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Wednesday, October 23, 2013

Patient harm escalates: patient safety is elusive.

Washington Bureau
Published: 22 October 2013 08:14 PM
Updated: 23 October 2013 12:47 AM

Parkland Memorial Hospital, which has a new facility under construction, saw its grade drop in the most recent Leapfrog safety ratings from A to C.
                Editorial: What Parkland needs in a new CEO
WASHINGTON — Sixteen of 41 Dallas-area hospitals slipped in safety ratings issued Wednesday by the nation’s largest self-insured employers.
Parkland Memorial Hospital and Baylor Medical Center at Carrollton fell two marks from A to C grades, while Texas Regional Medical Center in Sunnyvale fell from a B to a D.
Medical Center of Plano, meanwhile, went from a C to an A.
The grades, compiled by the Washington-based Leapfrog Group, are summations of 28 safety indicators and correspond to the letter grades most kids get in school.
Nine hospitals including Medical Center of Plano improved their grades from May’s evaluation. Another 16 hospitals stayed the same.
The middling showing for Dallas-area hospitals was reflected nationwide among 2,539 hospitals that were judged on the incidence of medical and medication errors, infections and injuries.
Two new types of hospital-acquired infections — for colon surgeries and urinary-tract catheters — were added to the latest report card. But a review of the data did not show they were responsible for the lower scores at some hospitals.
John T. James, a Houston toxicologist and head of an advocacy group called Patient Safety America, estimates that as many as 440,000 Americans die each year as a result of preventable harm while hospitalized.
The Leapfrog Group is made up of hundreds of large companies and includes the Dallas-Fort Worth Business Group on Health. It cited James’ findings in its latest report.
“We are burying a population the size of Miami every year from medical errors that can be prevented. A number of hospitals have improved by one or even two grades, indicating hospitals are taking steps toward safer practices, but these efforts aren’t enough,” said Leah Binder, president and CEO of the Leapfrog Group.
Parkland’s slump was “a disappointment,” said interim senior vice president Mike Malaise. The hospital had pulled itself up from a C to an A in Leapfrog’s May evaluation.
“We remain focused on sustaining the many improvements we have recently made. There is no question that Parkland is a much better health care provider than it was two years ago, but we must remain focused on continual improvement,” Malaise said in a statement.
No surprise
Medical Center of Plano’s jump from a C to an A was no surprise, said chief nursing officer Sandy Haire.
“We embrace public reporting of quality and safety data, and we work hard every day to improve the care we deliver. We fully anticipated our most recent score would accurately reflect our ongoing commitment to provide the highest level of quality patient care,” she said.
Baylor Health Care System saw grades fall at five of its nine Dallas-area hospitals, while one — Baylor Medical Center at Irving — improved from a B to an A.
Baylor chief quality officer Dr. Donald Kennerly said the hospital group supports Leapfrog and other evaluators, but he said it has improved by its own measures.
“Since there is no nationally accepted yardstick to judge patient safety, we use a variety of measures to evaluate our performance monthly, many of which are not available to Leapfrog,” he said.
“By constantly measuring and working to improve patient safety at all of our facilities, we have seen a more than 40 percent reduction in preventable adverse events over the past five years,” Kennerly said.
Texas Regional Medical Center and Dallas Medical Center (formerly Texas Hospital for Advanced Medicine) were the only area hospitals to get a D grade.
Texas Regional argued it would do better once more recent results become available.
First few years
“Much of the data Leapfrog used for this year’s assessment is based on the hospital’s first few years of business. Since Texas Regional Medical Center at Sunnyvale opened in September 2009, we are always improving,” said Dani Morales, the hospital’s director of quality.
Even though this is the second report card issued in 2013, Leapfrog officials said they were basing their latest results largely on data submitted a year or two ago by the hospitals to the federal government.
Hospitals are required to report information on medication errors, surgical site infections, bedsores, falls and other maladies that occur while patients are hospitalized. The information is summarized for consumers at
Those results plus information on electronic health records, staffing and training are sifted by Leapfrog analysts and reviewed by a panel of hospital safety experts.
Leapfrog analysts say they work with the latest data and invite hospitals to update information as it becomes available.
The Leapfrog grades are available at
Follow Jim Landers on Twitter at @landersjim.

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