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CMH: ‘A’ for hospital safety / January 09, 2013
A national non-profit group studying hospital safety has assigned an ‘A’ grade to Community Memorial Healthcenter, making the South Hill hospital the only one of five in the area to receive the top rating.

The grades were issued this week by The Leapfrog Group, a national nonprofit organization whose mission is to promote improvements in safety, quality, and affordability of health care.

Person Memorial Hospital in Roxboro, N.C. received a B grade, while Granville Medical Center in Oxford, N.C., Maria Parham Hospital in Henderson, N.C., and Halifax Regional Health System in South Boston each received C’s.

The grades, which draw on data which health care providers report to the federal government and other sources, reflects hospitals’ success in preventing medical errors, injuries accidents, and infections among its patient population. It also measures hospital performance, according to Leah Binder, president and CEO of The Leapfrog Group, “in the very basic blocks of medical care, such as hand-washing, computerized medication control, and nurse staffing levels.”

“Hospitals like this that earn an A have demonstrated their commitment to their patients and their community. I congratulate Community Memorial Healthcenter for its safety excellence, and look forward to the day when all hospitals will match this standard,” said Binder.

CMH is among the 43 percent of Virginia hospitals that received an A grade, placing Virginia eighth in the U.S. with the highest number of top-rated hospitals. Nationally, 30 percent of the more than 2,600 hospitals that were evaluated received an A rating, while 38 percent —1,004 hospitals — got a C rating.

CMH officials hailed the findings of the study. “We take very seriously our responsibility of providing high quality, compassionate care to our community and being recognized as an A graded hospital for patient safety is a resounding endorsement for the quality work being done here at CMH,” said CMH President-CEO Scott Burnette. “Absolute patient safety is the most important aspect of the comprehensive care and service we deliver, and we’re honored to be among the organizations earning top marks from Leapfrog.”

The Leapfrog Group said the ratings are a way to provide the public with information they can use to protect themselves and their families — by knowing how often a hospital gives its patients recommended treatment for a given medical condition or procedure, the environment in which patients receive care, and what happens to a patient while receiving care.

“One in four Medicare patients will walk out of a hospital with an issue they didn’t walk in with, many of which are fatal,” said Binder. “Some people do more research on what car to buy than what hospital to go to for medical care.

“A hospital may have the best surgeons and greatest technology in the world, but unless it is preventing infections, and eliminating medical and medication errors and injuries, it is not delivering on a very basic premise: ensuring the safety of you and your loved ones.”

The goal of the hospital safety report is to reduce the more than 180,000 deaths annually from hospital errors and injuries “by publicly recognizing safety and exposing harm.”

Both CMH and Halifax Regional Hospital in South Boston ranked among the best performing hospitals in three areas, with no or very few patients experiencing the following problems:

• Foreign object retained in patient after surgery

• Air embolism (air or gas bubbles blocking the bloodstream)

• Stage 3 and 4 Pressure Ulcers (bed sores)

CMH also scored well on other metrics, including prompt and appropriate use of antibiotics and prompt removal of urinary catheters. The hospital also had a sterling score on avoiding patient falls and trauma, with a rate of reportable incidents that was less than half the national average.

Three areas where CMH did not receive a top rating in terms of patient care — its scores put CMH at or slightly worse than the average for hospitals – were for patients who developed blood clots in their legs, thighs or pelvis despite doctors’ preventative steps (average score was 4.53 and CMH‘s score was a 5.15, with a low score desirable), and with wounds that split open after surgery (average score was a .96 and CMH got a 1.58). In both of the above categories, the lower the score the better the hospital performed.

The third area where CMH did not receive a top rating was with the discontinuance of antibiotics given before surgery to prevent infections after 24 hours following a routine procedure. The average performing hospital scored 96.1 out of 100 with 100 being perfect. CMH scored 93 out of 100.

Sherri Bee, clinical director of Cardiovascular Services & Quality at Halifax Regional, said while the hospital does not participate with Leapfrog, because its measures are geared more toward large teaching hospitals, it does regularly monitor for quality. “Leapfrog also picked only a few core standards by which hospitals are measured. These do not give a full picture of a hospital’s performance overall.”

For example, Halifax recently started using a computerized system for entering prescription information into patients’ medical records, she said, and this fact is not reflected in the score because the system was put in place after the scoring was completed.

“We are always looking at how we can improve and provide the best care for our patients,” said Bee.

She added that Halifax Regional, like most hospitals, reports not just safety standards, but “ten domains of care” to the Center for Medicare and Medicaid Services [CMS].” The domains measure overall patient satisfaction by looking at safety issues, cleanliness, communication and responsiveness.

CMS is the organization from which Leapfrog drew its records, and Bee said Halifax “is above the database mean in all CMS areas except one.”

The lone area where Halifax is deficient, she said, occurs when patients are asked if they would recommend Halifax for a particular treatment that is not offered at the hospital. “The patient says no, because it is not offered. CMS still records that as a negative response,” Bee explained.

Specific areas where Halifax measures above average include: cleanliness, pain management for patients, communication about medicines, overall communications from doctors and nurses to the patients, and with providing discharge information, she said.

The hospital safety score was compiled by a panel of nine top experts in patient and hospital safety, including Harvard University’s Drs. Ashish Jha, Sara Singer, and Lucian Leape, University of Michigan’s Dr. John Birkmeyer, Stanford University’s Dr. Arnold Milstein, John Hopkins University’s Peter Pronovost, University of California/Davis’ Patrick Romano, Vanderbilt University’s Tim Vogus, and University of California/San Francisco’s Robert Wachter.

The hospital safety reports, searchable by zip code, are available at Leapfrog’s report website:

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