Study Casts Doubt on Influential Hospital Safety Survey

Mar. 31 -- TUESDAY, March 31 (HealthDay News) -- The task just got harder for patients trying to figure out which hospital will provide the best care.

A new study casts doubt on a hospital safety rating conducted by the Leapfrog Group, a nonprofit business coalition.

Hospitals ranked in the highest quartile on the safety survey had about the same rate of in-hospital deaths as those in the lowest quartile, according to a study in the April 1 issue of the Journal of the American Medical Association.

"It takes time and money to assess quality of care," said senior study author Dr. R. Adams Dudley, an associate professor of medicine and health policy at University of California, San Francisco. "If we're going to do that, we need to make sure we put those resources into something that gives us a true signal of quality. Unfortunately, this doesn't seem to be doing that."

The Leapfrog Hospital Survey is a widely publicized report that assesses the safety, quality and efficiency of care at 1,200 U.S. hospitals, according to the Leapfrog Group's Web site.

The survey measures these main aspects of hospital quality: the extent to which physicians use computers to order prescriptions, which has been shown to cut down on medical errors; whether hospital intensive care units are properly staffed; and how well hospitals perform a selection of complex medical procedures.

Previous research has shown that death rates for complex procedures are lower at hospitals with lots of experience doing them, Dudley said.

In 2004, Leapfrog added a fourth measure: the Safe Practices Survey, which asks hospitals to supply detailed information about 27 measures of hospital safety, including how well it promotes a safety culture, ensures an adequate nursing workforce, provides anti-coagulation services and requires hand washing.

Hospitals are then ranked in quartiles based on their self-reported answers.

Dudley and his colleagues looked at 155 hospitals that took part in the 2006 survey and found little difference among those in the highest and lowest quartiles. The in-hospital death rate from lowest to highest quartile was: 1.97 percent, 2.04 percent, 1.96 percent and 2 percent.