More than half of the hospitals rated by Consumer Reports in a first-time safety report received a score below 50 on a scale of 1-100.
The low-score results included some well-known hospitals such as Massachusetts General Hospital, Ronald Reagan UCLA Medical Center, and Cleveland Clinic.
Consumer Reports rated 1,159 hospitals in 44 states in its August issue and online at www.ConsumerReports.org.
The safety scores give consumers a way to compare hospitals on patient safety, John Santa, M.D., M.P.H., director of the Consumer Reports Health Ratings Center, said in a statement.
The six categories included in the safety score are: infections; readmissions; overuse of scanning; communication about new medications and discharge; complications; and mortality.
Infections, surgical mistakes, and other medical harm contribute to the deaths of 180,000 hospital patients a year, according to estimates based on a 2010 report by the Department of Health and Human Services for Medicare patients.
Some highlights from the report:
- Overall safety performance: Even the highest scoring hospitals have room for improvement. Billings Clinic in Montana was at the top of Consumer Reports’ list, but its safety score was only 72. The majority of hospitals, 51 percent, rated by Consumer Reports earned scores below 50.
- Deadly infections: About one in 20 hospital patients will develop an infection that can be devastating, even deadly. Many can be prevented. Consumer Reports rates hospitals on surgical-site infections that develop after surgery as well as bloodstream infections caused by central-line catheters in intensive care units. Of the hospitals rated, 202 reported infections at rates higher than the national benchmark, and only 148 reported zero infections. Consumer Reports obtained its data from states that require infection reporting and through the Leapfrog Group, an independent organization that tracks hospital safety and quality. Some hospitals voluntarily report central-line infection data to Leapfrog.
- Radiation overload: While CT scans can provide essential diagnostic information, they also pose risks. Radiation from CT scans, which are equivalent to between 100 and 500 chest X-rays, may contribute to an estimated 29,000 future cancers a year, according to a 2009 study. Consumer Reports’ ratings reported on the percentage of chest and abdominal CT scans that are ordered twice for the same patient, once with contrast, and once without. Probably less than 1 percent of patients undergoing chest CT scans should get double scans, one doctor interviewed for the report said. Only 28 percent of the hospitals in the ratings had double-scan rates of 5 percent or less in both categories, the cutoff established by Consumer Reports to determine a top rating. Data about scanning were obtained from Hospital Compare, the online tool from the Centers for Medicare and Medicaid Services. This was also the source for scores on readmissions, mortality, and complications.
- Readmissions: Research suggests that up to three-quarters of readmissions may be preventable. Consumer Reports included readmissions in its safety score because the more often a patient enters a hospital, the greater the chance something will go wrong. No hospital earned Consumer Report’s highest score for readmissions; 166 hospitals received its lowest score.
- Communication: No hospital earned Consumer Report’s top score for communication about new medications and discharge plans while almost 500 hospitals earned its lowest score. The communication scores are based on questions answered by millions of discharged patients in a federally required survey.
- Some well known hospitals with less than outstanding scores: Many well-known hospitals did poorly in the safety analysis, including Massachusetts General Hospital, Boston, with a safety score of 45; Ronald Reagan UCLA Medical Center, Los Angeles, 43; Cleveland Clinic, 39; New York Presbyterian, New York, 32; and Mount Sinai Medical Center, New York, 30. However, Consumer Reports’ safety ratings don’t assess how successful hospitals are at treating medical conditions, and its ratings aren’t the only source that should be used to measure hospital safety and quality. Consumer Reports magazine suggests other sources a consumer can investigate.
- Medical harm: “Medical harm is probably one of the three leading causes of death in the U.S., but the government doesn’t adequately track it as it does deaths from automobiles, plane crashes, and cancer,” Peter Pronovost, M.D., senior vice president for patient safety at Johns Hopkins Medicine in Baltimore, Maryland, told Consumer Reports. “It’s appalling.” Pronovost also said that hospitals haven’t given safety the attention it merits.
The Consumer Reports safety score doesn’t look comprehensively at all medical errors. The scores are derived from several government and independent sources. Consumer Reports used the latest data available, supplementing it with interviews of patients, physicians, hospital administrators, and safety specialists. The ratings include only 18 percent of U.S. hospitals because data on patient safety isn’t reported fully and consistently nationwide.
For example, only some states require hospitals to report data for surgical-site infections, central-line infections, or both. And some hospitals voluntarily report central-line infection data to the Leapfrog Group. As a result, Consumer Reports can’t provide a safety score on every hospital.
The report outlines steps the government should take to fix the system, including establishing a national system for tracking and publicly reporting medical errors, as recommended by the Institute of Medicine more than 10 years ago.