Report: Delaware ties for worst state in hospital safety
Delaware is one of the worst states in the U.S. for hospital safety, even though it was in the top 10 only five years ago, according to a national report released this week.
The First State tied with the District of Columbia and North Dakota for 49th, or last place, in Leapfrog's "Hospital Safety Grade." The watchdog organization, which seeks public information about patient safety and quality, assigns letter grades to 2,600 U.S. hospitals every six months.
Because none of the hospitals in Delaware, D.C. and North Dakota got an A this year, all three automatically moved to the bottom of the list, said Erica Mobley, a Leapfrog spokeswoman.
The six Delaware hospitals received the following grades for fall 2017:
- Bayhealth Kent General — C
- Beebe Healthcare — B
- Christiana Care Health System, Christiana Hospital — B
- Christiana Care Health System, Wilmington Hospital — B
- Nanticoke Memorial Hospital — C
- St. Francis Hospital — C
Leapfrog tends to give tougher grades than the Centers for Medicare and Medicaid Services, which rates about 90 percent of U.S. hospitals as "average." Leapfrog's grades take into account medical errors, injuries and infections, responses from patient surveys and data from the CMS, the American Hospital Association.
Bayhealth is not a member of Leapfrog, and the data presented in the report is limited to information that is publicly available, said Dr. Eric Gloss, vice president of the hospital's medical affairs. He added that the hospital is the first in the state to institute High Reliability Organization principles and practices, which he believes will improve the quality of care.
"Delawareans can be sure that Bayhealth has a strong safety culture that protects our patients, visitors and employees," Gloss said.
Sharon Harrington, director of marketing and outreach for Nanticoke Health Services, said some of the data collected by Leapfrog dates back as far as 2013 and doesn't "reflect some of the recent measures put in place by Nanticoke and other quality monitoring agencies."
Several initiatives are also in the works to continue to monitor and address any potential safety issues, she said.
Marcy Jack, Beebe's chief quality and safety officer, said the hospital supports Leapfrog's work and its goal is to "consistently achieve a Leapfrog Hospital Safety Grade of 'A.'"
Beebe is implementing strategies to "achieve the best outcomes and lowest complication rates and bring hospital acquired infection rates to their lowest attainable and sustainable level with the ultimate goal of zero," Jack said.
Sharon Anderson, chief population health officer at Christiana Care, said the hospital system gains insight from all "respected national hospital ratings systems that help us to continually improve care."
She said the hospital system has been recognized by a handful of organizations this year, including U.S. News & World Report, which named Christiana Care the No. 3 hospital in the Philadelphia region and the No. 1 hospital in Delaware earlier this year.
Representatives for St. Francis could not be immediately reached for comment.
Leapfrog has released grades since 2012, and in that time, Oregon, Rhode Island, Hawaii, Wisconsin and Idaho had the most significant improvement. Delaware, on the other hand, was one of the states that had the most drastic decline. In 2012, it was ranked No. 8.
Mobley said medical errors are the third leading cause of death in the U.S., behind heart disease and cancer. Johns Hopkins University researchers found last year that these errors kill more than 250,000 people every year.
"Overall, we’re not seeing a lot of movements and improvements we want to see," she said.
University of Delaware professor Yi-Lin Tsai, who specializes in data analytics, said comparing the states by the percentage of A-graded hospitals is one way to do a rankings, but "not necessarily the ideal way."
While some states might have more A-graded hospitals, other states might have a better overall grade average. Just because some states have A hospitals doesn't necessarily mean an average resident will receive safer treatment, he said.
University of Michigan researchers raised questions about Leapfrog's methods in a study published in the journal Medical Care in March.
They found that most hospitals that participate in the Leapfrog survey self-report say they perfectly comply with most of the safe practices. But how a hospital did on these measures had "little in common with independent measurements of hospital-acquired infections, or with whether the government penalized the hospital for high infection or readmission rates," researchers said.
Some hospitals would have gotten better grades when they didn't report than when they reported imperfect compliance, researchers said.
One factor that hurts Delaware is its size and therefore limited number of hospitals, Mobley said. Several of Delaware's hospitals have earned A's in previous reports so it is important for Delawareans to take the grades "with a grain of salt," she said.
Leapfrog found that infections are one of the biggest factors in hospital safety — and can also be the most preventable. The most effective way to prevent infections is hand washing. Leapfrog said if hospitals have a hand hygiene policy, then there's a higher level of oversight and its seen as a priority.
Both Christiana Care hospitals and Nanticoke were deemed "above average" in the area of handwashing. Beebe, Bayhealth and St. Francis declined to report their respective policies on handwashing, according to Leapfrog's website.
Contact Meredith Newman at (302) 324-2386 or at email@example.com. Follow her on Twitter at @merenewman.
To learn more about the hospitals' grades, go to hospitalsafetygrade.org.