Jordan Ellis
Consumer Reports provides hospital safety ratings to help patients make informed decisions about their care. These ratings are based on various factors, including patient harm, infections, readmissions, communication, CT scanning, complications, and mortality. While the ratings only cover a small percentage of hospitals, they provide valuable insights into hospital safety and help patients identify potential problems. Additionally, organisations like The Leapfrog Group provide free patient safety data, while the Safe Patient Project gathers patient stories to promote legislative and regulatory changes. These initiatives aim to improve transparency, patient safety, and the overall quality of healthcare. With medical mistakes being a common occurrence, patients are encouraged to share their experiences and take steps to protect themselves, such as ensuring hand hygiene and inquiring about necessary procedures.
| Characteristics | Values |
|---|---|
| Safety Ratings | Infections, readmissions, communication, CT scanning, complications, and mortality |
| Patient Experience | Whether patients would recommend the hospital, their overall assessment, their experience with doctors and nurses, pain control, and room conditions |
| Hospital Practices | Use of electronic health records and appropriate use of CT scanning |
| Safety Score | Avoiding infections, readmissions, communication about medications and discharge, appropriate use of CT scanning, avoiding complications, and mortality |
| Sources of Information | The Leapfrog Group, U.S. News & World Report, Consumer Reports |
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What You'll Learn
Infection prevention and handwashing
Infection prevention is a critical aspect of ensuring patient safety in hospitals. One of the most effective ways to prevent infections and control their spread is through proper hand hygiene. According to the World Health Organization (WHO), appropriate hand hygiene can prevent up to 50% of avoidable infections acquired during healthcare delivery, including those impacting healthcare workers.
Hand hygiene is particularly crucial in preventing bloodstream infections introduced through large intravenous catheters in intensive care patients. These central-line infections account for about 15% of all hospital infections but are responsible for at least 30% of annual hospital infection-related deaths.
To maintain proper hand hygiene, healthcare workers should wash their hands with soap and water or use an alcohol-based hand rub or gel. This should be done before and after examining a patient, inserting or handling a catheter, and before touching a patient or invasive medical devices. Additionally, caregivers should wear sterile gloves when touching catheters and ensure dressings are in place.
Handwashing techniques should also promote healthy hand skin. This includes avoiding hot water, patting hands dry instead of rubbing, and using approved hand lotions to prevent skin dryness. Healthcare personnel should also avoid artificial fingernails or extensions when in direct contact with high-risk patients as germs can reside under them.
Patients and their loved ones can actively participate in infection prevention by reminding healthcare providers to practice hand hygiene. This includes asking them to wash their hands before providing treatment or examining the patient. By adopting these measures, hospitals can significantly reduce the risk of healthcare-associated infections and improve patient safety.
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Patient safety and experience
The CR Hospital Safety Score is not the only rating system available to patients. The Leapfrog Group, for instance, provides free patient safety data and assigns letter grades (A, B, C, D, or F) to hospitals based on safety. These ratings are updated twice a year and are designed to help patients make informed decisions about their care.
In addition to these safety ratings, patients themselves play a critical role in ensuring their safety and positive experience in hospitals. Patients or their advocates are often the best defence against drug mix-ups, hospital-acquired infections, surgical mistakes, and other errors. Patients are encouraged to be proactive in their care, asking questions and seeking clarification until they fully understand their treatment. This level of patient involvement can help identify and prevent potential mistakes, ultimately improving patient safety and experience.
Furthermore, patients who have experienced harm during hospitalisation are encouraged to share their stories. Initiatives like the Safe Patient Project by Consumers Union aim to address legislative and regulatory changes by amplifying patient voices. By sharing their experiences, patients can help identify systemic issues and drive improvements in hospital safety measures.
Overall, patient safety and experience are multi-faceted issues that require the collaboration of patients, healthcare providers, and advocacy organisations. By utilising resources like safety ratings and actively engaging in their care, patients can make more informed decisions and contribute to a culture of continuous improvement in healthcare delivery.
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Surgical wounds and accidental cuts
Surgery is a scary prospect for anyone. It usually involves having your body cut open, and sometimes things can go wrong. Patients may react badly to anaesthesia, or suffer breathing or heart problems. In some cases, the surgeon might accidentally nick a blood vessel, leave an instrument inside the patient, or even operate on the wrong body part.
However, less dramatic but often as serious and far more common are the complications that can arise after the patient has left the operating room. Up to 30% of patients suffer infections, heart attacks, strokes, or other complications after surgery, and sometimes these can even be fatal. Surgical incisions, catheters, and intravenous lines give bacteria direct access to a patient's bloodstream, and surgery patients are also prone to blood clots, in part because reduced mobility prevents blood from circulating. Clots that break off and travel to the heart or lungs can be deadly, and the combination of lying flat and shallow breathing can cause pneumonia.
Fortunately, experts have developed ways to reduce many of these complications. For example, smaller incisions mean patients lose less blood, and better instruments cause less soft-tissue damage. More effective pain medications mean that it is now feasible to perform certain surgeries on an outpatient basis. However, it is important to understand the potential risks of your particular surgery before deciding whether to have it at an ambulatory surgery centre (ASC) or elsewhere. Research suggests that certain procedures may be more problematic when done on an outpatient basis. For example, a 2016 study found that patients who had outpatient surgery for ankle fractures had lower rates of urinary tract infections, pneumonia, and blood clots, and required fewer blood transfusions than those who had the surgery in a hospital. However, trips to the emergency room, ambulatory surgery, and hospital admissions were more common after two other common outpatient procedures: prostatectomies and hernia repairs.
When considering outpatient surgery, it is a good idea to do some research first. If you are having surgery at an ASC that is not affiliated with a hospital, ask if it is CMS-certified. You can also ask your surgeon about their infection and complication rates for your surgery and check these against inpatient and outpatient hospital rates.
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CT scans and radiation exposure
CT scans are a valuable diagnostic tool, using ionizing radiation to create cross-sectional images of the body and providing more detail than X-rays. However, the radiation exposure from CT scans has been a growing concern. CT scans alone account for 24% of all radiation exposure in the United States, according to a 2009 report. The use of CT scans has surged by 35% since 2007, partly due to an increase in low-value and potentially unnecessary imaging.
CT scans expose patients to levels of radiation that can increase cancer risk. The projected cancer risks per CT scan are higher in children than in adults and are highest in children under one year of age. Abdominal and pelvic CT scans contributed to the largest number of projected cancers, with lung cancer being the most common type, followed by colon cancer. The risk is comparable to other population-wide risk factors for cancer, such as alcohol consumption and excess body weight. However, it is important to note that the benefits of CT scans often outweigh the risks, especially when the scan is clinically justified.
To reduce radiation exposure and cancer risk, it is recommended to limit CT scans to situations where they are necessary. Ultrasound and magnetic resonance imaging (MRI) are alternative options that do not use ionizing radiation. Optimizing the radiation dose used in each scan is also crucial, as the amount of radiation emitted by a CT scan can vary widely. Patients should keep track of their cumulative radiation exposure and only undergo tests when necessary.
Radiation protection experts at Memorial Sloan Kettering Cancer Center (MSK) emphasize that MSK physicians follow two fundamental principles to protect patients when using imaging tests that employ radiation. The first is justification, ensuring that the clinical benefit outweighs any associated risk. The second is optimization, minimizing radiation exposure while maintaining image quality. MSK utilizes mathematical models and simulation tools to assess radiation distribution and reduce exposure to areas outside the imaging site.
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Hospital safety ratings and transparency
Hospital safety ratings are an essential tool for patients to make informed decisions about their healthcare. These ratings provide valuable insights into the safety records of hospitals, helping patients choose the safest option for their medical needs. The ratings also encourage hospitals to improve their safety standards and enhance transparency in the healthcare industry.
One notable example of hospital safety ratings is the Leapfrog Hospital Safety Grade by The Leapfrog Group. This nonprofit employer-advocacy group has been collecting, analyzing, and publishing hospital data on safety and quality for over 20 years. The Leapfrog Hospital Safety Grade is unique in that it is the only hospital rating focused solely on hospital safety. It utilizes a simple letter grade system (A, B, C, D, or F) to indicate how safe hospitals are for patients. This straightforward rating method makes it easy for consumers to select the safest hospital for their care.
The Leapfrog Hospital Safety Grade evaluates hospitals on various factors, including accidents, injuries, errors, and infections. It also considers the hospital's commitment to patient safety through measures such as handwashing, strong healthcare teams, and policies for preventing mistakes. By assessing these aspects, the ratings provide a comprehensive overview of hospital safety, enabling patients to make informed choices.
In addition to The Leapfrog Group, other organizations also contribute to hospital safety ratings and transparency. Consumer Reports, for instance, offers safety ratings that cover categories such as infections, readmissions, communication, CT scanning, complications, and mortality. They also provide safety advice for patients, empowering them to take proactive measures to protect themselves during their hospital stay. Furthermore, Consumer Reports emphasizes the importance of choosing a safe hospital and understanding medical insurance coverage to avoid unnecessary costs.
The federal government has also recognized the significance of hospital safety, providing funding to improve safety standards and transition programs for Medicare patients. Additionally, hospitals are incentivized to adopt electronic health records, enhancing data collection and transparency. These collective efforts by nonprofit organizations, consumer groups, and the government are driving positive changes in hospital safety and transparency, ultimately benefiting patients and their families.
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Frequently asked questions
Before going to the hospital, you can ask questions such as whether the hospital uses a checklist of best practices for inserting and maintaining central lines and how you or your caregiver can help monitor those lines. You can also ask whether shaving your surgical site is necessary as nicks can cause bacteria to enter.
While at the hospital, make sure that everyone who touches you washes their hands and that the hospital follows infection-prevention guidelines. If you are scheduled to get a CT scan, ask whether it is required and whether an MRI or ultrasound could be used instead.
Schedule an appointment with your doctor about a week or two after your hospital stay. If you don't have a primary-care doctor, ask the physician who oversaw your care in the hospital whom you should see.
