Patient safety scores stir controversy, confusion

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As FierceHealthcare reported last week, hospitals got new safety report cards from the Leapfrog Group, with almost half of the facilities earning a C or below.  What was surprising was that some of the biggest and most renowned hospitals, such as Henry Ford Hospital in Detroit and the Cleveland Clinic's main campus, barely got a passing grade.

Despite intentions to better inform patients and motivate safety improvements, the report cards have drawn a lot of criticism, especially from hospitals that didn't make the grade.

Their chief complaint: The scorecards create a single letter grade for 26 different patient safety measures. Many of the low-scoring hospitals questioned how all of their efforts, especially ongoing improvements, could be evaluated with a one letter-grade scoring system.

The Cleveland Clinic disputed its C, pointing out that much of the data is old. "The question the public needs to be asking is, 'Are you working on this? Are you getting better?'" Michael Henderson, the Clinic's chief quality officer, told Kaiser Health News.

Similarly, C-scoring Mount Sinai Medical Center in New York blasted the scorecard saying, "It is an incomplete and imperfect snapshot, and much of the analysis is based on outdated information from disparate sources," in a statement to the Wall Street Journal's Health Blog.

According to critics, since the scores are based on Leapfrog surveys that hospitals participate in voluntarily and the Centers for Medicare & Medicaid Services Hospital Compare data, member hospitals have an  unfair advantage because they're getting scored on more elements.

Last fall, Cleveland Clinic, Henry Ford and Parkview Health in Indiana stopped reporting hospital-acquired infection rates to Leapfrog, for example.

Low scores also didn't sit well with Southcoast Health System and Southcoast Hospitals Group in Massachusetts--its Tobey Hospital and Charlton Memorial Hospital both earned Cs. It's "hard to have confidence in a study that also gets easily verifiable details wrong, such as the town in which one of our hospitals is sited," President and CEO Keith Hovan wrote in a recent letter to the editor of The Boston Globe.

But safety at Tobey and Charlton Memorial might actually not be that bad … that is, if you ask HealthGrades, which gave Southcoast a 2012 HealthGrades Patient Safety Excellence Award last week and put Tobey and Charlton Memorial in the top 5 percent of all U.S. hospitals for patient safety.

The motivation behind various report cards is important: increased transparency to encourage patient safety improvements and higher-quality care. But conflicting scores raise more questions than answers.

Each report card paints a different patient safety picture, confusing patients and potentially hurting hospital reputations.

With so many factors involved in keeping patients safe, healthcare consumers need to understand such rankings and "top hospital" lists are only small pieces of a much bigger patient safety puzzle.

Think back to your school days. Did you ever get a grade lower than you thought you deserved? Complaining never changed the grade. What worked for me was asking how I could do better next time--and following through.

So whether or not hospitals agree with the scores, criticizing them (or the methodology behind them) isn't going to make patients any safer at their facilities. So what can hospitals do to enhance safety and make sure they make it to the top of the class next time around?

For starters, they can work to improve communication between providers to do a better job at keeping their patients safe, or collaborate with other hospitals to boost care quality and reduce surgical site infections and adverse drug reactions.

What improvements and updated safety measures has your hospital implemented? What could make scorecards better represent hospital safety? - Alicia (@FierceHealth)