Shands at UF, Shands Jacksonville both get an A for patient safety

Shands at the University of Florida and Shands Jacksonville have scored the highest grade for patient safety in a national rating system.

Both hospitals received an "A" Hospital Safety Score on Nov. 28 from the Leapfrog Group, a national nonprofit organization that focuses on reducing preventable medical errors.

“The quality and safety of patient care is at the core of our efforts at UF&Shands,” said David S. Guzick, M.D., Ph.D., senior vice president for health affairs at UF and UF&Shands Health System president. “This score from Leapfrog is the latest recognition of our ongoing commitment to high-quality care.”

Leapfrog is a consortium of private and public employers that jointly purchase health care for more than 34 million Americans. The organization prides itself on using its members’ collective leverage to drive improvements in the safety, quality and affordability of health care.

A nine-person panel of patient safety experts oversees the Hospital Safety Scores, which are calculated twice each year. All hospitals in the U.S. are graded, except for critical access hospitals, pediatric hospitals and hospitals in Maryland and other territories exempt from public reporting to the Centers for Medicare and Medicaid Services.

An A to D or F grade is assigned based on 26 measures of publicly reported safety data including rates of errors, accidents and injuries, as well as the existence of systems and procedures to avoid them. Data sources include the Centers for Medicare and Medicaid Services, the Agency for Healthcare Research and Quality, the Centers for Disease Control and Prevention and the Leapfrog Hospital Survey.

Of the 2,600 hospitals rated, about 1,500 — including Shands at UF and Shands Jacksonville — did not participate in the 2012 Leapfrog Hospital Survey. For those institutions, Leapfrog used supplementary data from secondary sources such as the American Hospital Association.

When Leapfrog launched the Hospital Safety Scores in June, it was a matter of controversy. The president and CEO of the American Hospital Association wrote a letter to Leapfrog that outlined several “methodological shortcomings” in the survey, including what the association saw as the use of unreliable measures, a bias toward hospitals that participate in the Leapfrog Hospital Survey, significant variation in the weights applied to measures for different groups of hospitals and errors in the data.

The latest scores reflect data updated over the last six months and a modified methodology. Still, some hospital representatives remain dissatisfied, citing concerns similar to those articulated earlier by the American Hospital Association.

Even so, many say there is merit in the spirit of the scoring system as a way to encourage communication between patients and hospitals.

“Anything that has hospitals focused on performance improvement is a good thing, as long as it’s not taken out of context,” said Bruce Rueben, M.B.A., president of the Florida Hospital Association. “But every group that attempts to measure hospitals has different criteria, and you can’t take any one piece and make a judgment on that.”

About 30 percent of scored hospitals nationwide received an A. Shands at UF and Shands Jacksonville both went up two letter grades since June.

“We are very pleased that this score shows the improvement in publicly reported measures that has occurred at Shands over the past few years,” said Susan Hendrickson, director of Quality and Performance Improvement at Shands Jacksonville. “Shands has invested in a number of activities aimed at decreasing untoward events and reliably delivering evidence-based care. This more recent dataset used by the Leapfrog Group captures these improvements.”

The new grades reflect the most recent publicly available data, said Erica Mobley, program manager at Leapfrog. In June, most hospitals were judged on the basis of old data from 2010, but data used for the current round was mostly from 2011.

“We don’t see a significant jump happen just by accident; those hospitals seem to have put a significant emphasis on patient safety,” Mobley said. “We hope that patients will use this as one piece of information when selecting a hospital, whether they’re going for stitches or open heart surgery.”

This recognition from Leapfrog follows another national achievement this week for UF&Shands; a surgical intensive care unit at the Shands Cancer Hospital received an award from the U.S. Department of Health and Human Services and the Critical Care Societies Collaborative for reducing hospital-associated infections.

“National recognition for the quality of care provided at UF&Shands is a result of the constant attention of our caregivers to provide our patients the best experience possible,” said Randy Harmatz, chief quality officer at UF&Shands. “We are constantly moving toward our goal of being a national model for health care delivery.”