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UMMC’s ‘F’ in patient safety galvanizes effort

By JACK WEATHERLY 

Dr. Michael Henderson was recruited to the University of Mississippi Medical Center from the Cleveland Clinic in Ohio to do what he had done there.

Raise the level of quality and safety.

Eight months after he signed on at UMMC, his reward was a big fat F on the hospital’s report card on patient safety.

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The report issued last week by the Leapfrog Group, a nonprofit organization founded in 2000 by the Business Roundtable, said that the Jackson hospital scored below the national average in three of five broad categories of safety and below average in 18 of 28 subcategories.

It had a top score in two categories because of the weight of a particular factor in each.

In the Right Staffing to Prevent Safety Problems, it was awarded a top score because of its use of “intensivists” in its intensive care unit, even though it was below average in three of five subcategories and above average in two.

In Hospital Uses Standard Safety Procedures, it was below average in four of five subcategories and average in the other. But because it uses computerized prescription ordering it was awarded 100 points.

In other categories:

» Safety Problems With Surgery. The hospital scored below average in all six subcategories to compile a score of 142.77, compared with average of 118.15.

» Staff Follows Steps to Make Surgery Safer. The hospital scored below average in three of five categories to score 98, compared with the average of 98.99.

» Infections and Safety Problems: 0.769, compared with the average of 1.06.

Henderson suggested that because the hospital is “the No. 1 trauma center in the state,” and keeps injured patients for longer periods than most hospitals, it has a special challenge.

“But this isn’t about making excuses. There’s no question that we have opportunities to drive improvement here.”

“It’s equally important for our patients that they are not frightened by thinking there are terrible things happening.”

“This is a good hospital. It does a good job, but like any hospital we can do better.”

He agreed that the leadership at the hospital recruited him to address problems that, generally speaking, are highlighted in the Leapfrog report.

UMMC had gotten D’s in the four semiannual reports before the current one.

Henderson was the chief quality officer at the Cleveland Clinic. “When public reporting of metrics started a decade ago, Cleveland Clinic didn’t look that good,” he said.

But it’s not just about improving performance based on publicly disclosed measurements of success or failure, he said, adding that it’s: “Are we really improving the overall culture of an organization so that patients are the center of what we do.”

“I am pleased with what I find with leadership. I am pleased with the improving engagement of our staff as a whole. But it’s journey. It will take some time. It usually occurs over a few years to drive the overall levels of improvement.”

It took five years to achieve that level at Cleveland Clinic, he said, adding that he hopes it won’t take that long at UMMC.

The U.S. News and World Report rankings of the best hospitals for 2015-2016 listed the Cleveland Clinic as among the top three in nine of 16 disciplines. Many factors were considered, the magazine said, including death rates and patient safety.

The UMMC leadership was disappointed with the Leapfrog report card, but “they view it as a galvanizing moment to get people engaged in the work we already had underway.”

Henderson cited some good news.

The Center for Medicare and Medicaid Services has taken the hospital off its list of hospitals that are being penalized for shortcomings in patient care and safety.

It had imposed a $1.5 million penalty on UMMC for the fiscal year that ended Oct. 1.

Twenty-five percent of the hospitals in the country were penalized 1 percent of their Medicare payments, Henderson said, noting that two-thirds of those penalized are academic institutions.

Leah Binder, chief executive and president of Leapfrog, said that a trauma center need not score low.

Detroit Receiving Hospital, Lincoln Medical Center and Elmherst Hospital in New York – so-called safety-net hospitals – all scored A’s in the most recent report, she noted.

Yet Henderson’s commitment to continue to participate in the Leapfrog survey as a sign of transparency was encouraging to Binder.

“I’m certain this hospital can do it,” she said.

Yet she said an F is a serious matter. “An F is three standard deviations below average. That’s very dramatic,” she said.

Only 34 of the 2,530 hospitals in the report got F’s, she said.

Asked if she would use UMMC at this point, she said, “Not right now.”

She added: “I have a feeling that six months from now I might feel differently. I have no doubt they will fix it.”

Henderson said the hospital leadership is disappointed but “they view it as a galvanizing moment” in the push for improvement.

Since Henderson disagrees with some of the assumptions of the Leapfrog report, he suggested that people “be cautious about overinterpreting any one of these scorecards. Talk to your physician.”

About Jack Weatherly

One comment

  1. Michael Henderson has been here before. Cleveland Clinic was given a “D” rating by Leapfrog and ranked by CMS in the bottom 7% of all hospitals for hospital squired conditions. Read here to see the damage control effort by Henderson before he left the very dangerous Cleveland Clinic.
    http://www.modernhealthcare.com/article/20140613/BLOG/306139998

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