Medical Error Rates Vary Widely, HealthGrades Finds

Patients have a 46% lower risk of experiencing a safety incident at a top-rated hospital compared to a poorly rated hospital, HealthGrades reports this week.

The findings are from the annual HealthGrades Patient Safety in American Hospitals study, released Wednesday, which analyzed 40 million Medicare patient records, from 2007 to 2009. HealthGrades used 13 patient safety indicators published by the Agency for Healthcare Research and Quality to identify preventable medical mistakes that occurred during patients' hospitalizations.

"HealthGrades commends the efforts of those hospitals that are focused on providing consistent, safe and effective medical care," said Rick May, MD, vice president of clinical quality services at Denver-based HealthGrades, and co-author of the study. "But the fact remains that there are huge, life-and-death consequences associated with where a patient chooses to seek hospital care. Until we bridge that gap, HealthGrades urges patients to research the patient safety ratings of hospitals in their community and know what steps they can take to protect themselves from error before being admitted."

The HealthGrades study also found that:

• Four patient safety indicators (death among surgical inpatients with serious treatable complications, pressure ulcer, post-operative respiratory failure, and post-operative sepsis) accounted for 68.51% of all patient safety events during the three years analyzed.
• The 13 patient safety events studied were associated with $7.3 billion of excess cost, which equates to an additional $181.17 per Medicare patient hospitalization.
• Preventable medical errors are so pervasive and costly that the federal government has proposed linking incentive-based hospital compensation to four of the AHRQ Patient Safety Indicators, starting in 2014. In addition, the Centers for Medicare and Medicaid Services are currently developing a 10-year, $70 billion plan aimed at reducing hospital-acquired infections.

Even with encouraging research from the Centers for Disease Control and Prevention showing reductions in hospital-acquired bloodstreaminfections, that progress is inconsistent. Some hospitals have made rapid progress in reducing infection rates, but hospitals continue to show wide variations.

HealthGrades found that patients treated at the top 5% of hospitals for patient safety were 52% less likely to contract a hospital-acquired bloodstream infection or to suffer from post-surgical sepsis than those treated at poor-performing hospitals. Nearly one in six patients who acquired a bloodstream infection while in the hospital died, the study found.

HealthGrades used the AHRQ's 13 patient safety indicators – which include foreign objects left in a body following a procedure, excessive bruising or bleeding as a result of surgery, bloodstream infections from catheters, and bedsores – to identify those hospitals performing in the top 5%, naming them Patient Safety Excellence Award recipients. The list of these hospitals, along with clinical quality ratings for all of the nation's nearly 5,000 hospitals, can be found at HealthGrades.com.

The HealthGrades study also found regional variation in the prevalence of medical errors and preventable deaths and complications. The 10 cities with the fewest patient safety incidents are: Minneapolis-St. Paul; Wichita, KS; Cleveland; Wilkes-Barre, PA; Toledo, OH; Boston; Greenville, SC; Honolulu; Charlotte, NC; and Oklahoma City.

HealthGrades independently and objectively analyzed approximately 40 million Medicare patient records from fiscal years 2007 through 2009. To be included in the analysis, hospitals must have met minimum thresholds in terms of patient volumes, quality ratings, and the range of services provided.

In the HealthLeaders Media Industry Survey 2011, ninety-one percent of healthcare leaders specializing in quality improvement said compliance with government regulations in the next three years will be challenging or very challenging.