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Safety report cites infections, patient falls as concerns at Central Kentucky hospitals

Infections, patient falls and death from serious, treatable complications were cited as areas of concern in Lexington-area hospitals this fall, according to a watchdog report released Nov. 16.

The Leapfrog Group is a nonprofit organization that provides ratings and safety data for hospitals and it recently released ratings for nearly 3,000 hospitals across the country. The fall 2022 ratings marked the 10th anniversary of Leapfrog’s report.

Kidney injury after surgery and communication with doctors and nurses were also among the safety concerns Leapfrog identified in multiple Lexington-area hospitals.

Staffing issues remain a concern, as Clark Regional Medical Center, Georgetown Community Hospital, Saint Joseph Hospital and Saint Joseph East all received the lowest score given to any provider in the category “specially trained doctors care for [intensive care unit] patients.”

Baptist Health Lexington received its 10th consecutive “A” grade from Leapfrog, but also received the lowest score given to any hospital for hand-washing, one of the metrics Leapfrog advises patients to weigh more heavily.

Here’s how Central Kentucky hospitals performed according to Leapfrog, including how to interpret ratings and which areas should be most heavily considered.

UK Good Samaritan Hospital

Fall 2022 grade: B

Spring 2022: C

Fall 2021: C

Here are the areas in which UK Good Samaritan Hospital scored below average this fall:

  • MRSA (methicillin-resistant staphylococcus aureus) infection

  • Surgical site infection after colon surgery

  • Sepsis infection after surgery

  • Surgical wounds split open (0.01 points worse than average)

  • Death from serious treatable complications

  • Kidney injury after surgery

  • Harmful events

  • Patient falls and injuries

  • Effective leadership to prevent errors

UK Albert B. Chandler Hospital

Fall 2022 grade: B

Spring 2022: B

Fall 2021: C

Here are the areas in which UK Albert B. Chandler Hospital scored below average:

  • MRSA infection

  • Infection in the blood

  • Sepsis infection after surgery

  • Surgical wounds split open

  • Death from serious treatable complications

  • Kidney injury after surgery

  • Harmful events

  • Patient falls and injuries

  • Effective leadership to prevent errors

“The quality of care and safety of our patients is of utmost importance at UK HealthCare. Like many academic medical centers, UK HealthCare -- which includes UK Chandler Hospital, UK Good Samaritan Hospital and UK Kentucky Children’s Hospital -- serve a disproportionate number of patients with complex medical needs which is not accurately represented by some rankings. Nevertheless, the improved score for Good Samaritan Hospital shows that our continued focus on patient health and safety is working,” UK HealthCare spokesperson Allison Perry wrote in an email to the Herald-Leader.

“At the same time, UK HealthCare works with a number of organizations such as U.S. News & World Report, where we are a top performer, and academic medical centers are more appropriately compared providing better information for our patients and families.”

“This year, U.S. News & World Report ranked us as the #1 hospital in Kentucky for the 7th year in a row, proof of our commitment to delivering outstanding patient care. Our priority is taking care of the patients of the Commonwealth, and we will always be seeking ways to improve the patient experience.”

Saint Joseph Hospital

Fall 2022 grade: B

Spring 2022: C

Fall 2021: C

Here are the areas in which Saint Joseph Hospital scored below average:

  • Sepsis infection after surgery

  • Blood leakage

  • Kidney injury after surgery

  • Serious breathing problems

  • Accidental cuts and tears

  • Harmful events

  • Patient falls and injuries

  • Collapsed lung

  • Communication about medicines

  • Specially trained doctors care for ICU patients (Saint Joseph Hospital received a 5 out of 100 in this category, the lowest score given to any hospital.)

  • Communication with doctors

  • Communication with nurses

  • Responsiveness of hospital staff

Saint Joseph East

Fall 2022 grade: B

Spring 2022: B

Fall 2021: B

Here are the areas in which Saint Joseph East scored below average:

  • MRSA infection

  • Sepsis infection after surgery

  • Surgical wounds split open

  • Blood leakage

  • Serious breathing problem

  • Communication about medicines

  • Communication about discharge

  • Specially trained doctors care for ICU patients (Saint Joseph East received a 5 out of 100 in this category, the lowest score given to any hospital.)

  • Communication with nurses

  • Responsiveness of hospital staff

“Saint Joseph Hospital and Saint Joseph East are committed to quality and safety for the patients we serve. Our dedicated providers and caregivers continually work on improvement efforts to achieve the highest quality care for our patients,” Dan Goulson, director of CHI Saint Joseph Health, wrote in an email to the Herald-Leader. “There are multiple health care rating agencies, each with different ratings criteria, and scores continue to improve. For instance, Saint Joseph Hospital has been ranked among the top 250 hospitals by Healthgrades for four years in a row. These ratings are just one tool patients have at their disposal when making health care decisions, such as choosing a hospital.”

Baptist Health Lexington

Fall 2022 grade: A

Spring 2022: A

Fall 2021: A

Here are the areas in which Baptist Health Lexington scored below average:

  • Infection in the urinary tract

  • Sepsis infection after surgery

  • Death from serious treatable complications

  • Kidney injury after surgery

  • Patient falls and injuries

  • Falls causing broken hips

  • Hand-washing (Baptist Health Lexington received a 15 out of 100 in this category, the worst score given to any hospital.)

  • Effective leadership to prevent errors

Baptist Health Lexington officials wrote in a Nov. 16 statement this is the 10th consecutive “A” grade Leapfrog has awarded the hospital.

“This recognition is a reflection of our continuing commitment to quality care,” Chris Roty, president of Baptist Health Lexington wrote in the statement. “The safety of our patients is the highest priority for our physicians and staff.”

Clark Regional Medical Center

Fall 2022 grade: A

Spring 2022: B

Fall 2021: B

Here are the areas in which Clark Regional Medical Center scored below average:

  • Infection in the blood

  • Serious breathing problem

  • Accidental cuts and tears

  • Patient falls and injuries

  • Safe medication administration

  • Specially trained doctors care for ICU patients (Clark Regional Medical Center received a 5 out of 100 in this category, the lowest score given to any hospital.)

“Recently, the Leapfrog Group reported its fall 2022 Hospital Safety Grade, in which Clark Regional Medical Center earned an A. We are very pleased with this distinction, which celebrates our achievements in protecting patients from preventable harm and errors. Each of us works hard to ensure high-quality and safe care for all who come through our doors,” Clark Regional Medical Center CEO Matt Smith wrote in a statement. “While we value these public ranking systems and certainly want to celebrate our successes, it is essential to remember that each uses different methodology and data collection periods. Still, our commitment to quality has been recognized in various ways—including that all four Lifepoint hospitals in Central Kentucky have received the National Quality Leadership designation.”

Georgetown Community Hospital

Fall 2022 grade: C

Spring 2022: C

Fall 2021: C

Here are the areas in which Georgetown Community Hospital scored below average:

  • Serious breathing problem

  • Harmful events

  • Dangerous bed sores

  • Falls causing broken hips

  • Doctors order medications through a computer

  • Safe medication administration

  • Communication about medicines

  • Communication about discharge

  • Effective leadership to prevent errors

  • Specially trained doctors care for ICU patients (Georgetown Community Hospital received a 5 out of 100 in this category, the lowest score given to any hospital.)

  • Responsiveness of hospital staff

“Georgetown Community Hospital provides safe, high-quality care to patients, families and visitors and is committed to ongoing quality improvement efforts so that we can continue to ensure that everyone has a positive experience at our hospital. We value the information that public reports and ranking systems provide; it adds to how we regularly monitor our progress and helps us explore opportunities to continuously improve the care we provide,” Cliff Wilson, CEO of Georgetown Community Hospital and market president for Lifepoint in Central Kentucky, wrote in a statement.

“Currently, there are a number of public reporting systems, including the Leapfrog Hospital Safety Grade, which evaluate hospital performance. These systems use different quality measures, performance data and methodologies to calculate scores. As a result, a hospital may perform well on one report card and poorly on another. Our lab and hospital are accredited through The Joint Commission. We also hold Acute Stroke Ready Certification through The Joint Commission and Chest Pain Accreditation through the American College of Cardiology. We’re also designated with Lifepoint as a National Quality Leader.”

“Because of these variations, the Hospital Safety Grade, as with any public reporting system, must be appropriately interpreted. For example, some of the data used to calculate hospital grades is outdated, and does not reflect more recent performance improvement efforts. Since the time used to calculate this grade, Georgetown Community Hospital has implemented a number of initiatives designed to enhance quality. These include:

  • Bedside shift report—nurse to nurse handoff at the time of shift change to ensure the patient is part of the process of care delivery and can lead to measurable improvements in safety and quality

  • Best practices in the prevention of multiple hospital-acquired conditions.

  • Addition of a certified wound-care nurse to staff.

  • Emphasis of the national best practice known as the Foundational Five—briefs, debriefs, huddles, executive patient safety rounds and learning boards—all of which are communication tools used to bring safety and quality concerns to the forefront and prevent adverse outcomes.

“It is our privilege to serve the healthcare needs of our community, and we will continue monitoring our progress and exploring opportunities to ensure all patients have access to high-quality care close to home.”

How are hospital grades calculated?

Safety grades are calculated using up to 22 national safety measures from the Leapfrog survey and the Centers for Medicare and Medicaid Services. The full methodology is available online and is peer-reviewed by the Journal of Patient Safety.

Grades are composed 50% by process and structural measures and 50% by outcome measures. The scoring scales differ by the chosen measure.

Across the U.S., 30% of hospitals received an “A,” 28% received a “B,” 36% received a “C,” 6% received a “D,” and 1% received an “F” in the fall 2022 ratings.

How should I use these scores?

Leapfrog emphasizes you should not refuse emergency care based on hospital ratings. The group intends the scores to be used when planning hospital events, such as childbirth, surgery referrals or chronic illness treatment.

The areas you should pay most attention to when choosing a hospital include hand-washing, infection in the blood and patient falls, Leapfrog’s website says.

You should also consider how far off your hospital was from the average for any given standard. When evaluating a hospital, you can see the highest and lowest scores given, which helps in weighing a value. The “below average” category can include hospitals that scored 0.01 points under goal, along with facilities with the lowest possible score.

For hospitals that responded to Leapfrog’s survey, there’s often information available about which areas the hospital has improved in and which areas are not going in the right direction.

A hospital being ungraded does not denote a lack of safety. Ratings are often unavailable for facilities that decline to self-report, as well as smaller providers, children’s hospitals, surgical centers and critical access hospitals.

Where can I find more hospital ratings?

Leapfrog allows you to search for hospitals by name, location or state. There’s an search tool where you can find information about more hospitals.

Do you have a question about health in Kentucky for our service journalism team? We’d like to hear from you. Fill out out Know Your Kentucky form or email ask@herald-leader.com.