BR General tops in safety

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Baton Rouge General tops in safety; Ochsner gets B

Baton Rouge General Medical Center was the lone area hospital to get an A in Hospital Safety Score, a Leapfrog Group-created ranking of hospitals nationwide.

The grades are based on preventable hospital conditions, such as infections, medication errors, acquired injuries such as bedsores, and other sources of harm, including falls, that can often be fatal, according to the report.

Ochsner Medical Center-Baton Rouge received a B, while the other Baton Rouge-area hospitals received C’s, according to the report.

Some local hospitals complained of not receiving the report or knowing how grades were calculated and what they mean.

“We’re not saying that somebody who got a B or a C is a horrible hospital. We’re not,” said David Knowlton, president and chief executive officer of the New Jersey Healthcare Quality Institute and chairman of The Leapfrog Group’s Patient Safety Committee. “We’re saying we want everybody to get A’s.”

“Really there are two elements to your care. The first element is finding a physician and a team that’s going to provide optimal care …,” Knowlton said. “But then the other component that encompasses the majority of care in the hospital is what systems the hospital has in place to make sure the hospital is a safe place and to ensure that no harm is done to you by virtue of you being in the hospital.”

For example, a patient goes into a hospital for a hip replacement, the surgeon does a wonderful job and the operation is a success, Knowlton said. But while in the hospital, the patient picks up an infection and spends months fighting it off or, worse, dies from the complications.

Patients should consider the second element of care in deciding where to get care, he said.

The Leapfrog Group, whose membership includes various large corporations and public agencies that buy health benefits, uses employer-buying power to push the health industry to make big leaps in improving health-care safety, quality and customer value, according to its website.

The idea is to get people to ask questions, Knowlton said. Consumers may completely trust their doctors, but still be able to tell their physician they’re uncomfortable being sent to a C hospital.

Doing so will generate two results, Knowlton said. Doctors will put pressure on the hospital to do more to protect against errors, and hospital administrators will realize they have to pay more attention to patient safety or risk losing their physicians.

“Every time you take data and make it transparent, you bring about change and that’s what we’re trying to do,” Knowlton said.

In an email, Dr. Floyd Roberts, Baton Rouge General’s chief medical officer, said the hospital was pleased by its grade.

“Patient safety and quality are Baton Rouge General’s highest priorities and this is reflected in the culture of safety that we have created at our hospital,” he said. “We take a collaborative approach by engaging our physicians, frontline clinicians and staff in continuously enhancing our processes to provide the safest, highest-quality care for our patients,” Roberts said.

Amy Delaney, a spokeswoman for Ochsner, said the hospital’s administration and quality personnel had not gotten the report and could not comment.

“Since we have not seen the Leapfrog Group’s Hospital Safety Scorecard, and do not know the source of the data, we are unable to respond to these scores,” Teri Fontenot, Woman’s president and chief executive officer, said in a prepared statement.

Knowlton said Leapfrog had shared the data with the hospitals three weeks ago.

However, Woman’s and Ochsner are not alone in saying they had not seen the report.

According to the American Hospital Association, The Leapfrog Group had communications problems, so many hospitals were not able to see their own scores, had no information on how the scores were calculated or what the scores might mean.

Terrie Sterling, the Our Lady of the Lake’s chief operating officer, said the hospital has participated in a number of other databases that measure quality of care but this was its first time to participate in a Leapfrog Group database.

She is not sure the hospital will continue to do so.

The Lake was pleased by some of the results, she said. The Lake’s nursing score was 100 percent and its leadership ranking was also very strong.

But the hospital does have questions about other areas of the report, Sterling said.

Parts of the ranking were based on hospitals’ self-assessments, she said. The Lake graded itself stringently, but it’s possible other facilities took a different approach, she said.

The Lake’s analytics’ staff has taken a cursory look at the report but will drill down into the data for a more detailed review, Sterling said.

Sterling said the hospital was concerned that some Leapfrog participants, like the Cleveland Clinic, have opted out.

The Lake supports transparency and helping consumers make informed decisions, Sterling said. The Leapfrog rankings are just one source of information.

If consumers want updated information — Leapfrog used data from 2008 and 2010 — they can find it on the Lake’s website, www.ololrmc.com, she said.

Consumers will be able to access the Leapfrog ratings beginning Wednesday on hospitalsafetyscore.org.


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Comments (15)


1) Comment by rdm41234 - 13/06/2012

The 'lake' seems to want it both ways. When the reports are good then they exploit if for marketing purposes. When it's not so good, then they find something wrong with how the particular results were arrived at. Had this report been positive, the Cleveland Clinic, one of this country's most prestigious medical organizations, would not have been mentioned.

2) Comment by bourbon-soda - 07/06/2012

In addition, I cannot find an assertion that "non-clinical people will never know enough to make sense of this data and that different reporteda"quality' sources say varying things." The intelligent citizen should be able to understand the gravamen of these reports, or, why is this article in the newspaper? It is almost enough to make the citizen think that the "'quality' sources" are trying to obfuscate. The similarity to information regarding education is striking. It is also enough to make one think that G.B. Shaw had it right - all professions are a conspiracy against the laity.

3) Comment by bourbon-soda - 07/06/2012

I am not questioning the integrity of the data or results, merely its underlying logic as regards the patient, after looking at the weights assigned to different factors at the website. If your allegation regarding OLOL is true, why did OLOL not get a "D" or "F?" If the "infection issue" has been well known and not merely rumored for five years, why ware the affected facilities not shut down? What kind of doctor would choose to subject patients to the risk of operating there? Where are the whistleblowers and journalists?

4) Comment by polymath - 06/06/2012

To Bourbon-Soda, et al: The Leapfrog scores are primarily driven off of a hospital's clinical data from its billing information and, especially, required quality measures submitted to Medicare. These quality measures are not "self reporting" of a type where a hospital has leeway to put in what it wants. In fact, there are significant penalties for falsifying. A hospital must submit its data to one of several data vendors who put it in a format for Leapfrog. What i want to make clear is that these scores are driven off of what happens to patients, from a clinical basis, while they are in the hospital- given a certain diagnoses or procedure. I will agree with another comment made that non-clinical people will never know enough to make sense of this data and that different reported "quality" sources say varying things. As a disclaimer, I do not work for the BRGMC, but I have significant knowledge about the industry. Bottom line, it is well known throughout the local clinical community that OLOL has had significant infection issues, especially in the OR, that have been causing them big problems for the at least five years now.

5) Comment by Elderly Man - 06/06/2012

Good job. Thank you.

6) Comment by bourbon-soda - 06/06/2012

The people who conduct this kind of study tend to be obsessed with structure and process, probably because those things are more easily measured than is outcome, which gets complicated because of variability of raw material (patients or students, depending on whether talking about health care or schools). Also they have a vested interest in preserving the economic value of the credentials they grant to practitioners.

7) Comment by NewsReader - 06/06/2012

bourbon-soda, yup that pretty much summed up the way I read those results. Would be similar to rating a car dealer as being fantastic because they have only the best qualified ASE mechanics without verifying whether they were also performing their job the best and actually fixing your car. In this scenario a shop using unqualified mechanics who actually 99% of the time repaired your vehicle correctly would get a C.

8) Comment by bourbon-soda - 06/06/2012

So the outcome measure of whether a surgical patient with serious treatable complications goes out vertical or via the scenic route in the morgue weighs less than the structural measure whether Nurse Ratched sports the right credentials. It is also by no means clear that an A hospital is 25% better, especially in outcomes, than a B hospital. Smells very similar to the education grades that are usually published, to me.

9) Comment by bourbon-soda - 06/06/2012

It also seems to me that outcome measures might be underweighted compared to structural measures and process measures. The outcome is the only thing I really care about.

10) Comment by bourbon-soda - 06/06/2012

Newsreader, thanks. I tracked this to http://hospitalsafetyscore.org/wp- content/uploads/2012/06/Final_ScoringMethodology_June2012.pd f where I found weights of SP 9 Nursing Workforce - 3.3% and PSI 4 Death among Surgical Inpatients wit Serious Treatable Complications - 2.7%. Makes you go hmmmmm.

11) Comment by NewsReader - 06/06/2012

bourbon-soda, well there is a way: go to the website mentioned in the last paragraph and look at what all made up those grades. Pretty skewed if you ask me after perusing them. I am sure most people prefer a hospital where your chances of post-op survival are the highest. Not necessarily where admin is the best rated.

12) Comment by louisisanared - 06/06/2012

A immediate family member had surgery at OLOL Hospital and had to return 3 days after being discharged for an incision infection, they were in hospital an additional 5 days. This was a Hospital Acquired Infection and I have several stories from other patients of this facility that have gotten the same thing. This patient is also going to be on equipment and home health for at least 6 more weeks. On the first stay at hospital my relative was treated very poorly by the staff and nursing staff only came in room a couple of times a shift. But on their second stay during infection, the staff were better attentive, I wonder if it is because they were at fault for infection. Anyway, the relative that was in this facility was elderly and this could, and can, still be fatal to them. I do not know much about other facilities, but I have heard the Baton Rouge General was a better hospital for taking care of patients and less hospital acquired infections. I think this grading scale is on the money as far as Our Lady of the Lake Hospital is concerned, their lucky they didn't get a D.

13) Comment by bourbon-soda - 06/06/2012

As in education reporting, it is not possible for the reader to discern the meaning of these grades other than an "A" is better than a "B" is better than a "C." There is no way to know how much better, or whether the difference is significant.

14) Comment by Cousin Dave - 06/06/2012

It's easy to have a low number of accidents when you don't have many patients.

15) Comment by albermarle52 - 06/06/2012

OLOL has already begun its transformation into the new EKL. The General on Bluebonnet is the best. Kudos for Ochsner for running a decent facility on O'Neal.