Q: Have hospitals improved since the first Hospital Safety Score last year?
A: We saw an incremental improvement in the scores, though it is not as rapid or as dramatic as we would like. For the Spring 2013 Hospital Safety Score, there were more than 2,500 general hospitals scored, including 780 “As,” 638 “Bs,” 932 “Cs,” 148 “Ds” and 16 “Fs.” Those hospitals that lowered their grades demonstrate how patient safety can be seriously impacted when hospitals don’t stay vigilant. Safety is a 24/7, 365-day effort with all hands on deck; there is no time for excuses when it comes to preventing errors, injuries and harm. On the other hand, hospitals that showed improvement should be celebrating. They have clearly accepted the challenge to improve and have proven that any institution can make significant advances in patient safety over a short period of time. Now, they need to work on sustaining that achievement into the future.
Q: How is the Hospital Safety Score different from other hospital ratings?
A: The Hospital Safety Score is the standard assessment of how well hospitals perform at protecting patients from accidents, errors and injuries. The Score is 100-percent transparent, and the only hospital safety assessment to be (favorably) peer-reviewed in the Journal of Patient Safety. Unlike any other rating, you can see all the data that was applied to every scored hospital, as well as the entire methodology. Also unlike many other ratings, the Hospital Safety Score highlights both the best and poorest performers on safety in an effort to educate consumers on the hospitals they rely on for care.
The Hospital Safety Score assesses hospitals strictly on patient safety. Each “A,” “B,” “C,” “D,” or “F” score assigned to a hospital comes from expert analysis of infections, injuries, and medical and medication errors that frequently cause harm or death during a hospital stay.
Q: Why did some hospitals not receive a score?
A: The Leapfrog Group has strict criteria about which hospitals are eligible to receive a Hospital Safety Score. Hospitals must qualify as general acute care hospitals and must have enough publicly reported data to meet the threshold for scoring. Specialty hospitals (such as children’s or surgical) are excluded, as are hospitals in Maryland, Guam, and Puerto Rico, which are exempt from public reporting requirements. In some cases, hospitals that meet the standard during one iteration of the Hospital Safety Score will not receive a score in the next round, or vice versa, due to a change in the amount of publicly available data.
Q: Should patients be advised against going to hospitals that scored a “C,” “D” or “F?”
A: The Hospital Safety Score should be used as one important piece of information patients use to choose a hospital and as a tool to for them to raise questions with their doctors or hospital administrators. We advise consumers to never refuse care in an emergency because of the Hospital Safety Score, but rather, to use the Hospital Safety Score as a guide for planned events and a research tool for potential emergencies. Safety is the first thing that should be examined about a hospital, but it’s also important to take into account quality and procedure-specific metrics like those available from Consumer Reports or Hospital Compare.
Q: How can you fairly compare hospitals that are large, academic medical centers with a high-risk population to small, community hospitals?
A: Any hospital can afford to be safe. We were very pleased to see a wide range of hospitals serving all patient populations score an “A” on the Hospital Safety Score. These included academic medical centers, rural, urban, and suburban hospitals; safety net hospitals; community hospitals; and nonprofit and for-profit hospitals.
The Hospital Safety Score uses data publicly available at the national level. Where applicable, measures were risk-adjusted. Most of the data is not risk-adjusted, however, because it measures issues that should apply regardless of the frailty, economic hardship or other special characteristics of the patient. For instance, objects should never be left in after surgery, all hospitals should have a policy that employees must wash their hands, and hospital leadership should always place a priority on safety. Any hospital can earn an “A” Hospital Safety Score, and we look forward to the day when all hospitals practice this level of safety excellence.
To learn more about the Spring 2013 Hospital Safety Score release, visit the website or download the Hospital Safety Score app, available on the website.
Leah Binder is the CEO of The Leapfrog Group, a voluntary program aimed at mobilizing employer purchasing power to alert America’s health industry that big leaps in health care safety, quality and customer value will be recognized and rewarded.