Is it safe? This was the classic line from the movie Marathon Man, referring to a cache of stolen diamonds. But it could easily be asked of each of the nations hospitals. And the answer for most of them is that things may be getting better, but theres still much room for improvement.
This is the conclusion reached by The Leapfrog Group based on its latest report card on about 2,500 hospitals, which found that 790 earned an A, 688 got a B, 868 received a C, 148 made an D and 26 flunked. Maine once again claimed the number-one spot with 67 percent of its hospitals earning an A.
Despite the efforts of many patient safety and advocacy groups, more than 1,000 people die each day in the U.S. because of preventable hospital errors. That doesnt include the many others who survive accidents and injuries that take place in a hospital setting, reinforcing the need for hospital vigilance and patient awareness.
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Since medical mistakes in hospitals also impact businesses, Leapfrog has developed a
While the data tells us that hospitals are improving their safe practices, its concerning to see them moving backwards on any measure, says Leah Binder, Leapfrogs president and CEO. Patients enter a hospital trusting theyre in a safe place, but with 41% of hospitals receiving a mediocre-to-poor grades, its clear that some hospitals are safer than others. The recent experience with Ebola virus is cause for additional concern.
More good news is that hospitals soon will get help from the
PSMs Actionable Patient Safety Solutions focus on 9 key areas that are challenging hospitals:
Failure to rescue: Post-operative respiratory depression
Complications are inevitable and they are not always avoidable or the result of errors. However, when a patient dies because of a complication that was not recognized in a timely manner or treated appropriately.
Medication errors
These errors, defined as a preventable adverse event or effect of care, are a leading cause of death in the United States exceeding deaths attributable to motor vehicle accidents, breast cancer and heart failure. They include inaccurate or incomplete diagnosis or treatment, as well as when an appropriate method of care is executed incorrectly. Human error has been implicated in nearly 80 percent of adverse events that occur in complex healthcare systems.
Sub-optimal red blood cell transfusion
RBC transfusions rates or practices are highly variable by institution, procedure, and physician. Evidence from observational studies shows RBC transfusions can increase mortality by 69% and morbidity by 88%.
Central-line associated bloodstream infections
New methodology enables CDC and HICPAC to improve the validity and usability of its guidelines while also addressing emerging challenges in guideline development in the area of infection prevention and control.
Sub-optimal neonatal oxygen targeting
Unnecessary oxygen and the prolonged hospital stays add significantly to health care costs and, of course, lead to tremendous economic and emotional costs of preventable chronic conditions.
Failure to detect critical congenital heart disease
Nearly 40,000 infants are born with CHD per year in the U.S. and some 1.3 million globally. About 50% of CCHD deaths have been attributed to late or missed diagnosis. It is estimated that 2,000 infants/year die or have missed diagnosis in the U.S.
Health care-associated infections
Approximately 1 out of every 20 hospitalized patients will contract a health care-associated infection. More than 1.7 million patients will be infected with an HAI, and 99,000 of them will die, each and every year.
Hand-off communications
About 80 percent of serious medical errors involve miscommunication during the hand-off between medical providers. Breakdown in communication was the leading root cause of sentinel event between 1995 and 2006.
Creating a culture of safety
Almost one-third of patients are unintentionally harmed during a hospital stay through the absence of a culture of safety, where protecting patients is among the highest priorities.
Ozga is president of Medical Business Exchange, a health care consulting firm based in Vienna, VA and is active on patient safety issues.
