Grades for New York Hospitals: Goal Is To Improve Patient Care

July 14, 2012

Grades for New York Hospitals: Goal Is To Improve Patient Care

Grades are a basic component of a culture that values performance. In school, students get report cards. In business, it typically takes the form of an annual review.

For years, healthcare organizations were insulated from these periodic reality checks. In the abstract, doctors and patients are committed to patient care. Far too often, however, putting on the white lab coats seemed to also entail taking a vow of secrecy.

Fortunately, that is now beginning to change. This article will discuss how several New York hospitals fare in report cards given by a watchdog organization called The Leapfrog Group. The article will also touch upon recent efforts by some hospitals to develop internal checks in order to notify patients of medical mistakes.

Hospital Report Card Methodology

The Leapfrog Group was formed by several large employers over a decade ago to address concerns about healthcare quality. Employers, after all, contribute substantial sums to paying premiums for employees. So it is understandable that these employers want to measure the patient outcomes that flow from those premiums.

Leapfrog uses surveys to gather the data needed to assess hospitals' patient safety performance. The methodology also involves analysis from acknowledged safety experts at Harvard, Johns Hopkins and other institutions. The goal is to determine safety scores for 2,600 U.S. hospitals, as measured in grades that range from A to F.

The assessments seek to identify the extent of preventable conditions, such as infections and medication errors, as well as bedsores and other acquired injuries. The focus is on conditions that are potentially fatal.

New York Hospital Grades

Not surprisingly, hospitals that do not score well often try to find fault with the procedure used to assign the grades. For example, Mount Sinai Medical Center in New York received a C grade from Leapfrog. A spokesman for the hospital said the methodology lacked validity, because it relies so much on self-reports by hospitals.

To be sure, an organization may be tempted to game the system when self-reporting. It could fail to disclose incidents that seem damaging to its reputation, or parse the definitions and numbers trying to make itself look good.

But the fact that someone could cheat doesn't mean tests shouldn't be given at all. Leapfrog's reliance on such self-reports does not mean that the report card exercise lacks all validity. The data used in creating the report cards may be imperfect. Yet it is far better than no data at all.

To put it baldly, a white-coated conspiracy of silence hardly serves healthcare consumers well.

In addition, hospitals with concerns about the validity of measurement by outside groups can proactively create their own internal systems. Several hospitals around the country are trying to reduce litigation by having their own internal report cards. The premise of the programs is that medical mistakes will be immediately reported to patients who are injured by them.

The real purpose of such self-policing programs probably depends on the particular hospital. For some, it may genuinely be to improve patient care, recognize errors earlier and resolve disputes more efficiently. For others, however, it may be all about co-opting injured patients and preventing them from asserting their legal rights.

Article provided by Dankner, Milstein & Ruffo, P.C.
Visit us at www.danknermilstein.com