The number of Nevada hospitals adhering to best practices on patient safety jumped in a new report from an independent, nonprofit health care organization.
The state’s overall ranking rose to 16th, up from 40th in the spring, according to data released late Wednesday by The Leapfrog Group. The rankings are based on the percentage of hospitals in the state earning A grades from the organization, which more than doubled in Nevada from just under 17 percent to 35 percent.
The rankings, released twice a year, are based primarily on data from the federal Centers for Medicare and Medicaid Services and augmented by a volunteer Leapfrog survey.
Leapfrog Group CEO Leah Binder said such sudden improvements are not uncommon when hospital staffs work together to address areas where they fall short on safety.
“When hospital associations and hospital groups work together to address patient safety and to collaborate to figure out best practices for improving their own safety, we see clusters of results like this where a whole state will show improvement,” she said.
Seven Nevada hospitals received top marks, including four in Southern Nevada: Henderson Hospital, MountainView Hospital, North Vista Hospital and St. Rose Dominican Hospital, de Lima campus. Northern Nevada Medical Center, Renown South Meadows Medical Center and St. Mary’s Regional Medical Center in Reno also received As.
North Vista in North Las Vegas, which jumped from a C score in spring to an A in the group’s latest report, was the only Nevada hospital to improve by two letter grades.
Those improvements were largely tied to low rates of hospital infection, death from complications after surgery and relatively few instances of “never events,” Binder said, or events that shouldn’t happen, like leaving a foreign object in a patient after surgery.
“That’s been an improvement for them, and it’s significant,” she said of the changes. “So it’s helped their grade immensely.”
The hospital, which largely serves a poor clientele, was investigated by the state in the summer over alleged abuse of mentally ill patients, but Binder said that may not have been reflected in the hospital’s ranking because there’s little data publicly available on the quality of inpatient psychiatric care at hospitals.
“This has been a major concern of ours for a long time,” Binder said. “If we had more measures on safety specifically for psychiatric care, we would use them in an instant.”
A spokeswoman for North Vista declined to comment on the hospital’s psychiatric care, but Chase Bennion, performance improvement manager for the hospital, said it has tightened its bedside medication administration processes and worked to prevent infections, which helped boost its score.
In addition to seven A grades among Nevada’s hospitals, three hospitals scored a B, and 10 scored a C. University Medical Center, Desert Springs Hospital Medical Center and Valley Hospital Medical Center all improved from a D last spring to a C but have frequently vacillated between the two grades in previous reports.
A spokeswoman for Desert Springs and Valley hospitals, which fall under the Valley Health System umbrella, said via email that the facilities “have action plans in place that utilize real-time data for continuous quality improvement efforts. These include implementing best practices and committee recommendations, along with ongoing employee and medical staff education.”
A spokeswoman for UMC said in an emailed statement that The Leapfrog Group “gives no consideration to these unique services and the overall acuity of UMC’s patient population,” referring to the hospital’s Level 1 trauma unit, transplant center, pediatric trauma unit and burn unit.
“By focusing heavily on outdated hospital statistics and undervaluing key elements of patient safety, the Leapfrog rating system fails to accurately reflect UMC’s current position,” the statement read.
Binder said she doesn’t know how the state ranks when the lower grades are factored in, but she said hospitals should collaborate to continue improvement.
And grades can slip quickly, she added.
“People deserve better than a C, and hospitals, I’m sure, will work on that, because they don’t want to get a C either,” Binder said. “It’s important for people to put pressure on them to continue that effort and to get results.”
Binder’s best advice to patients: Research hospitals in advance, and then take an advocate, like a friend or family member, to make sure clinicians are paying attention to your treatment and their hygiene.
“Be willing to ask sometimes awkward questions, like, ‘Doctor, I didn’t see you wash your hands. Can you make sure you do that?’” Binder advised. “Those are very hard things for patients to say, but it’s critically important.”
She also said patient safety is improved when hospital leaders put patient care first, as opposed to following the latest trends in health policy and technology.
“When a leader puts that level of priority on a patient, they can inspire everybody else to put that same level of priority on patients,” she said. “It’s really an exercise in vigilance, (and) it can never stop.”
Look up a hospital’s grade
The Leapfrog Group maintains a searchable database of hospital safety grades.
Binder recommends that patients check the hospital’s grade breakdown and assess for themselves whether they feel the facility meets their standards.
To access the list, visit http://www.hospitalsafetygrade.org/.