Wednesday, January 2, 2013

Should Medical Rankings Exist of Be of Importance?

UVa Medical Center continues to struggle with safety issues

Posted: Tuesday, January 1, 2013 7:05 pm | Updated: 8:15 pm, Tue Jan 1, 2013.
A hospital safety ranking recently panned the University of Virginia Medical Center, giving it a much lower grade than its local competitors, but hospital officials say they're constantly working on quality and safety, and making important strides.
Hospital Safety Score gave UVa a D. Martha Jefferson Hospital got a B, and Rockingham Memorial Hospital and Augusta Health both received As.
"We have made some notable improvements in quality and safety over the past few years," UVa Medical Center spokesman Eric Swensen wrote in an email.
The UVa ranking is based in large part on data UVa recently began voluntarily providing to a hospital survey organization as part of an effort to improve patient safety.
In many cases, UVa is doing better than it did in the survey released in spring 2012, Swensen wrote.
“The Hospital Safety Score should be used as one important piece of information in choosing a hospital for you or your family and as a tool to raise questions with your doctor or hospital administrators,” the organization behind the ranking, the Leapfrog Group, said in a statement. “People should never refuse care in an emergency because of the Hospital Safety Score, but use the Hospital Safety Score as a guide for planned events and a research tool for potential emergencies.”
As an example of improvements at UVa, Swensen pointed to new practices that cut the rate of catheter-associated bloodstream infections by more than half.
Measures of air embolisms; falls and trauma; deaths from serious treatable complications after surgery; wounds split open after surgery; and other measures all improved. In a few categories, such as stage 3 and 4 pressure ulcers, UVa did worse.
On a wide number of measures, UVa is at the industry average or doing worse, though on some items it far exceeds the average.
"The Hospital Safety Score was developed under the guidance of the foremost national experts in patient safety," Leapfrog said. "Nine of the leading patient safety researchers voluntarily advised the Leapfrog Group on the methodology for calculating the Hospital Safety Score. No other ratings system has the advice from this caliber of experts in the medical and academic fields. With that, we stand behind the D Hospital Safety Score assigned to this hospital."
"Even with the improvements we have made, we are committed to the additional work we need to do in order to accomplish our goal of becoming the safest hospital in America," Swensen wrote.
He added, "We remain focused on providing quality care to all of our patients and continually finding ways to improve the care we provide as part of our regular, extensive quality improvement process," Swensen wrote.
To compare hosptials’ safety rankings, visit hospitalsafetyscore.org.

My opinion:
I like that Leapfrog does not make their ranking system should make a larger impact on patients' decisions than other factors.  Perhaps rankings can help lead the patient to certain outcomes, but are rankings really all that reliable?  I know that in the college industry, many people are against the U.S. News and World Report rankings because they might be biased towards more elite schools.  In fact, this ranking, along with the Forbes rankings and the Washington Monthly rankings are quite different from each other in some areas.  So what about different hospital ranking system?  Maybe by comparing the factors used in each of the systems, patients can better determine which qualities of each individual hospital ranking are reliable.  Additionally, what if rankings influence hospitals to improve certain measures, but ignore other measures that may be more crucial to the overall safety?  Feel free to comment.

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