26-Oct-2011 he results of a national survey on hospital quality and safety show St. John’s Medical Center has room for improvement on a number of key patient safety measures.
In its first year participating in the Leapfrog Hospital Quality and Safety Survey, St. John’s received the lowest possible marks in several categories, including preventing medication errors, reducing bed sores and reducing in-hospital injuries.
The hospital did, however, fully meet standards in normal deliveries and made some progress toward meeting standards in treating pneumonia, the only two treatment categories on which the hospital was rated.
St. John’s says a number of categories in the survey do not necessarily apply to smaller, rural hospitals, and points out that it has initiated or will be initiating several new safety measures.
“Quality is something we’re always focused on,” CEO Pam Maples said. “We look for ways to continue to improve patient care.”
The survey’s director, Matt Austin, said St. John’s low marks could partially be explained by the fact that this is the hospital’s first year participating in the survey. He said the full standards the survey measures are exacting and can take some time for hospitals to reach.
“The standards we’re asking hospitals to implement are pretty substantial changes culturally,” Austin said.
Overall, Austin said he appreciates St. John’s participation in the survey and hopes the hospital will be able to use the results to improve patient services.
“There’s an opportunity for the hospital to work on some of the areas now,” Austin said. “It’s much easier to manage something out in the open than something that’s secret.”
Transparency is goal
The survey is conducted each year by The Leapfrog Group, an initiative led by organizations that buy health care and are working for improvements in the safety, quality and affordability of care.
Started in 2001, the survey assesses hospital performance based on several criteria that are proven to reduce preventable medical mistakes. It is recognized by the National Quality Forum, a nonprofit organization that produces industry-recognized standards.
“Our goal is transparency, to share information with consumers and purchasers,” Austin said. “The scores are meant to help with decision making.”
A total of 1,300 hospitals across the country now participate in the survey, which can be viewed at www.leapfroggroup.org/cp.
In Wyoming, the survey effort is spearheaded by the Wyoming Business Coalition on Health, which was formed to bring together businesses that purchase healthcare in order to effect change.
“There is no silver bullet to fixing health care,” said Anne Ladd, the coalition’s CEO. “But we believe transparency is a platform for saying ‘this is where we are, and how do we get to where we need to be.’”
St. John’s participated this year after encouragement from several trustees, Maples said. “We thought we’d try it out,” she said, noting St. John’s also gets comparative data from VHA and Hospital Compare, other measures of quality and safety.
Willing to report
The results from the Leapfrog survey show that some of the data St. John’s submitted does not appear to be in line with national standards in several areas.
Out of seven patient safety categories in the survey, St. John’s received the lowest possible score — “willing to report” — in five categories, and declined to respond in another. The “willing to report” label means the hospital is in the lowest quartile for that category, according to the survey.
St. John’s did fully meet standards in the “managing serious errors” category because it has a policy in place to manage “never events,” such as surgery on the wrong body part or death from contaminated drugs or devices.
The survey criteria are based on rates seen across the country, and for the most part are applicable to hospitals of all sizes and in all locations, Austin said.
However, St. John’s said that in some cases the categories should not apply to a hospital of its size, and that in other categories they have made improvements that were not taken into account in the survey.
For example, the “appropriate ICU staffing” category requires hospitals to have an intensivist — a critical-care medicine specialist — available to the intensive care unit at all times, which isn’t feasible for smaller hospitals, Maples said.
She said St. John’s doesn’t see the volume to support a full-time specialist in the ICU, but that they have plenty of hospitalists with critical-care experience.
The other potential challenge for smaller hospitals is in the “preventing medication errors” category. To fully meet those standards, hospitals must enter at least 75 percent of medications through a computerized physician-order entry program, which passes records through a computer network.
St. John’s did not have a computerized entry system at the time of the survey, but it plans to implement one in the coming months, Maples said. The hospital also recently started bar coding medications.
To fully meet the standard for “reducing pressure ulcers,” or bed sores, hospitals need to report zero ulcers. St. John’s reported three new bed sores for 5,551 patient hours, which it considers fairly low, but which received a minimum score on the survey.
The standard for “steps to avoid harm” is the implementation of 17 nationally-recognized safe practices. The hospital fully implemented one of those standards, partially implemented another 15, and received no score for one, according to the survey.
To address that category, Maples said the hospital recently created a patient safety team, has increased checklist usage and is standardizing protocols.
Finally, the survey reports that St. John’s declined to respond in the “reduce ICU infections” category. Maples said that was the result of a misunderstanding regarding how a question should be answered.
In its first year participating in the Leapfrog Hospital Quality and Safety Survey, St. John’s received the lowest possible marks in several categories, including preventing medication errors, reducing bed sores and reducing in-hospital injuries.
The hospital did, however, fully meet standards in normal deliveries and made some progress toward meeting standards in treating pneumonia, the only two treatment categories on which the hospital was rated.
St. John’s says a number of categories in the survey do not necessarily apply to smaller, rural hospitals, and points out that it has initiated or will be initiating several new safety measures.
“Quality is something we’re always focused on,” CEO Pam Maples said. “We look for ways to continue to improve patient care.”
The survey’s director, Matt Austin, said St. John’s low marks could partially be explained by the fact that this is the hospital’s first year participating in the survey. He said the full standards the survey measures are exacting and can take some time for hospitals to reach.
“The standards we’re asking hospitals to implement are pretty substantial changes culturally,” Austin said.
Overall, Austin said he appreciates St. John’s participation in the survey and hopes the hospital will be able to use the results to improve patient services.
“There’s an opportunity for the hospital to work on some of the areas now,” Austin said. “It’s much easier to manage something out in the open than something that’s secret.”
Transparency is goal
The survey is conducted each year by The Leapfrog Group, an initiative led by organizations that buy health care and are working for improvements in the safety, quality and affordability of care.
Started in 2001, the survey assesses hospital performance based on several criteria that are proven to reduce preventable medical mistakes. It is recognized by the National Quality Forum, a nonprofit organization that produces industry-recognized standards.
“Our goal is transparency, to share information with consumers and purchasers,” Austin said. “The scores are meant to help with decision making.”
A total of 1,300 hospitals across the country now participate in the survey, which can be viewed at www.leapfroggroup.org/cp.
In Wyoming, the survey effort is spearheaded by the Wyoming Business Coalition on Health, which was formed to bring together businesses that purchase healthcare in order to effect change.
“There is no silver bullet to fixing health care,” said Anne Ladd, the coalition’s CEO. “But we believe transparency is a platform for saying ‘this is where we are, and how do we get to where we need to be.’”
St. John’s participated this year after encouragement from several trustees, Maples said. “We thought we’d try it out,” she said, noting St. John’s also gets comparative data from VHA and Hospital Compare, other measures of quality and safety.
Willing to report
The results from the Leapfrog survey show that some of the data St. John’s submitted does not appear to be in line with national standards in several areas.
Out of seven patient safety categories in the survey, St. John’s received the lowest possible score — “willing to report” — in five categories, and declined to respond in another. The “willing to report” label means the hospital is in the lowest quartile for that category, according to the survey.
St. John’s did fully meet standards in the “managing serious errors” category because it has a policy in place to manage “never events,” such as surgery on the wrong body part or death from contaminated drugs or devices.
The survey criteria are based on rates seen across the country, and for the most part are applicable to hospitals of all sizes and in all locations, Austin said.
However, St. John’s said that in some cases the categories should not apply to a hospital of its size, and that in other categories they have made improvements that were not taken into account in the survey.
For example, the “appropriate ICU staffing” category requires hospitals to have an intensivist — a critical-care medicine specialist — available to the intensive care unit at all times, which isn’t feasible for smaller hospitals, Maples said.
She said St. John’s doesn’t see the volume to support a full-time specialist in the ICU, but that they have plenty of hospitalists with critical-care experience.
The other potential challenge for smaller hospitals is in the “preventing medication errors” category. To fully meet those standards, hospitals must enter at least 75 percent of medications through a computerized physician-order entry program, which passes records through a computer network.
St. John’s did not have a computerized entry system at the time of the survey, but it plans to implement one in the coming months, Maples said. The hospital also recently started bar coding medications.
To fully meet the standard for “reducing pressure ulcers,” or bed sores, hospitals need to report zero ulcers. St. John’s reported three new bed sores for 5,551 patient hours, which it considers fairly low, but which received a minimum score on the survey.
The standard for “steps to avoid harm” is the implementation of 17 nationally-recognized safe practices. The hospital fully implemented one of those standards, partially implemented another 15, and received no score for one, according to the survey.
To address that category, Maples said the hospital recently created a patient safety team, has increased checklist usage and is standardizing protocols.
Finally, the survey reports that St. John’s declined to respond in the “reduce ICU infections” category. Maples said that was the result of a misunderstanding regarding how a question should be answered.
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