Click on the tabs below to see how the Leapfrog Group graded Nebraska and Iowa hospitals on its latest report card.
Nebraska hospital safety scores
Alegent Health Bergan Mercy Medical Center, Omaha: A
Alegent Health Immanuel Medical Center, Omaha: C
Alegent Health Lakeside Hospital, Omaha: B
Alegent Health Midlands Hospital, Papillion: A
BryanLGH Medical Center, Lincoln: C
Columbus Community Hospital, Columbus: B
Creighton University Medical Center, Omaha: B
Faith Regional Health Services, Norfolk: B
Fremont Area Medical Center, Fremont: B
Good Samaritan Hospital, Kearney: C
Great Plains Regional Medical Center, North Platte: A
Mary Lanning Memorial Hospital, Hastings: C
Nebraska Medical Center, Omaha: C
Nebraska Methodist Hospital, Omaha: C
Regional West Medical Center, Scottsbluff: C
St. Elizabeth Regional Medical Center, Lincoln: C
St. Francis Medical Center, Grand Island: C
Iowa hospital safety scores
Alegent Health Mercy Hospital, Council Bluffs: B
Allen Memorial Hospital, Waterloo: B
Broadlawns Medical Center, Des Moines: A
Covenant Medical Center, Waterloo: C
Finley Hospital, Dubuque: C
Fort Madison Community Hospital, Fort Madison: C
Genesis Medical Center-Davenport, Davenport: B
Grinnell Regional Medical Center, Grinnell: A
Iowa Lutheran Hospital, Des Moines: C
Iowa Methodist Medical Center, Des Moines: B
Jennie Edmundson Hospital, Council Bluffs: C
Keokuk Area Hospital, Keokuk: C
Lakes Regional Healthcare, Spirit Lake: Score pending
Mary Greeley Medical Center, Ames: A
Mercy Hospital of Iowa City, Iowa City: C
Mercy Medical Center of Cedar Rapids, Cedar Rapids: B
Mercy Medical Center of Des Moines, Des Moines: C
Mercy Medical Center of Dubuque, Dubuque: B
Mercy Medical Center of Sioux City, Sioux City: B
Sartori Memorial Hospital, Cedar Falls: C
Skiff Medical Center, Newton: C
Spencer Municipal Hospital, Spencer: A
St. Luke's Methodist Hospital of Cedar Rapids, Cedar Rapids: B
St. Luke's Regional Medical Center of Sioux City, Sioux City: C
Trinity Medical Center at Terrace Park, Bettendorf: A
Unity Hospital, Muscatine: A
University of Iowa Hospitals and Clinics, Iowa City: C
Look up more scores at hospitalsafetyscore.org.
Source: Leapfrog Group
Hospital errors kill people every day across the U.S. — an estimated 180,000 per year.
So hospital officials spend time and money working to eliminate errors.
How well are local hospitals doing at this? An independent nonprofit group last week handed out hospital safety grades, giving C's to 21 Nebraska and Iowa hospitals, including the respected Nebraska Medical Center and University of Iowa Hospitals.
C is the lowest grade the group handed out; hospitals that would have gotten a D or an F were given a “score pending” and the opportunity to improve.
Nationally, about 47 percent of the more than 2,600 hospitals that were graded got a C or the “score pending” grade, while about 26 percent got B's and 27 percent got A's, including two in the Omaha metro area.
The organization behind the grades is the Leapfrog Group, a consortium of employers and other large purchasers of health benefits. Its members provide benefits to more than 34 million Americans in all 50 states. The group enlisted patient-safety experts to boil down as many as 26 measures — from data that it collected from the hospitals or obtained from federal agencies — into a single letter grade.
The measures included how often patients fell or were injured; how soon urinary catheters were removed after surgery; whether patients developed severe pressure sores; whether an object was left in a patient after surgery; and how well a hospital identifies and addresses risks and hazards.
The measures were weighted depending on how many patients were affected and the severity of the harm.
The purpose of the grades is to present hospital safety information in an understandable way, said Leah Binder, Leapfrog's president and CEO.
“We are talking about medication errors. Accidents. Things that shouldn't be happening,” she said. “Everybody needs to put patient safety first.”
Leapfrog recommends that people use hospitals that received an A. If they go to another hospital, the group said, they should recognize that there is an increased risk and pay close attention to their care.
Leaders at two local hospitals that received C's say they focus on safety and question Leapfrog's ability to accurately assess their programs given its use of old numbers or lack of access to certain data.
Dr. Stephen Smith, the Nebraska Medical Center's chief medical officer, said some of the government data used in compiling the grade is more than two years old and doesn't reflect the progress the med center has made since then.
One example, he said, is that the hospital's ICU now is staffed around the clock by critical-care physicians called intensivists. “That is a huge step forward for us,” Smith said.
Leapfrog considered intensivists an important measure because intensive care is the most complicated care given to patients outside the operating room, said Dr. Lucian Leape, an adjunct professor of health policy at Harvard who served on the Leapfrog panel. “You need to have people who are expert at that.”
Smith said intensivists can provide better care in the ICU because critical care is their specialty. Because they are in the ICU all the time, he said, they can immediately address any changes in a patient's condition. “The mortality drops, the length of stay goes down and the quality of care goes up,” Smith said.
Smith said the hospital will get credit for the intensivist change on the next report, which will reflect upgrades through June 30. It won't, however, get immediate credit for instituting a computerized physician order-entry system, which is set to begin Aug. 4 and is costing “tens of millions of dollars.”
Such systems reduce errors by having physicians enter orders into the computer instead of on paper. The orders are integrated with lab and prescription data and automatically checked for errors.
Binder said patients should look for a hospital that has such a system because it can lower order-error rates by about 75 percent.
Dr. Anton Piskac, vice president of performance improvement at Methodist Health System, said Methodist Hospital stopped sending data to Leapfrog several years ago. The Leapfrog forms, Piskac wrote in a letter to the hospital's board, are “some 85 pages long and would require hundreds of man-hours to complete. Frankly, we found participation in Leapfrog more work and expense than it was worth.”
He said the group, therefore, doesn't know about Methodist's progress in implementing a computerized physician order-entry system.
Leapfrog also doesn't know about the hospital's use of intensivists, Piskac said.
Binder said that if a hospital did not report to Leapfrog, the group's experts used other data sources.
She added that Leapfrog's survey has changed over the years and now is shorter than it was several years ago.
Hospitals in the Alegent Health system that were graded got a mixed bag: two A's, two B's and one C. Dr. Richard Miller, Alegent's senior vice president and chief quality officer, said in a written statement that the ratings are encouraging. He said there were problems with the way the data was collected but applauded Leapfrog's efforts “to raise the quality of health care.” He didn't address Immanuel's C grade other than to say that progress has not been even across the Alegent system.
Smith, from the Nebraska Medical Center, said it is difficult to compare his institution's scores with those of other Nebraska hospitals because the med center has the only transplant program in Nebraska, which by its nature attracts the sickest patients. Binder, however, said hospitals across the country that serve “challenged” patients received A's.
“You should consider the grade as one factor when picking a hospital,” Binder said. “This is not quality data. This is not patient satisfaction. ... This is just injuries, infections and errors.”
Binder and Smith both said patients should review the grades and discuss them with their physicians.
Patients should “go to their doctor, go to their hospital and ask, ‘What are you doing to address this?'” Smith said. “‘Is this a good place to be hospitalized? What are you doing to correct these problems?'”
Contact the writer: