Maryland hospitals have made strides overall in reducing errors, accidents, injuries and infections, but still have a way to go to make their facilities as safe as they can be, according to a new safety assessment by Leapfrog Group.
Maryland moved out of the bottom five in Leapfrog's biannual state rankings of the country's safest hospitals. Ten hospitals in the state improved their grades since they were first analyzed in 2017.
But the majority of the state's hospitals — 37 — received a grade of C or worse, signaling the need for more change.
"It is good to see these incremental improvements in Maryland and hopefully we will continue to see more progress over time," said Erica Mobley, director of operations at Leapfrog. The nonprofit group, which was formed by large employers of all kinds, collects data and issues reports on about 2,600 hospitals nationwide looking at 26 different measures.
Leapfrog said it puts together the report to bring attention to the issue of hospital errors, accidents, injuries and infections that collectively are the third leading cause of death in the United States.
"By raising awareness about patient safety, all hospitals can make improvements," Mobley said. "Hospitals can see where they have the biggest room for improvement and make those areas a priority."
Maryland hospital officials said that safety is one of their top concerns, but sometimes the many rankings and assessments can confuse patients. Patients should look at many different factors, they said. Leapfrog's data also is not the most current, so it doesn't account for the most recent improvements hospitals may have made.
"I would offer some caution that the Leapfrog rankings, as with any other report, should be interpreted in context," said David Simon, a spokesman with the Maryland Hospital Association. "It is one more tool consumers should use."
Leapfrog said it collects data from sources such as Medicare, the American Hospital Association and a voluntary survey it gives to hospitals. Some hospitals choose not to do participate in the survey. Some of the data is older, but most comes from 2016 and 2017, Mobley said.
Three hospitals in Maryland received the highest grade of A: Howard County General Hospital, Northwest Hospital and The Johns Hopkins Hospital. No hospital received the lowest grade of F.
Bon Secours in West Baltimore received an F last year, but was not included in this year's report because it did not provide enough data. Mobley said not having enough data doesn't necessarily mean a hospital did anything wrong and that other hospitals had also fallen off the rankings this reporting period.
Bon Secours officials said that Leapfrog's information is dated and that the hospital has improved coordination of patient care to reduce re-admissions. The hospital serves a largely poor population with many chronic conditions and behavioral health challenges. Most of its patients end up in the hospital through the emergency room.
"It won't show our current work because the data is behind substantially," said Ruth Coby, Bon Secours director of quality management. "We won't see until the report next spring, the results of the work we are doing right now."
One hospital that backslid was MedStar Good Samaritan in Northeast Baltimore, which fell to a D from a C last year.
MedStar Health does not participate in the voluntary Leapfrog survey. MedStar officials said in a statement that data about their hospitals comes from many different sources and "lag current performance."
"The Leapfrog safety grades do not reflect the continuous improvement we are seeing in all of our hospitals," the statement said. "As always, we encourage patients to discuss their needs and questions with their provider when making healthcare decisions."
The University of Maryland Medical Center Midtown also received a grade of D. The hospital was the site of an incident earlier this year in which a woman was discharged in just a hospital gown. The hospital was cited by federal officials for several violating several patient safety regulations. The university medical system's main hospital in Baltimore rose to a grade of B.
"All UMMS affiliates are strongly committed to optimal safety and quality in the delivery of care to our patients," system officials said in a statement. "The journey to achieve the highest possible performance on safety and quality measures is a never-ending one, as there is always room to improve no matter how high scores on reports and rating scales may go."
Greater Baltimore Medical Center in Towson received a grade of C. The hospital has taken many measures to be more transparent and improve safety in recent years, including posting quality measures on its website and instituting new best practices that helped reduce urinary tract infections associated with the use of catheters and blood stream infections associated with central lines.
"We acknowledge that our score, in the recent Leapfrog safety report, shows that we still have work to do, but want the public to know that our efforts and energy are focused on our patients and their needs and less on meeting arbitrary criteria of various rating systems that all use different methodologies for evaluating health care delivery," hospital officials said ina statement. "Leapfrog is only one tool of many that the public can utilize to making decisions regarding their healthcare needs such as choosing a hospital."
Leapfrog Hospital Safety Grades for Baltimore-area institutions:
Howard County General Hospital
Johns Hopkins Hospital
Anne Arundel Medical Center
Johns Hopkins Bayview Medical Center
MedStar Union Memorial Hospital
Mercy Medical Center
University of Maryland Medical Center
University of Maryland St. Joseph Medical Center
Carroll Hospital Center
Greater Baltimore Medical Center
MedStar Franklin Square Medical Center
MedStar Harbor Hospital
Sinai Hospital of Baltimore
St. Agnes Hospital
University of Maryland Baltimore Washington Medical Center
The Morning Sun
University of Maryland Harford Memorial Hospital
University of Maryland Upper Chesapeake Medical Center
MedStar Good Samaritan Hospital
University of Maryland Medical Center – Midtown Campus