Wednesday, November 4, 2015

UMMC responds to hospital safety rating

*Earlier post with copy of report and ratings.

Dr. Louann Woodward, Vice Chancellor for Health Affairs and Dean of the School of Medicine
 at UMMC
, sent out the following email to UMMC staff in response to the Leapfrog report that gave the medical center an "F" for hospital and patient safety.*

Leapfrog and UMMC

Good morning.

I'm sending out a VC Notes on a Monday, in addition to the usual Friday edition, to respond to a news story that appeared this weekend. 

On Saturday, the Clarion-Ledger carried an article about our hospital's safety scores as published by The Leapfrog Group.  We think the article was essentially accurate, but it painted an incomplete picture of patient safety at UMMC.

The Leapfrog Group has contributed to putting patient safety on the map by publishing safety scores for hospitals during the last three years.  It produces numeric scores for hospitals based on two sources of information.  First, it uses publicly available quality data for all hospitals, and second, it invites hospitals to take a lengthy, self-reported survey. 

About half of the country's hospitals actively participate in the survey, and this is the first year that UMMC has submitted data to Leapfrog, in hopes of gaining additional insight toward our ongoing efforts to improve clinical quality.  To our knowledge, UMMC is the only metro-area hospital that voluntarily submits data to Leapfrog.

There are 28 safety measures in all, covering such areas as avoidance of pressure ulcers, practicing good hand hygiene and preventing death from serious treatable complications.  Leapfrog reduces these numeric scores to a report card-style rating system using A through F grades that one would commonly see in a school setting.  This report card is the primary means by which it communicates hospital quality to the public.  

And there lies the problem.  

UMMC received an “F” in the Leapfrog report.  But, as we all know, we are not an "F" hospital.

When you receive a grade of F in school, that means you failed the test or the course.  UMMC and the other hospitals receiving an F did not fail anything.  We simply scored marginally lower than other hospitals. 

And we didn't even score that much lower.  The differences in the higher-scoring hospitals and the lower-scoring hospitals for any of the metrics are not that large.   In fact, we exceeded the national average in 11 of the 28 metrics Leapfrog uses.

The point here is not to criticize Leapfrog, which we consider a partner helping us to achieve the very highest clinical quality, or the newspaper, which is just passing on information we believe the public deserves to have.  The point is that clinical quality is a complex, multi-faceted subject that, we believe, can't be adequately or fairly reduced to a grade in a school report card format.  To represent this as a “failure” to the public on such a sensitive issue is inflammatory and does not serve patients as they make decisions about their health care. 

UMMC is a safe hospital.  Patients can and do come to us with confidence that we are on top of our game and that they will receive superb care.

Are we perfect?  No.  Despite our very best efforts, we do occasionally make errors or oversights that could potentially expose patients to harm, as do all hospitals.  But if you look at the Leapfrog data you will see that those instances are extremely rare.

One thing the data may not fully reflect is that we are a major trauma and referral center.  We are constantly caring for the state's most critically ill and injured patients.  We embrace this responsibility, but the challenges associated with it may not be completely captured in a particular survey's risk adjustment calculations. 

You should also bear in mind that most of the data on which the scores are based are more than two years old.  In those two years, we have made major strides in our clinical quality program.

Here are a few of the major things we've done: 

  • Recruited Dr. Michael Henderson from the Cleveland Clinic as chief medical officer.  A proven national leader in clinical quality improvement and patient safety, Mike is leading the charge to our becoming a high-reliability organization.
  • Identified clinical quality as our Number 1 priority for strategic investment
  • Required every employee to participate in error-prevention training
  • Begun a hand-hygiene initiative that we feel confident will dramatically improve our compliance
  • Begun monthly “Leadership Rounds” to promote engagement of UMMC's 150 top leaders with our clinical quality efforts
  • Achieved outcomes in complex transplant and congenital heart surgeries that are among the best in the country
  • Shifted to an electronic health record that is ensuring our performance data isn't undermined by poor coding.  More importantly, our Epic EHR allows us to use data analytics to better identify and correct behaviors that result in errors.    
  • Standardized best practices in surgery, such as “time outs” for the whole team to do final checks that the right things get done and everyone knows and agrees with the surgical plan

Leapfrog and its peers set the quality bar high, and it should be high.  Our goals are zero preventable harm and progressive, measurable improvement in quality outcomes.  We also welcome the transparency that Leapfrog and other measurement groups provide.  Transparency can be uncomfortable, but it will help us drive continued improvement.  

In the final analysis, each of us owns our performance, and we own this Leapfrog report.  Patients are at the center of what we do every day and the commitment to this improvement is the responsibility of every person who works in the hospital every day.  

I know and appreciate that you have embraced this responsibility and are working very hard on behalf of our patients.  I'm confident that in time, our “grade” will reflect it.  And knowing that is all the motivation we need to keep moving onward toward A Healthier Mississippi.
*UMMC provided the email to this website upon request.


Because It's Good For You said...

UMMC takes on the worst patients ever. No other hospital would have a decent grade if they took on the amount of trauma patients as in UMMC. Some of the "patients" are even brought in with barely a pulse. I witnessed one man who was apparently dead already but yet the doc's made every attempt to save this man's life, regardless of the fact that he was not wearing his seatbelt. His fatal accident could have been prevented by something that millions of people do everyday. Diabetes patients walk in with severe symptoms, all the while not having taken their med's and having full access through the guv'mint.
If you want a sleepy old doc to give you a Z-Pack, go to MEA. They hand them out like candy. But don't try to compare apples with herpes. It doesn't work.

Anonymous said...

It may be true that the lack of employment opportunities in this state is directly correlated to the uneducated (or, at best, undereducated) work force. However, the "education crisis" is not solved with by allocating more money to public schools. In my opinion, most supporters of Initiative 42 and other such measures attempt to solve a problem that can't be solved with money: the quality of the home life and upbringing of our youth.

There is a culture of entitlement and lack of personal responsibility in our state, and to a lesser extent our country. I am not necessarily against more funding for public schools, but no amount of money will solve the parenting problem. Schools were not established or designed to raise children. That is a job reserved for parents. Until parents do their jobs, children will remain uneducated and largely a drain on society. The state's economy will continue to suffer because of the quality of our parents, not our schools.

Anonymous said...

4:46, Did you get lost or what? This thread is about UMMC.

Anonymous said...

I know the trauma center and the neurology floors of UMMC to be first rate from family experience. I am grateful UMMC is there. I know they have saved lives from what I have seen.

Anonymous said...

If not for the UMMC's NICU unit, my child would not be alive today. Thank you UMMC!!! Don't let any survey, poll, or rating group convince you that you're substandard. You are the best!!!

Anonymous said...

Ole Miss med center is now in the health club bizness.

Why doesn't Lou Ann focus on health care?

Anonymous said...

"Each of us owns our performance."

Wow! That takes guts. Dr. Woodward has earned my respect. Rather than attacking the messenger, she has taken the difficult, but courageous, path of moving forward, promising to use the Leapfrog grade as an opportunity for improvement. How refreshing.

Y'all Got My Uncle Up In Heah? said...

They got rid of the state flag at UMMC. Things are lookin' up. Plus, Jones is back. He may be in a basement office, but he's BACK.

Anonymous said...

Hey 11:07, in case you haven't noticed Baptist and St D's are now also in the health club business. What a concept huh, a hospital trying to improve the publics health.....

Schwinn Airdyne said...

These hospital 'health clubs' have zero to do with a desire to improve public health. I get a birthday invitation from St. D every year and can go in and choose a free plate lunch of fried chicken, french fries, fried okra and banana puddin'. I've been on their 'free lunch list' ever since I got two stents there.

When these so called services are free, you'll know they're offered in the interest of healthy lifestyle.

Anonymous said...

Where are the St. D's health clubs?

Why don't they go in the restaurant bizness

Or the grocery bizness

Or sell safe automobiles

Or, dare I say it . . . guns !

And they need to take all these biznesses off the friggen TAX ROLLS. We don't need tax money in The Sipp.

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There will be a hugging booth where in exchange for your young son, Frank Melton will give you a loooong hug. Trollfest will have a dunking booth where Muhammed the terrorist will curse you to Allah as you try to hit a target that will drop him into a vat of pig grease. However, in the true spirit of Separate But Equal, Don Imus and someone from NE Jackson will also sit in the dunking booth for an equal amount of time. Tom Head will give a reading for two hours on why he can't figure out who the hell he is. Cliff Cargill will give lessons with his .80 caliber desert eagle, using Frank Melton photos as targets. Tackleberry will be on hand for an autograph session. KIM Waaaaaade will be passing out free titles and deeds to crackhouses formerly owned by The Wood Street Players.

If you get tired come relax at the Fox News Tent. To gain admittance to the VIP section, bring either your Republican Party ID card or a Rebel Flag. Bringing both will entitle you to free drinks.Get your tickets now. Since this is an event for trolls, no ID is required, just bring the hate. Bring the family, Trollfest '07 is for EVERYONE!!!

This is definitely a Beaver production.

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