Two hospitals improve and two regress in latest hospital quality report card

Just four San Diego County hospitals saw their grades change in the latest biannual Leapfrog hospital safety report.

Released Wednesday, the report card, which Leapfrog issues each spring and fall, rates more than 2,600 hospitals nationwide across 28 measures gleaned from federal data sources and responses to surveys it asks hospitals to voluntarily complete.

The list includes "outcome" measures, such as infection and readmission rates, and "process" measures, such as whether facilities follow best practices from using computerized physician order entry systems and scanning medication bar codes at the bedside to help prevent medication errors.

While some outcome measures represent performance in 2018 alone, most incorporate several years of data, in some cases incorporating performance numbers from as far back as 2015 to build the grades that are published each spring and fall on the nonprofit's website.

This time around, two hospitals improved on the grades Leapfrog assigned them in the fall of 2018 while two experienced grade deflation.

Alvarado Hospital Medical Center in La Mesa and Scripps Green Hospital in Torrey Pines both moved from Bs to As while Scripps hospitals in La Jolla and Encinitas drop a letter grade from A to B and from B to C respectively.

The majority of hospitals operating in the region saw no change in their grades. Sharp Memorial Hospital in Serra Mesa continues to lead the class with a string of As stretching back to the spring of 2016 when it received a C.

A grades do not denote perfection. Sharp Memorial, for example, is listed as underperforming in seven of 28 categories including infections and falls. Leapfrog is clearly grading on a curve, awarding top grades to those who best national averages most often.

The latest detailed results show that Scripps Memorial Hospital Encinitas, while nowhere near the bottom performers nationwide, had higher-than-average rates of blood, urinary tract, MRSA and surgical site infection after colon surgery. Scripps Memorial Hospital La Jolla also saw somewhat higher-than-average rates of urinary tract, surgical site and MRSA infections though the gaps were smaller than they were at its sister facility to the north.

Leapfrog, which started releasing safety scores for the nation's hospitals in 2012, is far from the only player in the ratings game. In recent years, researchers and others have noted that there is no uniformity in the outcome of various rankings systems. Scripps La Jolla is one of the better examples of this phenomenon. For two years running, it has been awarded the largest number of nationally-ranked specialties in the annual "Best Hospitals" report from U.S. News and World Report.

Experts advise patients trying to choose a facility to look at more than one set of scores before making a decision. And ratings systems are not the only source of information. Word of mouth, experts say, can be a valuable component for decision-making in situations where a patient's insurance coverage provides options about where to receive care.

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