Iowa hospitals get grades from nonprofit group for safety, injuries
SIOUX CITY | Sioux City’s two hospitals scored average grades for patient safety from a national nonprofit organization that calls attention to deaths and injuries that result from medical errors.
UnityPoint Health — St. Luke’s Spring 2017 Leapfrog Hospital Safety Grade remained unchanged from 2014, when the hospital moved up from a “D” to a “C.” Mercy Medical Center, which earned an “A” in the spring of 2014, fell to a “B” later that fall. In the spring of 2016, the hospital dropped another letter grade to a “C,” which it has maintained.
Of the 31 hospitals in Iowa that were graded, 11 received “A’s,” six got “B’s” and 12 were given “C’s.” Two hospitals received a “D,” the lowest grade handed out in the state. Those hospitals were Mercy Medical Center of Des Moines and Mercy Medical Center — West Lakes in West Des Moines.
The three Siouxland hospitals to receive “A’s” were Avera Sacred Heart Hospital in Yankton, South Dakota; Lakes Regional Healthcare in Spirit Lake, Iowa; and Spencer Hospital in Spencer, Iowa.
“Our providers actively put patients and their safety at the heart of every decision, and care is always coordinated between clinics, hospitals or homes,” Mike Kafka, medical director of quality and safety for St. Luke’s, said in response to the hospital’s grade. “Our teams continuously prioritize best practices throughout the system to sustainably manage resources and ensure the best outcome for every patient at every time.”
In a statement, Dave Smetter, Mercy Medical Center — Sioux City’s vice president of communications and community development, said the hospital is committed to delivering innovative, safe and quality health care to every patient.
“To maintain our performance and focus, Mercy voluntarily seeks out some of the most rigorous certifications and accreditations available,” he said. “The findings of these reviews show a consistent conclusion — Mercy is a high performing organization in terms of quality and safety.”
The Leapfrog Group hands out letter grades from A to F to more than 2,500 U.S. general hospitals based on infections, injuries and medical and medication errors that are publicly reported.
Iowa ranked 22nd in the nation based on its percentage of “A” hospitals (35.5 percent). Maine earned the No. 1 spot with 68.8 percent of its hospitals receiving “A’s.” North Dakota, Alaska, Delaware and the District of Columbia tied for 47th place. No hospitals in those states received an “A” grade.
The Leapfrog Group says the choice of a hospital could be a life-or-death decision as hospitals vary greatly based on infection rates, surgical errors and patient injuries.
Mercy Medical Center — Sioux City recorded a zero, the best possible outcome, for preventing Methicillin-resistant Staphylococcus aureus infection, a type of staph bacteria that can cause life-threatening bloodstream infections, pneumonia and surgical site infections.
Mercy’s scores were worse than the average hospital’s scores for infection in the blood during an intensive care unit stay, infection in the urinary tract during an ICU stay and for Clostridium difficile infection or C. diff — a bacterium that can cause diarrhea, abdominal pain, loss of appetite and fever.
For surgical site infections after colon surgery, Mercy’s score was 2.647. The worst hospital scored a 3.461, while the average hospital had a score of 0.899. According to the Leapfrog Group, such an infection after surgery can be very serious as it could spread throughout the body, resulting in a long ICU stay or even death.
St. Luke’s fared better than the average hospital in four of those five categories. The hospital scored worse than Mercy (1.324) and the average hospital (0.893) for C. diff infection with a 1.397. In the patient falls category, St. Luke’s received a score of 1.198. Mercy’s scored a 0.276, which was better than the average hospital’s score of 0.390. The Leapfrog Group says falls, which can cause serious injury or result in death, commonly occur in hospitals when patients who can’t walk on their own try to get out of bed.
While the Leapfrog Group recommends that health care consumers seek out the safest hospital in their area, preferably one with an “A” grade, the ranking is one of several that patients can consider when choosing a hospital. For example, the Centers for Medicare & Medicaid Services (CMS) offers an online Hospital Compare tool which gives hospitals an overall star rating.
Although the Leapfrog Group uses national performance measures from its own hospital survey, as well as data from CMS, the American Hospital Association’s Annual Survey, the Centers for Disease Control and Prevention and other sources to generate its grades, the independent organization has come under attack by researchers.
A University of Michigan study published in March in the journal Medical Care found that more than 50 percent of hospitals that participated self-reported perfect scores for all but one Safe Practices Scores measure. Researchers concluded that Safe Practices Scores had little connection to hospital-acquired infections or whether CMS imposed penalties for excessive readmission rates and high rates of patient injuries.
Kafka said St. Luke’s doesn’t voluntarily report to Leapfrog’s Hospital Survey, but does provide data to other agencies that measure patient safety.
“Providing additional data to Leapfrog is not required to receive a safety grade, however, other independent groups have ranked St. Luke’s high in patient safety absent self-reporting,” he said.
Smetter said Mercy believes in open communication and the reporting of quality and safety results, but recognizes that “the sheer volume of ratings surveys and methodologies such as the Leapfrog Survey can lead to confusion.”
He cited a study conducted by Johns Hopkins researchers that evaluated measures for hospital safety used by common public ranking systems, including Leapfrog’s Hospital Safety Score. The study, which was published in the journal Medical Care in December 2016, found only one measure out of 21 that met scientific criteria for being considered a true indicator of hospital patient safety.
“As an acute care medical and referral center, Mercy serves many patients suffering from traumatic injuries and critical illnesses,” he said. “Despite caring for high volumes of these most critical patients, Mercy meets or exceeds quality and safety targets.”
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