Quality of Care and Transparency Issues Linger at Nation’s Hospitals

Patient quality of care remains a persistent problem for hospitals across the United States. And to help remedy these issues, hospitals need to be more forthcoming with patients and their families, especially when mistakes are made – mistakes that may provide grounds for a medical malpractice lawsuit.

These are two of the primary findings reported in an annual survey by Leapfrog, a national nonprofit watchdog organization. The 2014 report examined patient quality of care at more than 1,500 general acute care hospitals nationwide, focusing on four areas:

Never Events

Never events are serious, reportable adverse events that should never happen. For example, one never event is wrong-site surgical errors — that is, doctors operating on the wrong part of a patient’s body or leaving a foreign object in a patient’s body after surgery.

Compliance with never event policies has stalled at 79 percent during the past three years. Leapfrog standards dictate that a hospital will: 1) apologize to the patient and/or the family for a never event, 2) report the event to an outside agency, 3) perform a root-cause analysis, 4) waive the costs directly related to the event and 5) make a copy of the never events policy available to patients. According to the survey, one in five hospitals will still not agree to apologize to patients or waive costs if a never event occurs.

Hospital-Acquired Conditions

The rate of certain hospital-acquired conditions, like infections, has improved in recent years, but it is still problematic. For example, the survey reveals that 88 percent of hospitals had a less than expected rate for central line-associated bloodstream infections, while 48 percent had a higher than expected urinary tract infection rate associated with catheters.

Safety Practices

When it comes to patient safety, rural hospitals continue to struggle with compliance more than urban facilities. Leapfrog’s standards require hospitals to:

• Provide effective leadership to prevent errors
• Offer training to improve safety
• Have staff work closely together to prevent errors
• Track and reduce risks to patients
• Ensure there are enough qualified nurses
• Communicate correct medication information
• Observe proper hand washing
• Take steps to prevent ventilator problems

Seventy percent of urban hospitals were at or above these Leapfrog safety standards, compared to 45 percent of rural hospitals.

Staffing of Intensive Care Units (ICUs)

One positive finding is that more hospital ICUs reported compliance with physician staffing benchmarks. The Leapfrog standard is that ICU doctors should be certified in critical care medicine and be present in the ICU at least eight hours a day, seven days a week. The survey indicates that 46.1 percent of hospitals fully met this standard, which is an improvement over the previous rate of 41.7 percent.