Category Archives: healthcare quality

Patient Safety Watchdog Group Issues Latest Hospital Ratings

The Leapfrog Group, a national patient safety watchdog group has released their latest Hospital Safety Scores, assigning letter grades to hospitals nationwide based on a 30 measures of publicly-available safety data. The grades of A, B, C, D or F are assigned twice a year to 2,500 hospitals across the US.

Copyright Alberto G. https://www.flickr.com/photos/albertogp123/In Washington State, Overlake Medical Center, University of Washington Medical Center, and Virginia Mason Medical Center all received A grades for excellence in patient safety. These hospitals have earned “straight A’s” over the last three years, and are the only three in Washington State to do so (153 hospitals have earned this distinction nationwide).

The Hospital Safety Score was developed under the guidance of Leapfrog’s Blue Ribbon Expert Panel, which, for the first time, included five measures of patient-reported experience with the hospital as well as two of the most common infections, C.diff and MRSA.

“Avoidable deaths in hospitals should be the number one concern of our health care leaders,” said Leah Binder, president and CEO of The Leapfrog Group, “Hospitals that earn an ‘A’ from Leapfrog are leaders in saving lives, and we commend them and urge their continued vigilance.”

“We are so honored and proud to receive this ‘A’ grade from The Leapfrog Group for a third year in a row,” said Overlake CEO J. Michael Marsh. “Patient safety is our hospital’s top priority and this award demonstrates our commitment and consistency.”

Those who would like more information on how their local hospital ranks, or for information on the methodology behind the grade system, are encouraged to learn more at http://www.hospitalsafetyscore.org/

Study Finds Most Successful Hospitals are Nonprofits

An article recently published in “Health Affairs” has identified that seven of the ten most profitable acute care hospitals in the United States are not-for-profit organizations. The data examined was retrieved from Medicare Cost Reports and Final Rule Data, and analysis considered the 2013 net income from patient care services per adjusted discharge.

According to the study, ” Forty-five percent of hospitals were profitable, with 2.5 percent earning more than $2,475 per adjusted discharge. The ten most profitable hospitals, seven of which were nonprofit, each earned more than $163 million in total profits from patient care services.” (Bai G. Anderson G.) Caring for patients was a net loss for 55% of hospitals in 2013. Roughly one-third of hospitals which earned a profit made between $1 and $1,000 per patient discharged. Only 12% of hospitals fared better, at $1,000+ per patient discharged.

Study co-author Ge Bai believes that it is important to understand which hospitals are profitable and to what extent they are affected by various public policies. Bai believes that it is up to the general public to monitor hospital consolidation, and to consider its impact on operating expenses and insurance negotiating power.

Mayor Laurel Prussing of Urbana, IL. discussed the phenomenon in an article published in the Associated Press. Urbana lost 11% of its assessed tax value, $6.5 million annualy, when the Carle Foundation Hospital in her city was no longer responsible for property taxes. “We need to question this whole idea of what not-for-profit means,” Prussing said. “This is a highly profitable business that manages to not pay taxes.”

Others aren’t so sure that losing money should be a prerequisite to earning nonprofit status. Danny Chun of the Illinois Hospital Association makes the case that increased spending power tends to directly benefit future patients and the community at large. He claims that income earned each year is reinvested in ” the latest technology, newer equipment, modern facilities, highly-trained staff and other programs that ensure access to quality health care services and benefit the health of their community.”

One thing is for sure: when hospital care makes up almost one-third of national health care spending, nearing $1 trillion, the debate about the relationship between nonprofit hospitals and profit margins will continue to be a hot topic.

 


Ge Bai, Gerard F. Anderson Health Aff May 2016 vol. 35 no. 5 889-897 doi: 10.1377/hlthaff.2015.1193

Johnson, Carla “Study: 7 of 10 most profitable US hospitals are nonprofitsAssociated Press, May 2nd, 2016./sup>

Leapfrog Top Hospital Awards

LeapfrogGrp2014

133 hospitals earned the “Straight A” designation. These hospitals have consistently received an A grade for safety since the Hospital Safety Score launched in 2012.

Nearly 69 percent of the hospitals in Maine received an A rating making it the Top State – for the fourth year in a row!

2,530 hospitals participated.  28 measures are used to calculate the grades. The Hospital Safety Scores: 773 earned an A; 724 earned a B; 866 earned a C; 133 earned a D; and 34 earned an F. No hospitals in the District of Columbia, Alaska, North Dakota, New Mexico, Vermont, or Wyoming received an A grade.

Here’s the link to learn more: The Leapfrog Group: Top Hospital Awards

State Total Top Children’s Hospitals Top Rural Hospitals Top Urban Hospitals
AL 1   1  
AZ 2     2
CA 22 2   20
CO 1   1  
FL 4 1 2 1
GA 1   1  
ID 1   1  
IL 5   1 4
KS 1     1
KY 3   2 1
MA 10 1   9
ME 9   9  
MI 4 1 2 1
MO 2     2
NC 1   1  
NJ 5 1   4
NM 2     2
OH 3     3
OR 1     1
PA 1 1    
RI 1     1
SC 1     1
TN 3   2 1
TX 6 2 1 3
VA 1     1
WA 1     1
WI 2   1 1
Totals 94 9 25 60

 

How’s your hospital’s quality? Are you sure? Who told you?

Anyone can rate your hospital’s quality of care. Without transparency, each opinion is as valid as your dad’s (didn’t say mom’s cause no one crosses her!).  Defining the metrics, where and how was the data gathered, what period is measured vs. what’s an extrapolation, etc. Learned in college, ‘you can prove anything with enough numbers’ and ‘statistics don’t lie, statisticians do’ (dad was a statistician).

The AAMC (Association of American Medical Colleges) convened a panel of quality experts who developed the Guiding Principles for Public Reporting of Provider Performance (pdf). These 25 principles to evaluate Provider Quality reports call for data and reporting methodologies to be well-defined in terms of purpose, transparency, and validity.

When hospitals are rated, “[they] want to know, ‘How do we talk with our boards, why we should put a lot of emphasis on this rating system or why we shouldn’t, and where is it important?’” explains Joanne Conroy, MD, chief healthcare officer for the AAMC, which spearheaded the project last year. “They need a clear set of principles that’s not their opinion to justify why they should emphasize one [rating] system and not another.”

In fact, none the rating systems published to date, including those from The Joint Commission, the Leapfrog Group, Consumer Reports, Hospital Compare, the Commonwealth Fund, Truven, Healthgrades, and U.S. News and World Report, meet all of the AAMC’s guiding principles. “Nobody meets them all,” Conroy says.

Read More: HealthLeaders Media (3-10-2014)

This is not breaking news. Washington state legislature wants to mandate a statewide Healthcare Procedures Cost Database in response to its ACA implementation. I applaud the efforts for transparency and have trouble trusting those organizations that don’t want to cooperate.