Leapfrog Doles Out Safety Grades
The latest hospital safety survey by the Leapfrog Group suggests California's facilities are sort of like Lake Wobegon's children – not all of them are above average, but a large number of them certainly are.
However, the survey's controversy does not lie among the nearly 40% of hospitals that received “A” grades from the quality measurement organization, or the nearly 70% that scored a grade of “B” or better.
Instead, the issues lie with the remaining laggards: The 40% or so hospitals that received grades of “C” or lower. Some of those recipients are among the most prestigious or prominent institutions in California.
The hospitals were graded on 26 different safety issues ranging from the frequency of retained surgical objects to the prevention of bedsores, based on data they voluntarily reported to either Leapfrog or the American Hospital Association, and on data compiled by the Centers for Medicare and Medicaid Services.
Easily the most prominent in this group was Ronald Reagan UCLA Medical Center. It received a grade of “F” – one of only four hospitals in California and 25 nationwide to do so. Its score on preventing air embolisms – the introduction of potentially deadly air bubbles into the bloodstream during surgery or the introduction of catheters – was among the worst in the nation, according to Leapfrog.
Leapfrog recommends that patients only visit hospitals with an “A” grade. Leah Binder, Leapfrog's executive director, said that hospitals receiving “D's” and “F's” are the “most hazardous environments for patients in need of care.”
Binder termed the safety problem in the nation's hospitals as “terrible,” adding that 180,000 people die every year in hospitals due to medical errors, injuries, accidents and infections.
“Consumers, patients, families of patients, employers, unions, and hospitals themselves can all make a difference if we resolve here and now to make patient safety a national priority,” Binder said.
However, UCLA pushed back against Leapfrog's assessment.
“While we appreciate Leapfrog’s efforts to provide important hospital safety information to the public, the problem with nearly all of the hospital report cards promoted by various organizations is that there is no consistency,” the hospital said in a statement. “The same hospital can rank high on one report card and low on another report card.” UCLA inferred that Leapfrog should use publicly-reported quality data in order to compile a report card.
UCLA's other hospital, Santa Monica-UCLA Medical Center, received a “B” grade. UCLA Chief Executive Officer Tom Rosenthal, M.D., said in media interviews that the Leapfrog methodology was flawed.
Indeed, UCLA was not the only notable teaching institution in the U.S. to receive a poor grade. The Cleveland Clinic, one the nation’s premier research hospitals, was awarded with a “D.”
In California, Santa Clara Valley Medical Center, San Jose's public hospital, received a “D.” Cedars-Sinai Medical Center in Los Angeles, the city's most prestigious hospital, received a “C,” with relatively poor scores for in-hospital falls and traumas, pulmonary embolisms deep-vein thromboses, and the lack of intensivist physicians in the intensive care unit.
Spokespersons for both hospitals did not immediately respond to requests for comment.
All 30 of Kaiser Permanente's facilities in California received “A” grades, as did Stanford University Hospital & Clinics and 11 hospitals operated by Sacramento-based Sutter Health.
Nationwide, 2,618 hospitals were surveyed by Leapfrog. Of those, 790 received “A's,” 678 received “B's” and 1,004 received “C's.”
