How safe are you when you become a patient at a South Florida hospital?
Not as safe as you should be, according to newly released ratings from the Leapfrog Group.
The nonprofit watchdog organization’s fall 2023 ratings report revealed six hospitals in South Florida between Jupiter and Key Biscayne received a “D” grade for patient safety. Those hospitals are Jackson South in Miami, North Shore Medical Center in Miami, HCA Florida Northwest Hospital in Margate, Florida Medical Center in Fort Lauderdale, Baptist Health Boca Regional Hospital, and HCA Florida JFK Hospital in Atlantis. All six hospitals saw their scores decline from a C rating a year ago.
The majority of the other 33 hospitals in South Florida received Bs and Cs when graded for medical errors, injuries while in the hospital, and infections during an inpatient stay.
Only four hospitals in the tri-county area earned an A rating — Baptist Health Doctors Hospital in Coral Gables, Baptist Health Homestead Hospital, HCA Florida Westside Hospital in Plantation, and Memorial Hospital Miramar. No hospital in Palm Beach County scored an A.
Florida is one of three states that experienced the most significant decreases in patient experience scores between the fall of 2021 and the fall of 2023, according to the Leapfrog Group. How did Broward County’s oldest hospitals fare? Broward Health Medical Center earned a B and Memorial Regional earned a C. Both scores represent a decline in patient safety over the last two years.
In its scores, Leapfrog considers three infection measures — the number of MRSA cases (staph infection), central line infections and urinary tract infections — that occurred in hospitalized patients. It also includes communication about medicines and staff responsiveness to patients.
Nationally, for the second year in a row, hospitals on average scored worse on measures like nurse and doctor communication and discharge information. Experts believe workforce shortages have made nurses less available to answer call buttons in a timely manner and spend time with patients.
“It is disturbing, as typically we don’t see a lot of change in patient experience scores over time,” Leapfrog Group President and CEO Leah Binder told Modern Healthcare. “Not this time. In addition to deteriorating during the pandemic, they also deteriorated post-pandemic.”
Baptist Health South Florida, which prides itself on its nursing care, saw the rating at its Boca Raton hospital drop from a C last fall to the D this year. The hospital scored poorly for the number of sepsis infections and accidental cuts or tears after surgery as well as dangerous bed sores and blood clots as complications. Yet Baptist Health South Florida managed to maintain its patient safety rating of A at its hospital in Coral Gables and in Homestead, scoring above average for keeping its MRSA infection rate low and for patient falls or injuries.
Workforce shortages are a national concern for hospitals, which makes quality of care more challenging, says Steven Ullmann, director of the Center for Health Management and Policy at the University of Miami. Regardless, he said, “There are processes one can do to improve these kinds of patient safety outcomes, but they have to come from the top down and the bottom up.”
For their part, patients need to do their homework, he said. “A hospital might have the greatest physicians, but if it doesn’t have great controls in how it sets up its operating rooms and how it makes sure no errors go on and watches its infection control, then it may not be where you want to go.”
Ullmann said patients need to realize that even within a health system, each hospital has different CEOs, different patient populations, and different areas of focus. “It’s more useful and more important to look not just at general ratings, but also to see what a hospital is good at for specific services,” he said.
The Leapfrog safety grades are measured using patient responses to a national and standardized patient survey after a hospital visit. Patients are asked to rate their experience of nurse communication, doctor communication, staff responsiveness, communication about medicine, and discharge information. Leapfrog is the only hospital ratings program based on prevention of medical errors and harm to patients.
“The goal of the Leapfrog Hospital Safety Grade is to reduce the over 200,000 yearly deaths from hospital errors and injuries by publicly recognizing safety and exposing harm,” the company website says.
Rayna Letourneau, executive director of the Florida Center for Nursing, said coming out of the pandemic, this report is especially useful for hospitals to assess their quality controls.
“If you are finding those are not grades you would want to see, the question would be why,” she said. “Nurses make up the largest workforce in a hospital setting, but we are one part of a team. Within a specific institution, you have to look at whether they have an adequate supply of qualified nurses, what supporting resource nurses have, and what ancillary staff hospitals have.”
She hopes hospitals will use their decline in scores as motivation.
“We will have to continue to monitor and continue to study patient safety and take deep dives into the issues we are seeing in Florida,” she said. “The Leapfrog report gives us a starting point to look at opportunities for improvement and understand why we are not meeting desired outcomes.”
Sun Sentinel health reporter Cindy Goodman can be reached at cgoodman@sunsentinel.com.