Researchers evaluated more than 2,500 U.S. hospitals on five categories, including death rates among heart and surgery patients; readmissions (an event for which hospitals are now subject to penalties by the CMS); overuse of CT scans; the incidence of hospital-acquired infections; and on effective communication to patients about medications and discharge plans. Each hospital received a score between one and 100. The average was 51.
“That's just not good enough,” said Dr. John Santa, medical director of Consumer Reports Health. “These are major, preventable causes of death and suffering. We think they should be at the top of the list of priorities for hospitals.”
Among the hospitals scoring well above the average; Miles Memorial Hospital in Damariscotta, Maine, scored a 78; Oaklawn Hospital in Marshall, Mich., scored a 77; and Aurora Medical Center of Oshkosh in Wisconsin scored 75.
Among those who scored the lowest: Harris Hospital in Newport, Ark., and Lake Cumberland Regional Hospital in Somerset, Kent., both scored a 20; Tulane Medical Center in New Orleans scored a 19; and Bolivar Medical Center in Cleveland, Miss., scored an 11. Several of the low-rated facilities responded, saying their ratings do not necessarily reflect the recent progress they have made in addressing safety.
The data that was taken into account has a “considerable lag,” said Dr. Rusty Holman, chief medical officer for Life Point, which owns and operates Bolivar Medical Center, the lowest ranked hospital on the survey. Since that hospital system got involved in 2012 with the Hospital Engagement Network, a part of the CMS Partnership for Patients program, he said Bolivar Medical Center has seen significant improvements in quality and safety measures, including a 45% drop in mortality rates and a 9% reduction in readmissions. “These improvements are happening in real time,” Holman said, “and we expect they are going to be reflected in future publications.”
A representative from Harris Hospital, ranked third from the bottom, said it has also instituted changes during the past calendar year.
“We have seen significant progress in … reducing infections and (improving) communication with patients about their medications. This success will be reflected in future updates to public reports,” a hospital spokesperson said, noting that it is already being recognized for its efforts. “Last October, our hospital was recognized as a top performer on key quality measures by the Joint Commission, based on our effective use of evidence-based clinical process shown to improve care for certain conditions.”
Santa said Consumer Reports uses the most current data from the federal government. For this particular rating, it obtained CMS data on blood, surgical and catheter infections from April 2012 to March 2013; avoiding readmission from July 2011 to June 2012; avoiding medical mortality from July 2009 to June 2012, avoiding surgical mortality from July 2010 to June 2012; communication from April 2012 to March 2013; and on overuse of brain scans from January 2011 to December 2011. It is quite possible, Santa said, the low-scoring hospitals may have more current data that had not been reported to the federal government.
“We're in a tricky and awkward phase in terms of how hospitals are being evaluated,” said Santa, who also noted that various reports—Leapfrog, Hospital Compare, the Joint Commission and the hospitals themselves—all have different models.
“The science of performance management is still in the early stage and we have not all come together and agreed on an evaluating system.” There are many dimensions to hospital safety and no single measure captures everything, he said.
The new report also found that only 35 hospitals earned a top rating in terms of ensuring that a patient admitted for a heart attack, heart failure or pneumonia did not die within 30 days of admission; 66 hospitals received a low rating in this category. One hundred and seventy-three hospitals scored highly in reducing surgical mortality, but 288 received the lowest rating. For every 1,000 surgical patients who develop serious complications in a top-rated hospital, 87 or fewer died, compared to 132 deaths in low-rated hospitals.
“The differences between high-scoring hospitals and low-scoring ones can be a matter of life and death,” Santa said. He also noted that simple policy changes can make a significant difference, but leadership has to make safety a priority.
“In high performing hospitals, I often find the CEO has made it clear this is priority No. 1,” he said. “If the CEO makes this a top priority, it happens, if they don't, it doesn't.”
Follow Sabriya Rice on Twitter: @MHSRice