Published by Susan K. Livio on NJ.com.
Fewer hospitals in New Jersey earned an “A” for patient safety in the latest national report card released Tuesday.
That drove New Jersey’s national rank down from 11th to 17th best for the strategies they used to prevent infections, falls and other harmful mistakes, according to the report.
Just 22 of the 65 hospitals graded earned an A compared to the 30 hospitals that aced the survey in October, the report said.
The Leapfrog Hospital Safety Grades, released twice a year since 2012, was developed in the wake of a landmark 1999 report by the Institute of Medicine that revealed hospital errors kill about 98,000 patients a year. The survey doesn’t measure a doctor’s care, but rather how safe the hospital has kept a patient while receiving that care.
Although some hospitals have criticized the survey as too simplistic and reliant on dated information, Leapfrog’s report card has become a widely tool to educate the public, prod poor-performing hospitals to improve and reward high-achievers which proudly use their A’s in marketing campaigns.
Here’s what you need to know about New Jersey hospitals based on the newest report:
Leapfrog graded 2,500 hospitals for this report.
Hawaii, Idaho, Rhode Island, Massachusetts and Virginia ranked in the top five, while North Dakota, Delaware, Alaska, which had no “A” hospitals, tied for last. New York and Maryland ranked just above them.
“The national numbers on death and harm in hospitals have alarmed us for decades,” said Leah Binder, Leapfrog’s CEO and president. “What we see in the new round of Safety Grades are signs of many hospitals making significant improvements in their patient safety record. Leapfrog Hospital Safety Grades have definitely spurred these improvement efforts.”
A dozen New Jersey hospitals improved and 15 hospitals slipped one or two grades, in the latest report.
Of the 65 hospitals Leapfrog graded in New Jersey, 22 earned an A, down from 30 hospitals last fall.
* Bayshore Medical Center, Holmdel;
* Capital Health Medical Center – Hopewell;
* CarePoint Health – Bayonne Medical Center;
* Clara Maass Medical Center, Belleville;
* Hackensack University Medical Center;
* Holy Name Medical Center, Teaneck;
* Inspira Medical Center, Vineland;
* Jefferson Stratford Hospital;
* Jefferson Washington Township Hospital;
* Jersey Shore University Medical Center, Neptune;
* Monmouth Medical Center, Long Branch;
* Morristown Medical Center;
* Newton Medical Center;
* Overlook Medical Center, Summit;
* Riverview Medical Center, Red Bank;
* Robert Wood Johnson University Hospital at Hamilton;
* Saint Barnabas Medical Center, Livingston;
* Shore Medical Center, Somers Point;
* The Valley Hospital, Ridgewood;
* University Medical Center of Princeton at Plainsboro;
* Virtua Marlton Hospital;
* Virtua Voorhees Hospital.
There hospitals earned a B:
* Atlantic Regional Medical Center, Atlantic City;
* Atlantic Regional Medical Center, Pomona;
* Cape Regional Medical Center, Cape May Courthouse;
* Capital Health Regional Medical Center, Trenton;
* CarePoint Health, Hoboken University Medical Center;
* CentraState Medical Center, Freehold;
* Chilton Medical Center, Pompton Plains;
* Community Medical Center, Toms River;
* Englewood Hospital and Medical Center;
* Hunterdon Medical Center, Flemington;
* Inspira Medical Center Woodbury;
* Jefferson Cherry Hill Hospital;
* Jersey City Medical Center;
* JFK Medical Center, Edison;
* Newark Beth Israel Medical Center;
* Ocean Medical Center, Brick;
* Our Lady of Lourdes Medical Center, Camden;
* Raritan Bay Medical Center, Perth Amboy;
* Robert Wood Johnson University Hospital, New Brunswick;
* Robert Wood Johnson University Hospital-Somerset, Somerville;
* Saint Peter’s University Hospital, New Brunswick;
* Southern Ocean Medical Center, Manahawkin;
* St. Francis Medical Center, Trenton;
* St. Mary’s General Hospital, Passaic.
These hospitals earned a C:
* CarePoint Health-Christ Hospital, Jersey City;
* Cooper University Hospital, Camden;
* Hackensack University Medical Center-Pascack Valley;
* Hackensack University Medical Center-Mountainside;
* Hackensack University Medical Centers-Palisades, North Bergen;
* Hackettstown Regional Medical Center;
* Lourdes Medical Center of Burlington County, Willingboro;
* Memorial Hospital of Salem County, Salem;
* Raritan Bay Medical Center, Old Bridge;
* Robert Wood Johnson University Hospital-Rahway;
* St. Clare’s Hospital, Denville;
* St. Clare’s Hospital, Dover;
* St. Michael’s Medical Center, Newark;
* St. Joseph’s Regional Medical Center in Paterson;
* St. Joseph’s Wayne Hospital;
* St. Luke’s Warren Campus, Phillipsburg;
* Trinitas Regional Medical Center, Elizabeth;
* Virtua Memorial Hospital, Mount Holly.
University Hospital, a state-run facility in Newark, received the only F in New Jersey, and one of 22 in the nation, according to the report.
No New Jersey hospital received a D.
University Hospital spokesman Richard Remington said the grade does not reflect the most recent strategies the hospital has adopted to improve patient care. They include a greater reliance on electronic medical records, bringing in more social workers for evening and weekend shifts, and hiring more employees focused on safety.
“LeapFrog uses a variety of factors when developing its grade, and the data can go back as far as 2014. What we know by looking at our own data is that if Leapfrog used real-time or 2017 data alone, our grade would be in alignment with our national peers,” Remington said. “But we are not satisfied with being average, either. We have an aggressive plan in place to get to an ‘A’ grade, and we remain focused on providing high quality care to all of our patients.”
Four hospitals did not voluntarily share their data with Leapfrog, a factor that likely hurt their standings. They are:
- East Orange General Hospital (no grade);
- Hudson Regional Hospital (the renamed Meadowlands Hospital Medical Center) in Secaucus (no grade);
- Memorial Hospital of Salem County, Salem (C);
- St. Luke’s Warren Campus, Phillipsburg (C).
Leapfrog was able to find enough publicly available data to give East Orange and Hudson Regional a grade, said Linda Schwimmer, president and CEO of the New Jersey Health Care Quality Institute, a research and consumer advocacy nonprofit.
Her organization prods hospitals throughout the year to submit their information, she said.
“Being transparent about quality and safety is one of the ways you focus on and improve patient safety,” she said.
The St. Barnabas Medical Center success story
St. Barnabas Medical Center is the only hospital in New Jersey and one of 49 in the nation to earned an A in all 13 report cards since the Leapfrog surveys began.
“We are very proud. We are in a rarefied group,” President and CEO Stephen P. Zieniewicz said. “Everybody on the health care team participates to ensure the patients and their families and the people who work here have a safe environment.”
Before Leapfrog’s report card surveys began, St. Barnabas instituted an anonymous safety hotline and encourages its staff to use it to report mistakes or concerns, Zieniewicz said.
Two years ago, the hospital instituted a daily morning briefing, attended by 30 managers, to discuss any safety concerns that arose in the previous 24 hours, he said.
Barnabas also created its own internal safety scoring system, and instituted a “read-back” protocol, which requires pharmacists, nurses and other professionals to verify a physician’s orders, he said.
Linda Schwimmer, president and CEO of the New Jersey Health Care Quality Institute, which promotes hospital participation in the Leapfrog safety report card. (Courtesy of NJHCQI)
New Jersey’s drop in the national rankings is not a major concern, Schwimmer said. The state’s standing rise and fall depending on how other states improve or decline, she said.
Only two hospitals fell by two letter-grades. Both CarePoint Health-Christ Hospital in Jersey City and Virtua Memorial Hospital in Mount Holly slipped from an A to a C, according to the report.
“As long as they continue to show progress, and they have a team internally making this a priority, I don’t get so worried about hospitals slipping from an A to a B,” she said. She said she is more concerned about hospitals that “make excuses, or say the data aren’t relevant. They are in the denial stage.”
The survey doesn’t measure a doctor’s care, but rather how safe the hospital has kept a patient while receiving that care. The score is based on 27 categories which include physician and nurse staffing ratios, the number of post-surgical infections, and the incidence of blood clots and falls. The data is based on the most recent information available, which ranges from 2014 to 2017, depending upon the measurement.
“We always think of safety in the broad sense, but for the person who enters a hospital and ends up with an infection they did not plan on taking home with them, this is extremely meaningful, and matters a great deal,” said Schwimmer. “Everyone in health care wants to avoid that kind of outcome, and focusing on safety is the first step toward that.”
Schwimmer said she hoped the Gov. Phil Murphy’s administration uses the information to make healthcare decisions for state employees. Michigan passed a law requiring hospitals to participate in the safety survey. And Maine lets state employees pay less in co-pays and other cost-sharing expenses if they use hospitals that have scored an A or a B, Schwimmer said.
“Once you start connecting the dots to out-of-pocket costs, the consumer pays attention more,” said Schwimmer, who serves on Leapfrog’s board of directors. “The state should be thinking about how it uses its power as a purchaser.”