New hospital-safety grades find several South Sound facilities deficient

A national hospital-safety evaluator has ranked Washington’s facilities among the bottom tier of states, and low grades given to several South Sound hospitals are a significant reason why.

The nonprofit Leapfrog Group, which updates its evaluations twice yearly, ranks Washington’s hospitals collectively at 41st in the country.

The state’s neighbors ranked far higher, with Idaho and Oregon placing in the top 5. More than half of the hospitals in each of those states got A grades for safety. Seven of the 46 Washington hospitals graded got A’s, the same number evaluators gave a D or F score.

The grades came in especially harsh for hospitals operated by CHI Franciscan. The Tacoma-based medical nonprofit’s Highline Medical Center in Burien received the only F in the state and was one of 10 nationally to get that grade, which it also received in the fall 2016 evaluation.

Three of CHI Franciscan’s South Sound facilities were responsible for half of the state’s six D grades: St. Joseph Medical Center in Tacoma, St. Francis Hospital in Federal Way and St. Clare Hospital in Lakewood.

No CHI Franciscan hospital got higher than a C grade, and no other operator’s South Sound facility scored worse than a C.

CHI Franciscan chief medical officer Michael Anderson said in a statement that the organization “is committed to enhancing our systems and processes in order to provide the safest high-quality care possible.”

Leapfrog was founded by a consortium of large employers, including Boeing, General Motors and AT&T. It is one of four major hospital evaluators that uses various combinations of publicly available statistics and survey data. The rating systems often disagree. A 2015 study of 2012-13 grades by Health Affairs magazine found that no hospital nationally had been ranked as a high performer by all four agencies.

Leapfrog’s measurements come from a hospital-submitted report from 2016 on each facility’s practices and structure, and on the publicly submitted incident data collected by the federal Centers for Medicare and Medicaid Services.

That information takes several years’ incident reports — including deaths among inpatients, infections and accidental cuts — into account.

The separation between letter grades can result from coming up just short in Leapfrog’s data formulation, or the result of fundamental shortcomings.

For example, MultiCare’s Auburn and Good Samaritan hospitals missed out on A grades by 0.05 of a point, MultiCare spokeswoman Marce Edwards said.

The B grade given to Providence Centralia hospital, though, was the highest that facility was eligible for. Getting A grade required that intensive-care doctors have specialized training, and the Centralia doctors don’t have it.

“We’re looking at options to do that in a tele-health model,” said Jill Cooper, vice president of quality in southwest Washington for Providence.

MultiCare did not fare as poorly as CHI Franciscan in the latest rankings. Its South Sound facilities scored B or C. Edwards said that because some of the statistics are based on cases from prior years, the data doesn’t reflect up-to-the-moment conditions at hospitals.

One South Sound hospital was among the 823 nationally — and seven in Washington — to receive an A grade: Providence St. Peter Hospital in Olympia. The hospital, which has gotten A marks from Leapfrog in every evaluation since 2014, was the only Providence-run facility in Washington to get the top score in the state.

The best use to an average consumer of national-evaluation reports comes in tracking how a hospital’s grade changes over time by the lights of one evaluator, Cooper said.

If the same evaluator takes a hospital from a C grade to an A, she said, it can indicate the hospital made specific improvements.

“We think this is a good indicator of patient safety,” Cooper said of Leapfrog’s findings, “We always strive to do better, and there’s always improvement to make, but this is a good validation of the things we’ve been doing.”

She recommended that a consumer scrutinizing hospital evaluations with an eye toward future treatment would be well-served to call the hospital directly with specific questions.

“I wouldn’t ask them, ‘Do you take good care of me?’ ” she said. “I want to ask them, ‘How many of those do you do? Where do I find your surgical site infection rates?’ because those are publicly reported.”

This story was originally published April 11, 2017 at 5:08 PM with the headline "New hospital-safety grades find several South Sound facilities deficient."