Survey Highlights the Nation’s Safest Hospitals, Points Out Gaps in Patient Care

A group backed by some of the nation’s largest employers has published its first rankings of the country’s top hospitals for patient safety in a survey that also highlights major gaps in patient safety.

More than 1,200 of the approximately 5,500 hospitals nationwide responded to the survey conducted by the Leapfrog Group, an employer-led coalition founded in 2000 by the Business Roundtable. The group, whose members include General Electric, GM, IBM and Boeing, developed a list of 30 “safe practices” it says hospitals should follow to reduce preventable hospital errors.

Employers have become increasingly concerned over the amount of money they waste on hospitals where not enough is done to prevent life threatening, costly medical errors.

If non-rural hospitals in the U.S. followed the group’s safety guidelines, such as physicians’ use of computers to avoid mistakes resulting from illegibly or incorrectly written prescriptions, the lives of 65,000 people could be saved annually, the groups says. The U.S. health care system would in turn save $41.5 billion annually, savings that would eventually come back to employers.

The safest hospital, by Leapfrog’s standards, is Akron General Medical Center in Ohio. The also list includes such notable hospitals as Brigham and Women’s Hospital in Boston (No. 5) and Cedars-Sinai Medical Center in Los Angeles (No. 7.) The top-ranked children’s hospital is Children’s Hospital in Columbus, Ohio.

Among the positive findings by the group: Ninety percent of hospitals have procedures in place to avoid operating on the wrong part of a patient’s body, and 80 percent of hospitals require a pharmacist to review medication orders before medicine is given to patients.

But the hospitals failed to implement a number of other safety measures, the study reports. More than 90 percent of hospitals do not use computers to enter physicians’ orders. Nearly all hospitals failed to meet the standards for performing two high-risk surgeries: coronary artery bypass surgery and abdominal aortic aneurysm repair.

Half of the hospitals do not have procedures to make sure the hospital has enough nurses. Thirty percent do not meet the group’s standards for preventing malnutrition in patients, and a similar percentage of hospitals do not vaccinate their health care workers against the flu.

The hospitals in the report serve 56 percent of Americans, but some of the most prestigious hospitals in major cities chose not to participate. Chicago’s two most prestigious hospitals, the University of Chicago Hospitals and the University of Illinois Medical Center at Chicago, did not participate; nor did the region’s largest public hospital, Cook County Hospital.

“It’s unfortunate that they haven’t released their progress on meeting patient safety measures,” says Larry Boress, resident of the Midwest Business Group on Health, whose organization is a Leapfrog Group member.

A spokesman for the University of Chicago Hospitals, John Easton, said the hospital did not participate because its $70 million computerized physician order entry system, a five-year project designed to prevent prescription errors, was not yet complete. The hospital system would likely participate next year.

Though the patient safety measures are supported by purchasers of health care, including the Centers for Medicare and Medicaid Services, the largest single purchaser of health care in the country, hospitals have openly worried that the measures developed from health-services research studies do not translate well into real-world medical situations.

Hospitals have also said labor shortages facing the nursing industry and the overall high expense of compliance make it difficult to follow the Leapfrog Group’s voluntary safe-practices guidelines.

Boress says 60 percent of hospitals in Illinois did not participate in the survey. In the 31 regions of the U.S. where Leapfrog targets hospitals for participation, 56 percent of urban, general acute-care hospitals responded.

Leapfrog Group plans to continue its survey on an annual basis.

—Jeremy Smerd