CASPER — Wyoming hospitals rank 43rd in the nation for hospital safety and quality, according to a national report card that released its annual fall Hospital Safety Grades report last week.
The Leapfrog Group collects and aggregates data on hospital safety and quality to help patients learn more about their local health care providers. The group has been releasing hospital report cards for more than a decade.
Of nine Wyoming hospitals that provided information to the group, Jackson’s St. John’s Health received an A and Banner Wyoming Medical Center in Casper received a B grade. There were five hospitals that received C grades located in Cheyenne, Laramie, Lander, Riverton and Sheridan.
Below-average D grades were given to Campbell County Memorial Hospital in Gillette and Memorial Hospital of Sweetwater County in Rock Springs.
While the overall report doesn’t look good for Wyoming hospitals in general, Wyoming Hospital Association Vice President Josh Hannes said the organization does not rate Leapfrog grades high on its list of safety and quality indicators.
“There’s some problems with their methodology in the way that they score and then how they compare to other hospital safety rating scores from other reviewers,” he said. “There is not a correlation between those two. If there is not a solid methodology that is repeatable in multiple places than I don’t know if you can really look at Leapfrog and make a lot of good conclusions about a particular hospital’s safety scores and quality.”
He pointed to Memorial Hospital of Sweetwater County in Rock Springs, which received a 4 Star rating from the Centers for Medicare and Medicaid Services, but a D from Leapfrog.
According to Leapfrog, none of the state’s hospitals were given “green” ratings as none were acceptable, for hand hygiene.
Just three, Banner Wyoming Medical Center and SageWest Healthcare hospitals in Lander and Riverton, were in the “yellow,” or caution, range. The other hospitals were in the “red” and not recommended.
Hand Hygiene
Hannes disputed the study’s assessment and said hospitals in the state make hand hygiene an emphasis. The best-practice standard is for all clinicians to “wash in” and “wash out” of patient rooms using soap and water or an alcohol-based hand gel.
“It’s taken incredibly seriously in Wyoming,” he said. “And that’s one of the problems of Leapfrog methodology. They score you very heavily on whether or not you fill out their survey.”
Hospitals that don’t complete the survey are automatically put at the “mean” or average of comparable hospitals, he said. Hannes said some hospitals in Wyoming participate, but many do not and that could be because of the burden for reporting to so many agencies such as CMS, The Joint Commission, OSHA, and state a local fire inspectors to name a few.
The Leapfrog report also indicates that only Banner Wyoming Medical Center in Casper and SageWest Health Care in Riverton are appropriately using computerized physician order entries, the best practice standard for ordering medications.
Hannes said all of the state’s hospitals use electronic medical records. He said that score is another example of penalizing hospitals that do not fill out the survey.
The Leapfrog Group describes itself as an independent nonprofit focused on patient safety that uses 30 performance measures to evaluate about 3,000 hospitals across the nation in areas of patient safety that include medical errors, hospital acquired infections, patient falls, and much more.
Hospitals are assigned letter grades A through F using a public, peer-reviewed methodology, calculated by top patient safety experts under the guidance of national experts to determine trends and rankings, the group says.
State Rankings
For fall 2024, Utah ranks No. 1 with the highest percentage of A-rated hospitals for the third cycle in a row, followed by Virginia and Connecticut in second and third.
Leapfrog indicated the latest grades show hospitals nationally are making progress in patient safety across several performance measures, including notable improvements in lowering health care-associated infections, improving hand hygiene and prioritizing medication safety.
"Preventable deaths and harm in hospitals have been a major policy concern for decades. So, it is good news that Leapfrog’s latest safety grades reveal that hospitals across the country are making notable gains in patient safety, saving countless lives," said Leah Binder, president and CEO of The Leapfrog Group. “Next, we need hospitals to accelerate this progress, because no one should have to die from a preventable error in a hospital.”
Every state that borders Wyoming did better than the Cowboy State, except South Dakota, which ranked 48th with no hospitals achieving an A grade.
In addition to Utah ranking first nationally in terms of the highest percentage of hospitals with the highest marks, Idaho ranked eighth, Colorado 10th, Montana 16th and Nebraska 37th.
Hannes said one thing to note with Leapfrog is that it does not grade veteran’s or critical access hospitals across the country. And there are 16 critical access hospitals and two veterans’ hospitals, all important facilities for health care in the state.
At the American Hospital Association in Washington, D.C., Senior Director of Quality & Patient Safety Akin Demhin characterized Leapfrog as “one tool among many available to patients when making health care decisions.”
“As with any report card, Leapfrog grades must be interpreted in context. For example, some of the data used to calculate grades are more than two years old and may not reflect more recent performance improvement efforts,” he said. “In addition, not all measures apply to all patients, which can limit any report card’s usefulness to specific patients.”
Demhin advised patients to use all the tools available prior to making care choices, including talking with healthcare providers who “know their clinical needs.”
Leapfrog’s grades showed St. John’s Medical Center in Jackson improved from a C in the spring. But according to information on the Leapfrog website for fall, the hospital still scored in the red for “harmful events” under the safety category. It was in the green or at acceptable levels for patient falls with injury, dangerous blood clots or air or gas bubbles in the blood.
Under the category of practices to prevent errors, the hospital scored in the green for communication about medicines, communication about discharge and staff working together to prevent errors.
The hospital has a 5-star rating on medicare.gov. Officials at the hospital did not return a request for comment.
Campbell County Memorial Hospital
At Campbell County Memorial Hospital in Gillette, there was just one area that scored acceptably in the safety category: “air or gas bubbles in the blood.”
The hospital scored in the red for harmful events which represent complications or harmful events following a surgery, procedure or childbirth.
It also scored in the red for patient falls and injuries, collapsed lung and dangerous blood clots. It was in the yellow, representing caution, for dangerous bed sores and falls causing broken hips.
Under the surgery category, it was in the red for surgical wounds spilt open and serious breathing problems, and under the category of practices to prevent errors, in the red for how doctors ordered medications through a computer, safe medication administration and hand washing.
It was green for communication about medicines and communication about discharge.
The hospital scored in the green for communication with doctors, communication with nurses and responsiveness of hospital staff.
Campbell County Memorial’s overall D grade represents its fourth below-average mark since the spring 2023.
The hospital did not respond to a request for comment by deadline. The hospital currently has a 2-star rating on medicare.gov.
Memorial Hospital Of Sweetwater County
In Rock Springs, Memorial Hospital of Sweetwater County fell backward to a D grade from a C in the spring, according to Leapfrog.
The hospital scored in the red for harmful events, dangerous bed sores, patient falls with injuries. The hospital was in the yellow for falls causing broken hips, collapsed lung and dangerous blood clots. It was in the green or acceptable for air or gas bubble in the blood.
In the category of practices to prevent errors, it was red on safe medication administration, hand washing and doctors order medications through a computer. It was green on communications about medicines to patients and communication about discharge.
Hospital spokesperson Deb Sutton said the hospital does not participate in the annual voluntary Leapfrog Hospital Survey and emphasized the hospital recently received a 4-star rating out of 5 from the Centers for Medicare and Medicaid Services. She said the hospital also is accredited.
“And they look through all of those patient safety and life safety measures,” she said.
Leapfrog states on its website that when hospitals do not participate in its survey, “the majority of the data used to calculate the safety grade comes from … CMS.”
Despite the red indicator for physician medication orders through the computer, Sutton said the hospital does use a computerized physician order entry system.
One positive for all the hospitals in the Leapfrog review was that all nine scored in the green under one item in the “problems with surgery” category. None left a “dangerous object” in a patient’s body, according to the Leapfrog.
Hannes said the wisest thing for Wyoming patients to do is ask their providers and nurses when they are going to have a procedure about the outcomes for that procedure in that facility.
“Readmission rates, complications — they should be asking those things of their providers,” he said. “I think a wise thing for them to do is have insight into patient safety and what those hospitals are doing. I know our hospitals are happy to talk about the very specific things that are happening there to demonstrate how seriously they take safety and their constant improvement in safety.”
Dale Killingbeck can be reached at dale@cowboystatedaily.com.
