Survey evaluates safety of hospitals


The rate of deaths from serious treatable complications after surgery at both Desert Springs and Summerlin hospital medical centers ranked as nearly the worst in the nation, according to a report that will be issued today by one of the nation's leading patient safety organizations.

At the same time, the Southern Nevada hospital with the lowest death rate from surgical complications, Southern Hills Hospital and Medical Center, still had a rate double that of the U.S. hospital with the least number of deaths in that category.

The Leapfrog Group hospital survey, which will be released today in Washington, D.C., also revealed that only one local hospital staffed its ICU with a specialized intensivist physician to minimize errors: St. Rose Dominican Hospitals, de Lima campus.

Despite that sobering news, three hospitals in Southern Nevada - Southern Hills, St. Rose Dominican Hospitals, de Lima campus, and Valley Hospital Medical Center - were among 729 hospitals in the nation to be awarded an A grade by Leapfrog, which means they had safety scores above 3.133.

Data from sources that include the Agency for Healthcare Research and Quality, the Centers for Disease Control and Prevention, and the Centers for Medicare and Medicaid Services from 2010 were weighted by patient safety experts to produce a composite score that is published as a letter grade. Twenty-six safety measures were analyzed for 2,664 hospitals nationwide.

Five valley hospitals - Desert Springs, MountainView Hospital, North Vista Hospital, St. Rose Dominican Hospitals, Siena campus, and Spring Valley Hospital Medical Center - received B grades, with scores above 2.964. Local hospitals that received a C grade, above 2.476, were Centennial Hills Hospital, Summerlin, Sunrise Hospital and Medical Center, University Medical Center and St. Rose Dominican Hospitals, San Martin campus.

"We want to give consumers a tool they can use," said Leah Binder, CEO of Leapfrog. "Where you go to the hospital can literally be a life and death decision."

Binder said she didn't see any problems unique to Nevada.

The entire report can be viewed at www.hospitalsafetyscore.org.

When Dr. Lucian Leape, of the Harvard School of Public Health was informed of the rates of death from surgical complications at valley hospitals - ranging from 95.97 per 1,000 to 164.79 per 1,000 - he wondered aloud about how well surgical teams were working together and whether a surgical checklist was properly in use.

"We've found through research that surgical teams who take a timeout before surgery to make sure the right patient is to be operated on in the right place ... that the right blood is available, for instance, can reduce complications as much as 50 percent," he said. "Everybody must be in agreement that they're doing the same thing. Has everybody introduced himself? Is everybody comfortable about speaking up? How effectively they work together as a competent team makes a big difference."

According to the report, the lowest rate of deaths of patients from complications after surgery was 48.6 per 1,000 patients and the highest, 167.33. Leapfrog did not release the names of the institutions with those scores on Tuesday.

Southern Hills, which scored best in Las Vegas on that measure, had a rate of 95.97 deaths per 1,000 from surgical complications; Desert Springs' rate was 164.79 deaths per 1,000 and Summerlin's was 160.47.

Dan Davidson, a spokesman for the Sunrise Health System - Sunrise, MountainView and Southern Hills hospitals - said he is "pleased with the successes" of all three hospitals. Lori Harris, a spokeswoman for Desert Springs and Summerlin, said the hospitals "have dozens of safety initiatives in place."

Every day in the United States, Leapfrog statistics show, more than 400 people die of a preventable hospital error, the equivalent of a jumbo jet crash.

A 1999 report by the Institute of Medicine, which found that as many as 98,000 Americans die every year from preventable medical errors made in hospitals alone, gave Leapfrog its mission of reducing those errors. There are more deaths in hospitals each year from preventable medical mistakes than from vehicle accidents, breast cancer and AIDS, according to Leapfrog's statistics.

Another issue of concern in Leapfrog's study was the presence of intensivists in ICUs. Mortality rates are reduced, Leape said, by having a specialist on hand familiar with the complications that can occur in an intensive care unit.

Jennifer McDonnell, a spokeswoman for St. Rose Dominican Hospitals, said her hospital system is proud of its record, including its intensivist at the de Lima campus.

"Quality patient care is our No. 1 priority," she said.

Brian Brannman, CEO of UMC, said it won't be long before intensivists are on hand at University Medical Center.

"We agree that this is something very important," he said.

The 2010 data used by Leapfrog also showed that no local hospital had a computerized physician order entry system, which intercepts errors when they most commonly occur - at the time medications are ordered. But Lori Harris, a spokeswoman for Valley Health System in Las Vegas, said the electronic system was recently implemented in all five hospitals (Desert Springs, Centennial Hills, Spring Valley, Summerlin and Valley hospitals).

Harvard's Leape was stunned that no hospitals in Las Vegas were using computerized order entry systems as of 2010.

"It was demonstrated 15 years ago that these symptoms significantly decreased the risk of medication errors," he said, explaining that it not only cuts down on handwriting issues but also reduces dosage errors, including giving someone a drug he is allergic to or that will interact negatively with another drug.

Leape said it takes money and time to set the system up, but it is worth it "in lives."

Brannman said UMC is implementing an electronic system.

"The cost and staffing of it are high," he noted.

Why one hospital received an A grade and another a C can be illustrated in some of the outcome measures analyzed by Leapfrog. For instance, A hospitals Southern Hills, St. Rose Dominican Hospitals, de Lima campus, and Valley Hospital didn't have any patients suffer bedsores while C hospital Sunrise had 1.018 per 1,000 patients with bedsores.

In addition, fewer than two patients per 1,000 suffered accidental cuts or tears from medical treatment at A hospitals Southern Hills, St. Rose Dominican Hospitals, de Lima campus, and Valley while more than two patients per 1,000 had such accidents at C hospitals Summerlin, Sunrise, UMC and the St. Rose Dominican Hospitals, San Martin campus.

Hand hygiene programs in the valley were poorest at all three St. Rose campuses.

"We've made considerable improvements in quality metrics over the last two years," St. Rose spokeswoman McDonnell said.

Central line infections were nonexistent at Southern Hills Hospital. Central lines often carry medication and nutrition to patients.

"There's no reason that every hospital can't have zero central line infections," Harvard's Leape said. "If you follow the proper protocols, that's what happens."

Contact reporter Paul Harasim at pharasim@reviewjournal.com or 702-387-2908.

 

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