More than three-dozen New Jersey hospitals received the top rating in the latest semiannual Leapfrog Hospital Safety Grades report, released early today, giving the Garden State the highest percentage of “A” ratings nationwide and sparking praise from a number of healthcare quality experts.
All but five Garden State hospitals rated in the survey either improved or maintained their scores when compared with the spring 2018 report from the Leapfrog Group. Twice a year, the healthcare watchdog assigns grades of A through F to hospitals nationwide based on their use of best-practices and safety protocols, appropriate staffing levels and communication, and patient outcomes in key areas. The peer-reviewed scores are focused on avoidable errors, accidents, injuries and infections, the group said, issues that kill an average of 500 people a day in this country.
A grades went to more than half of the 67 acute-care facilities assessed in New Jersey, a rate far exceeding the outcomes in neighboring states; Pennsylvania ranked 14th and New York 46th. Oregon had the second-highest percentage of A-rated hospitals and Virginia came in third, according to the fall report.
New Jersey moved to the top position in the nation for the number of A ratings, a big leap from the 17th place it notched in last spring’s report. The state was also tops for the rate of hospitals participating in the survey.
Working for years to improve quality
“Healthcare is complex, but at the end of the day nothing is more important than the safety and well-being of our patients. And I have to tell you, it’s rewarding to see New Jersey’s focus on quality care reflected in this national report,” said Cathy Bennett, president and CEO of the New Jersey Hospital Association, which represents all acute-care facilities and has been working for six years on quality improvements as part of a national initiative.
“It really takes an ‘all-in’ approach to move the needle on healthcare quality. I would match New Jersey’s physicians, nurses, allied health professionals, support staff and hospital leaders with anyone, anywhere,” Bennett added, thanking them for their hard work and dedication.
While the scope and methodology of the surveys have evolved over time, hospitals here generally seem to be improving. Five Garden State facilities have received straight A’s since the first Leapfrog survey, conducted in the spring of 2015; and four improved two letter-grades in six months alone. (The five with all A’s include: Jefferson Stratford Hospital; Monmouth Medical Center; Saint Barnabas Medical Center; and Virtua’s hospitals in Marlton and Voorhees.)
At the bottom of the Leapfrog ratings were University Hospital in Newark, which received a D — up from the state’s only F last spring — and East Orange General Hospital, which has not been graded in three years and received an F, data showed.
Reports provide critical information
“Transparent reporting on care quality is an absolutely critical tool to drive improvements,” said state Department of Health Commissioner Dr. Shereef Elnahal. Since last summer, his department has been working closely with University Hospital to address a number of quality and financial challenges and is leading an infection-control campaign to assess practices at a handful of long-term pediatric facilities, two of which have been struck with a viral outbreak that killed 10 highly vulnerable patients.
“These reports provide us with critical information on where improvement opportunities exist in New Jersey, and incent institutions to continuously improve. In this way, patients benefit the most from quality reporting,” Elnahal added.
Formed in 2000, the nonprofit Leapfrog seeks to use data to improve hospital performance and to help patients — and those paying for care — make good medical-treatment decisions. Hospitals are asked to voluntarily submit information to document their operations and medical outcomes; these details are assessed along with publicly available data to create the public reports twice a year. Subsets of these findings are also shared in specialty reports, like the organization’s annual maternity care report.
In New Jersey, most of the state’s 71 acute-care facilities willingly participated by submitting their own data — an important indication of transparency, experts note. Three operations — St. Luke’s Warren Campus, in Phillipsburg, East Orange General Hospital, and Memorial Hospital of Salem County — were graded only on the information Leapfrog could obtain from publicly available records, according to the report.
(Leapfrog was unable to grade two facilities: Hudson Regional — formerly the Meadowlands Hospital and Medical Center, which has been flagged by Leapfrog for some of the most worrisome maternity metrics nationwide, including its high number of C-section deliveries — did not participate and didn’t produce enough relevant public data, and Monmouth Medical Center’s Southern Campus, in Lakewood, submitted information, but it was not enough for Leapfrog’s purposes in this report. Two others — New Bridge Medical Center, the former Bergen Regional Medical Center, in Paramus, which is focused on behavioral health needs, and Deborah Heart and Lung Center, in Browns Mills — do not produce the full spectrum of data necessary to compare to the other acute-care facilities.)
“We’re proud of the high number of hospitals in New Jersey that voluntarily submit their quality and safety data to Leapfrog, and then also use that information to continually improve patient care,” said Linda Schwimmer, president and CEO of the New Jersey Health Care Quality Institute, which serves as the regional leader for Leapfrog in New Jersey.
“We encourage all hospitals to use the survey to improve their performance,” said Schwimmer, a Leapfrog board member. “Our experience shows that hospitals committed to creating a culture of safety and quality perform well. That’s the common denominator.”
More than half at the top
Of the 67 Garden State hospitals included in the fall 2018 report, 38 (or nearly 57 percent) received an A rating, 16 more than notched the top score in the spring report, Leapfrog said. Some 16 facilities (24 percent) scored a B this time, and another 11 (more than 16 percent) got a C grade.
University was awarded the lone D and East Orange got the only F.
Dr. Lawrence Ramunno, chief medical officer at University said the D grade, up from an F in the fall survey, indicates a positive trend. The state-funded hospital is currently operating under a monitor and the state identified a number of serious infection control deficiencies during a recent inspection, following a bacterial outbreak that infected four medically fragile infants, one of whom may have died as a result.
“University Hospital knows that patient trust is built upon the quality and safety of care we provide. Our new Leapfrog grade shows that we are headed in the right direction as a result of our focus on building a culture of safety and implementing new quality initiatives over the past 18 months,” Ramunno said.
“It also confirms our continued need for safer, more effective, and more consistent processes for creating the best patient experience possible,” he continued. “We know this won’t happen overnight, but we are fully committed to providing quality health care to the Newark community, and we won’t be satisfied until we receive an ‘A’.”
Financial stability pays dividends at Saint Michael’s
The success stories in the fall report include Saint Michael’s Medical Center in Newark, which had never scored above a C since spring 2015 but received an A grade this time around. In 2016, after a prolonged regulatory review that left it struggling, Saint Michael’s closed a sale to Prime Healthcare Services Inc., a for-profit operator.
Saint Michael’s CEO Robert Iannaccone said the financial stability that came with the deal has helped contribute to a better score. Other improvements have taken time to show up, given the lag in assessing the data, he said.
“Under Prime Healthcare’s ownership, Saint Michael’s had the resources needed to achieve an entirely new level of intense focus on patient quality and safety,” he said. “From the moment Prime Healthcare took ownership of the hospital, patient safety and continuous quality improvement were the top priority.”
Doctor of Osteopathy Claudia Komer, one of the facility’s chief medical officers, praised staffers for their work in the transition. “The employees and physicians of Saint Michael’s truly deserve this award because it is their dedication and commitment to a culture of safety that allowed the hospital to receive this national designation,” she said.
While Leapfrog does not publicly release detailed hospital assessments, users can search its database by hospital name or location, thanks to its comparison tool at www.hospitalsafetygrade.org. Visitors can also compile lists of all hospitals assessed in a state.