Patients who are fearful of entrusting their health to doctors, nurses, and other hospital workers can breathe a little easier, according to a new report that ranks Maine first in the nation in hospital safety.
According to a hospital watchdog group report released Wednesday, 80 percent of Maine’s hospitals earned an A for safety, a larger proportion than any other state, and much larger than most states. Among more than 2,500 hospitals across the country that received grades, only 31 percent got an A.
Of 20 Maine hospitals ranked, 16 earned an A, three got a B, and one — York Hospital of Maine — received a C.
Making sure hospitals don’t inadvertently violate one of the fundamental ethical principles of medicine — often summarized in the three-word phrase “do no harm” — has taken on added importance in the national discussion on American health care in recent years, in part because the federal Medicare system and private insurers are limiting reimbursements for costs associated with preventable errors.
Despite this, preventable hospital errors and accidents continue to be widespread.
A 2010 report from the U.S. Department of Health and Human Services found that one in four Medicare patients leave the hospital with a medical problem they didn’t have when they entered. Hospital errors and injuries cause 180,000 deaths each year, according to Leapfrog, the watchdog group.
Leapfrog, a nonprofit group supported by the Robert Wood Johnson Foundation, works to drive down health care costs by identifying avoidable mistakes. Twice a year, it grades hospitals based on 26 measures of hospital safety. Those include whether doctors use computer systems to enter their orders, whether a system is in place to identify and address risks, and patient outcomes, such as preventable blood infections.
The report found Maine’s health care providers are less likely to do harm than their counterparts around the country.
In central Maine, Inland Hospital and MaineGeneral Medical Center’s Thayer campus, both in Waterville, received A’s. Franklin Memorial Hospital in Farmington and MaineGeneral’s Augusta campus both received B’s.
MaineGeneral’s two campuses got different grades despite scoring identically in 25 of 26 measures. The exception was the number of patients who got bloodstream infections associated with “central lines,” narrow tubes that doctors sometimes insert into a patient’s neck or chest to deliver medication.
According to Leapfrog, the infections are usually preventable and can happen when the tube is not inserted or cleaned properly, in which case they can become entry points for germs and bacteria.
Lisa Simm, administrative director of quality at MaineGeneral, said there was just one such infection at the Augusta campus among the thousands of patient days covered in the report, but that one infection was enough to make the difference.
A separate measure gives points to hospitals that use computer systems to help doctors make better decisions for their patients.
At Inland, Mike Palumbo, vice president of medical affairs, said that when he prescribes medication for a patient, he types the prescription into a computer, which uses a “decision support matrix” to check for allergies or conflicts with other medications, among other things.
Implementation of the system earned Inland a perfect score of 100 on that measure. Each of the MaineGeneral campuses received a 50, while Franklin Memorial received a 5.
Simm said MaineGeneral does use the new technology, but its implementation is unfinished because of a major transition to a new regional health care facility, expected to be completed this fall. So many changes are associated with the move, Simm said, that administrators decided not to push the new technology on all doctors right away.
Despite Franklin Memorial’s low score on that measure, the hospital does have the computer system in place, said Ralph Johnson, chief information officer.
He said the hospital did poorly on that measure because his predecessor, for unknown reasons, chose not to fill out paperwork for Leapfrog demonstrating the system’s viability.
He said his predecessor, whom he did not name, also failed to document other things that could have helped Franklin Memorial’s score.
“We have a little bit of a knowledge deficit in what the thought process was,” he said.
Gerald Cayer, Franklin Memorial’s executive vice president, said the B grade doesn’t reflect a failure in providing hospital safety, but it is an accurate measure of how Leapfrog’s survey was handled in 2011.
Cayer said staff members are filling out the paperwork for a fresh round of grading in June, and when the grades are updated, he is confident his hospital’s grade will be raised to an A.
Cayer also said some of Leapfrog’s measures unfairly penalize small, rural hospitals such as Franklin Memorial.
Leapfrog is supported by its members, large health care purchasers, including large employers such as Toyota and the University of Michigan, as well as groups such as the Maine Health Management Coalition. In all, member groups buy health care plans for 34 million Americans.
Leapfrog provides different services to hospitals, including the surveys that form the basis of the grades and reports on industry benchmarks.
The grades are based on numeric scores that use data from performance measures of various groups, including the Centers for Disease Control and Prevention and the Centers for Medicare and Medicaid Services.
Simm said Maine has the top spot in the nation because of its strong natural work ethic. The state’s hospitals do well in national measures from other groups as well, she said.
“In Maine, there’s just an incredible amount of earnestness,” Simm said. “People like to do things well here. It’s the culture in our health care.”
Simm also credited professional organizations such as the Maine Hospital Association, which she said provide support that helps hospitals succeed.
Maine’s 80 percent is a much more impressive figure when compared to other states, almost all of which lag far behind.
There is a big drop between Maine and second-ranked Massachusetts, where 70 percent of hospitals received an A grade, and the third-ranked state, Minnesota, where 46 percent received a top grade.
In Indiana and Pennsylvania, which make up the median at 25th and 26th place, respectively, 28 percent of hospitals received an A.
At the bottom of the rankings, Idaho, Nevada, Kansas and Oregon had 10 percent each, just ahead of West Virginia, which had 8 percent, and New Mexico, which ranked last with 7 percent.
Matt Hongoltz-Hetling — 861-9287