She said data collected through this survey lags behind a year for some parts of the survey.

Brennan said the university's health care system has taken many steps to improve its score.

She cited the health care system's office of quality and safety which is led by a chief quality officer and co-directed by a chief safety officer. In addition, through a strategy called team step, every member of the team is engaged. That includes housekeeping, dietary staff, nurses and physicians, she said.  The idea is to create a "culture of safety" amongst all staff so everyone works together and has a common understanding of best practices.

When it comes to preventing infection, housekeeping is very important to cleanliness, she noted.

Team step is now in place in the general medicine ward and hospital staff are in the process of introducing the practice in the operating room.

"That team approach as we go into a new era of health care is really going to be the way we have to function, that every member of the team has to own their role," she said.

Combined with the fact that the data is more than a year old, and the fact that the hospital system uses other metrics, Brennan said the hospitals' score in the Leapfrog survey doesn't accurately reflect safety measures in place.

Garth Bowen, the co-chair of the Iowa Health Buyers Alliance said the association of health care consumers will use the hospital safety score to educate the public about patient safety and taking precautions when admitted to a hospital. In addition, the Health Alliance will use the scores to work with policymakers to hold hearing and advance legislative options to reduce deaths by infection, injury and error.