CHARLOTTE, N.C. -- Just as diners compare restaurants by their sanitation scores, patients can now evaluate hospital safety by letter grades compiled by a group of national medical experts.
The first annual Hospital Safety Score was released Wednesday, grading more than 2,600 U.S. hospitals based on data that tracks preventable errors and medical complications, such as hospital-acquired infections and medication mix-ups.
Charlotte-area hospitals received a range of scores, from A for Gaston Memorial Hospital and Presbyterian Hospital Huntersville to C for Carolinas Medical Center, CMC-Mercy and CMC-University.
“We are looking at how safe it is for you at various hospitals relative to each other,” said David Knowlton, CEO of New Jersey Health Care Quality Institute and an advocate for the new patient safety score.
“We’re not saying that somebody who got a B or a C is a horrible hospital. But we want everybody to get As.”
The Hospital Safety Score is based on recent publicly available data and was developed by an expert panel led by the Leapfrog Group, a group of large employers that is pressuring hospitals to improve quality and reduce errors.
Referring to Charlotte-area hospitals, Knowlton said patients can get a good doctor and good care at hospitals with a C grade, “but the likelihood of harm being done to you at Gaston Memorial (which received an A) is significantly less.”
Leah Binder, CEO of the Leapfrog Group, added: “What we need is for the public to put pressure on hospitals to make this a priority.”
‘Culture of safety’
Officials at CaroMont, which owns Gaston Memorial, credited their high score to the “culture of safety” they have created in the past two years.
Chief medical officer Dr. Jerry Levine said the hospital has five councils of physicians and administrators focused on oncology, cardiovascular disease, orthopedics, primary care, and women’s/children’s care.
The groups meet every other month to review data, such as the number of surgical-site infections. Instead of disguising doctors’ names, as they would have done in the past, the names are transparent, and doctors discuss openly the reasons for the differences in outcomes and complications.
“That’s part of the culture shift,” Levine said. “They (doctors) are the ones that have to drive this process of change. ... It’s really opening up the curtain.”
Dr. Roger Ray, chief medical officer for Carolinas HealthCare System, said he wasn’t sure why Carolinas Medical Center and other system hospitals didn’t score better.
“I’m not criticizing them,” Ray said. “They’re probably not aware that we’re as far along as we are.”
Carolinas HealthCare was chosen to be one of 26 Hospital Engagement Networks by the federal Centers for Medicare and Medicaid Services. As a result, it received $4.3 million to demonstrate patient safety improvements in 10 areas, such as prevention of falls and bloodstream infections.
Also, CMC and CMC-NorthEast recently received patient safety excellence awards from Health Grades, a private company that develops quality and safety ratings of health care providers.
Finally, Ray said Carolinas HealthCare is more than halfway through the process of installing a computerized physician order-entry system. That is one of the steps recommended to reduce medication errors.
Missy Danforth, Leapfrog’s senior director for hospital ratings, pointed to some factors that drove down the scores at Carolinas HealthCare hospitals in Charlotte: They had not reported their work on a computerized prescription system. Also, she said CMC, CMC-Mercy and CMC-University scored below most others on some outcome measures, such as “death from serious treatable complications after surgery.”
Theresa Smiley, director of quality performance for Novant Health, which owns Presbyterian hospitals, credited their good scores to a patient safety initiative called First Do No Harm. It includes mandatory training for all employees and doctors on good practices, such as hand-washing after every patient encounter and double-checking names and birth dates before giving medicines.
“We have a very strong safety culture,” Smiley said.
How scores were developed
The Hospital Safety Score uses 26 national performance measures from the Leapfrog Hospital Survey, the Agency for Healthcare Research and Quality, the Centers for Disease Control and Prevention, and the Centers for Medicare and Medicaid Services.
Those measures were used to produce a single score that represents a hospital’s overall performance in keeping patients safe.
Although consumers won’t be able to identify a hospital’s specific problems, the score is still useful, said Knowlton, who chairs Leapfrog’s patient safety committee.
“What I’ve found is it’s a culture,” he said. “If they’re not doing well in safety, they’re not doing well in a number of areas.”
No Ds and Fs were reported for now. Hospitals that received those grades are listed as “score pending” and will have six months to improve, Knowlton said. The lower scores will be published in September.
Of 59 hospitals graded in North Carolina, eight received As and only Johnston Memorial in Smithfield got a “score pending.” Of 39 S.C. hospitals graded, the only “score pending” went to Loris Community Hospital. Fourteen hospitals received As, including Springs Memorial in Lancaster.