Death risk nearly doubles for patients in hospitals graded as “D” or “F”

The Leapfrog Group, a nonprofit organization that grades hospital performance, has released its spring 2019 Hospital Safety Grades along with an update on the estimate of deaths caused by errors, accidents, injuries and infections. The report reveals that risk of death increases measurably among patients that receive treatment at hospitals that have “D” and “F” grades.

“Medication errors are the most common error that happens in the hospital,” said Erica Mobley, Director of Operations at The Leapfrog Group, noting that many medications look and sound similar, which can create confusion among caregivers. “A report from the Office of the Inspector General found that on average Medicare patients experience one medication error per patient per day.”

The Leapfrog Hospital Safety Grades are an independent, nonprofit grading system that assigns “A,” “B,” “C,” “D” and “F” letter grades to general, acute-care hospitals in the United States. The group contracts with the Johns Hopkins Armstrong Institute for Patient Safety and Quality to assess more than 2,600 hospitals receiving Hospital Safety Grades and found that when compared to “A” hospitals:

·   Patients at “D” and “F” hospitals face a 92 percent greater risk of avoidable death

·   Patients at “C” hospitals on average face an 88 percent greater risk of avoidable death

·   Patients at “B” hospitals on average face a 35 percent greater risk of avoidable death

·   Even ‘A” hospitals are not perfectly safe, but researchers found they are getting safer. If all hospitals had an avoidable death rate equivalent to “A” hospitals, 50,000 lives would have been saved, versus 33,000 lives that would have been saved by “A” level performance in 2016.

“The Safety Grade evaluates two technologies proven to reduce medication errors,” said Mobley in response to questions from HPN. “Computerized Physician Order Entry (entering prescriptions through a computer with built-in logic to alert to potential errors) and Bar Code Medication Administration (scanning a patient’s ID wristband and the medication each time medicine is delivered to ensure the right patient, dosage, delivery method, and time). These technologies can help prevent inevitable human error from harming the patient.”

Overall, an estimated 160,000 lives are lost annually from the avoidable medical errors that are accounted for in the Leapfrog Hospital Safety Grade, a significant improvement from 2016, when researchers estimated 205,000 avoidable deaths, according to the organization’s news release.

When asked what led to the improvement, Mobley said, “Hospitals have increasingly placed an organization-wide focus on patient safety that has permeated across all harms measured in the Safety Grade. Due to changes in measure specifications its often difficult to determine exactly where hospitals most focused their efforts; the 15 outcomes measures included in the Safety Grade cover a wide swath of potential errors that can happen in the hospital, though do not capture all possible harms that could occur.”

But do all patients have knowledge of these findings or access to hospitals that receive higher grades?  

“While it is true that some patients may have limited choice in the hospital where they receive care due to the urgency of the medical need, geography, or other factors, all patients can and should take steps to protect themselves in the hospital.” Responded Mobley. “In our interactions with consumers, we find that almost all patients who learn their hospital has received a C, D or F find that performance unacceptable and try to find a safer hospital, even if it means choosing a less convenient option.”

Across all states, additional Leapfrog Hospital Safety Grade findings for spring 2019 include:

·   Of more than 2,600 hospitals graded, 32 percent earned an “A,” 26 percent earned a “B,” 36 percent earned a “C,” 6 percent a “D” and just under 1 percent an “F”

·   The top five states with the highest percentages of “A” hospitals are: Oregon (58 percent), Virginia (53 percent), Maine (50 percent), Massachusetts (48 percent), and Utah (48 percent)

·   There are no “A” hospitals in Wyoming, Arkansas, Washington, D.C., Delaware or North Dakota

·   Impressively, 41 hospitals nationwide have achieved an “A” in every grading update since the launch of the Safety Grade in spring 2012

“We encourage hospital leaders to follow the examples set by some of their peers and acknowledge their shortcomings,” said Mobley. “Use this as an opportunity to commit or recommit to significant changes and improvements in safety practices so that you can give your community the confidence they need and deserve that they won’t experience harm in their local hospital.

“Our staff is happy to speak with hospital leaders of lower graded hospitals and help them to understand the data that resulted in their low grade as well as identify the measures where they scored poorly,” she continued. “Some hospital leaders will try to discredit Leapfrog or our methodology. Increasingly however, we are seeing hospitals take ownership of their shortcomings and use this as an opportunity to commit to improvement and to providing their community with safer care. We have even seen some hospital CEOs hold a press conference or take out an ad in the local paper to acknowledge the low grade and commit to striving for an A in the future. Leapfrog’s goal in creating the Hospital Safety Grade was to drive a movement for improved patient safety; it’s encouraging to see hospital leaders who share that goal regardless of the grade their hospital receives.”