"Overall we see the number of patient safety incidents in American hospitals continuing to increase, at an enormous cost, and we still see a large gap between the incidence rates at the nation's top-performing and worst-performing hospitals," said Dr. Samantha Collier, HealthGrades vice president of medical affairs. "But we do find the results of serious attempts to grapple with this issue in the success of top-performing hospitals and in progressive states like Minnesota."
The third HealthGrades Patient Safety in American Hospitals study, the largest annual study of its kind, also finds:
Differences Among Hospitals
Number and Cost of Patient Safety Incidents
State Rankings and Differences
Trends in Patient Safety Incidents
State Rankings The study ranked the nation's states in terms of the prevalence of patient safety incidents in each states' hospitals and are grouped as performing better, as expected, or worse than expected to a statistically significant degree:
Performed Better Than Expected
1. Minnesota
2. Wisconsin
3. Iowa
4. Michigan
5. Kansas
6. Indiana
7. Ohio
8. Pennsylvania
9. South Dakota
10. North Dakota
11. Montana
12. Utah
13. Florida
14. Washington
15. Connecticut
16. Arizona
Performed As Expected
17. West Virginia
18. Idaho
19. Georgia
20. Maine
21. Illinois
22. Massachusetts
23. Colorado
24. Oklahoma
25. Wyoming
26. Oregon
27. Rhode Island
28. Louisiana
29. North Carolina
30. Missouri
31. Alabama
32. South Carolina
33. Delaware
34. Mississippi
35. Vermont
36. Alaska
37. New Hampshire
38. Texas
39. Virginia
40. Kentucky
41. Nebraska
Performed Worse Than Expected
42. California
43. Hawaii
44. Arkansas
45. Maryland
46. New Mexico
47. District of Columbia
48. Tennessee
49. Nevada
50. New York
51. New Jersey
Minnesota ranked first overall in this year's state ranking by HealthGrades, and in this state are progressive efforts to improve patient safety. While twenty-five states now have some form of mandatory reporting of medical errors, Minnesota was the first state, in 2003, to legislate mandatory public reporting, using guidelines from the National Quality Forum. Minnesota's Safest in America program allows competitive hospitals to work together to share data, highlight best practices and implement evidence-based, community-tested solutions. Of the eight non-children's hospital systems participating in the Safest in America collaborative, four have hospitals that ranked in the top 15 percent in the national according to this study.
"Two of the patient-safety incidents found in the study to be among the most prevalent are failure to rescue and post-operative sepsis," continued Dr. Collier. "Failure to rescue is the inability to save a hospitalized patient's life when that patient has acquired in the hospital a complication, such as when a patient admitted for a total knee replacement develops pneumonia and dies. An example of post-operative sepsis is when an otherwise previously healthy patient is admitted for a total knee replacement and develops an overwhelming bacterial bloodstream infection requiring potent antibiotics and other treatment resulting in a longer hospital stay and possibly death. Both of these are areas of focus for the most progressive hospitals, who have developed successful ways of minimizing or eliminating deaths from these incidents."
Distinguished Hospital Awards and Findings
Based on the study, HealthGrades identified 238 hospitals reaching the top 15 percent in the nation in terms of patient safety, qualifying them to receive the HealthGrades Distinguished Hospital Award for Patient Safety. The award was designed to highlight hospitals with the best records of patient safety in the nation and to encourage consumers to research their local hospitals' patient safety records before undergoing a procedure. As a category, Medicare patients at Distinguished Hospitals experienced patient safety incidents, on average, 43.27 percent less often than patients at the bottom 15 percent of all hospitals.
Methodology
The study is based on 13 patient safety indicators developed by the Agency for Healthcare Research and Quality (AHRQ), and applied to the most recent MedPar file of Medicare admissions at nearly 5,000 hospitals covering 2002, 2003 and 2004. Teaching hospitals and non-teaching hospitals were evaluated separately, based on a recommendation from AHRQ that hospitals be compared to their peer group. All data was risk adjusted, so that hospitals with sicker patient populations could be compared equally with others.
The 13 AHRQ indicators are:
The complete study and methodology can be found at http://www.healthgrades.com .
About HealthGrades
Health Grades, Inc. (Nasdaq:HGRD) is the leading healthcare ratings organization, providing ratings and profiles of hospitals, nursing homes and physicians to consumers, corporations, health plans and hospitals. Millions of consumers and hundreds of the nation's largest employers, health plans and hospitals rely on HealthGrades' independent ratings and decision-support resources to make healthcare decisions based on the quality of care. More information on the company can be found at http://www.healthgrades.com . HealthGrades® and Distinguished Hospitals for Patient Safety are either registered trademarks or trademarks of Health Grades, Inc.