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SCORES from Page A1 ratio of bloodstream infections being found in patients. In addition, Tuomey received poor scores for having, according to the survey, inadequate staffing for both nurses and intensive care unit physicians. Within the ICU physician staffing category specifically, Tuomey received the lowest score recorded, although a majority of hospitals in South Carolina received the same low score. Dr. Gene Dickerson, vice president of Medical Affairs for Tuomey, pointed out that in several of the categories — such as the ICU physician report — the local hospital scored poorly not because it was providing inadequate services but because Tuomey was not handling issues in the way the survey asked. Within its report, Leapfrog indicates the only way for a hospital to score well in the ICU category would be to hire dedicated intensivists, doctors certified specifically for these departments. This is a luxury most hospitals do not have, Dickerson said. “We don’t, nor do any hospital our size in this state, or any other state,� Dickerson said. “One thing we do provide is an advanced, or teleICU service, that we pay $1 million a year for, that provides 24-hours-aday, 7-day-a-week remote intensivist coverage for all of our patients in the ICU.� Dickerson also said while the report was still under review so that Tuomey officials could use the results to find ways to improve patient care, he did not think the single grade should be much of a reflection on the hospital. “We’re not ashamed of this. We try to do the best we can and answer the questions the best we can. The data’s not perfect,� Dickerson said. “We never bragged on having an A. If you read my comments from the last time, I kind of downplayed it. It’s one little survey and one little measure out of several that we participate in.
THURSDAY, OCTOBER 24, 2013
Leapfrog Hospital Safety Score results by subcategory - Fall 2013 report Outcome Measures (Lower scores indicate a better performance. Numbers per 1,000 patient discharges unless otherwise noted) Foreign Object Retained after Surgery Air Embolism Pressure Ulcer - Stages 3 and 4 Falls and Trauma Central line-associated bloodstream infections (ratio) Catheter-associated infections (ratio) SSI Colon (infection ratio) Death Among Surgical Inpatients with Serious Treatable Complications Collapsed Lung Due to Medical Treatment Breathing Failure after Surgery Post-op Pulmonary embolism (PE) / deep vein thrombosis (DVT)
Tuomey Regional Medical Center 0.00 0.00 0.323 0.431 2.21 0.22 2.222 120.62
Clarendon Memorial Worst Scoring Hospital Hospital 0.389 0.00 0.103 0.00 0.907 0.000 2.005 0.595 2.6 N/A 3.626 0.00 3.456 N/A 163.08 N/A
National Average 0.03 0.00 0.1 0.48 0.56 0.73 0.79 113.56
Best Scoring Hospital 0 0 0 0 0 0 0 54.89
0.20 5.32 3.74
0.39 N/A 4.36
0.75 21.27 11.88
0.34 11.66 4.53
0.07 4.99 0.97
1.17 0.89
0.82 2.40
2.73 4.2
0.96 2
0.17 0.38
Computerized Prescriber Order Entry (CPOE) (scale: 0-100) ICU Physician Staffing (scale: 0-100) Leadership Structures and Systems (scale: 0-120) Culture Measurement, Feedback and Intervention (scale: 0-20) Teamwork Training and Skill Building (scale: 0-40) Identification and Mitigation of Risks and Hazards (scale: 0-120)
15 5 120 20 40 120
50 5 102.86 20 40 120
5 5 0 0 0 0
46.25 28.19 110.42 17.78 34.2 108.73
100 100 120 20 40 120
Nursing Workforce (scale: 0-100) Medication Reconciliation (scale: 0-35) Hand Hygiene (scale: 0-30) Care of the Ventilated Patient (scale:0-20) Patients Received Antibiotic 1 Hour Prior to Surgical Incision (%)
90.48 35 30 20 98
95.24 35 27 20 96
0 0 0 0 0
90.73 31.79 27.27 18.16 98.43
100 35 30 20 100
99 97 97
95 90 89
0 0 0
98.49 97.33 95
100 100 100
Wounds Split Open after Surgery Accidental Cuts or Tears from Medical Treatment Process Measures (Higher scores indicate a better performance)
Patients Received the Right Antibiotic (%) Antibiotic Discontinued after 24 Hours (%) Urinary Catheter was Removed on Postoperative Day 1 or 2 (%)
Surgery Patients Received Appropriate Treatment to Prevent Blood 0 97.34 99 82 Clots at the Right Time (%) Overall Grade C C F B Numbers in red below national average. Numbers in green above national average. Source: www.hospitalsafetyscore.org
It’s really just a snapshot of the care that we provide.� Six months ago, however, when Tuomey received an A for its Spring 2013 score, the hospital released a statement quoting Dickerson as saying, “As chief medical officer for Tuomey Healthcare System, I think that I can speak for the entire medical staff and administration when I say that we are very proud of achieving an ‘A’ grade from the Leapfrog Group. I firmly believe that this is a direct reflection on the professional attitudes and performance of our physicians, nurses, respiratory therapists, radiology technologists, nursing assistants and all of the health provider staff at our hospital and is well deserved.� The recent report is not without its high points for the local hospital. Tuomey received above-average scores in 17 of the subcategories considered, including perfect scores in seven of the 15 process-orient-
ed categories and two of the 13 outcome-oriented categories. Despite scoring higher than the national average in a majority of the categories, however, the end result of the recent report was a two-lettergrade drop. Of the 2,539 general hospitals issued a score, only 2.8 percent dropped by two or more grades, according to Amanda Ferraro, media specialist with Stern & Associates, the public relations firm working with Leapfrog. Survey results also indicated 32 percent of the hospitals in the report received an A, while 26 percent received a B, 35 percent a C, six percent a D and less than one percent re-
ceived an F. “We were disappointed in the result of the letter C,� said Brenda Chase, spokeswoman for Tuomey Healthcare System. “We would like to take our time and go line by line through every piece of quality data that we report to see any changes that might have taken place over the last quarter that might impact the numbers. It could be a change as minuscule as .001. We absolutely know our data, but we go through thousands and thousands of lines of data and look at thousands of quality indicators. ... We feel like we do an excellent job with the safety of our pa-
tients, and this is one indicator among many. We will use this information to move forward.� Clarendon Memorial Hospital in Manning also received a C, which is an improvement from the spring score of D and even more so from the Fall 2012 score of an F. “We’re not satisfied with our current score,� said Richard Stokes, CEO of Clarendon Memorial. “We’re going to get better, and we are getting better. We want to incrementally, internally prepare ourselves to sustain our score. We don’t want to jump up to an A to drop down to a C the next round. We are putting our internal
100 A
processes in place to sustain our scores.� While he supports Leapfrog’s efforts overall, Stokes does not think it is a perfect measuring system, he said. “I think Leapfrog has some adjustments it needs to make to do smaller facilities,� Stokes said. “I don’t think we should be graded the same as UCLA (Ronald Reagan UCLA Medical Center.)� For more information about the Hospital Safety Score or to view the list of state rankings, visit hospitalsafetyscore. org. Reach Jade Anderson at (803) 774-1250. Reach Braden Bunch at (803) 774-1201.
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