By Charles Elmore
Two hospitals in southern Palm Beach County received “D” grades for patient safety in a nonprofit watchdog group’s latest report, and Florida landed among the five worst states with declines in hospital patient-experience scores that graders called “disheartening.”
The number of infections that patients acquired in each hospital partially contributed to the below-average grades that The Leapfrog Group assigned to Baptist Health Boca Raton Regional Hospital and HCA Florida JFK Hospital in Atlantis. Fewer than 8% of hospitals surveyed nationwide received D or F grades.
At the same time, Florida showed encouraging signs, too, ranking among 10 states with the highest percentage of A grades. Responding hospitals did not always agree with their scores, but voices across the industry acknowledged challenges to retain experienced staffing and other issues coming out of a grueling pandemic.
Boca Raton Regional’s D grade included a worse-than-average score for sepsis infection and other complications after surgery. The score followed a D in the spring of 2023 and a C in the three years ending in 2022.
“Our goal is to provide high-quality, safe care for our patients and community and we take great pride in doing this,” said Gina Halley-Wright, communications manager for Baptist Health South Florida. “We recognize that tools like Leapfrog Group’s ratings help health care organizations continue to improve.”
She continued in a statement, “It is important to note that the Leapfrog grades for the most recent scores were calculated by using data dating back to 2019, and include periods of time when South Florida experienced severe patient surges due to the pandemic. Our health system has taken steps to improve in areas where needed, and we are committed to continuing to use the data to make positive changes.”
JFK Hospital’s D came in part because it performed worse than average on blood infection rates, according to the report. The hospital had been awarded C grades in 2022 and the first part of 2023, after a B in the fall of 2021. Attempts to get comment from the hospital were not successful.
Leapfrog’s roots date to when business leaders gathered in 1998 to figure out a way to offer watchdog grades to help the public. It assigns letter grades to nearly 3,000 hospitals across the nation based on measures of how well they prevent medical errors, accidents and infections.
Leapfrog says it uses up to 28 performance measures to grade hospitals twice a year. The latest scores are from fall 2023.
The scoring methodology is determined by a panel of experts from Harvard, Stanford and other universities. Various categories involve data from one-year or multiyear periods.
Some scores, such as in-hospital infections, draw from publicly available data. Other parts cull information from surveys, in which hospitals do not always participate.
In the latest grades, nearly 30% of hospitals nationally received an A, 24% got a B, 39% registered a C, with 7% drawing a D and less than 1% an F.
Delray Medical Center received a C, its same grade since a B in the spring of 2020.
West Boca Medical Center also received a C, unchanged since the fall of 2021 after B grades in 2020 and the first part of 2021.
“Delray Medical Center and West Boca Medical Center are proud to provide safe, high-quality care to our patients,” said Andrew Lofholm, communications and community relations manager for Palm Beach Health Network.
His group’s hospitals do not participate in the Leapfrog survey, he said in a statement.
“However, Leapfrog may assign a score, but it is based on limited publicly available data from secondary sources that haven’t been verified,” he said. “We take our responsibility to provide the safest possible environment for our patients very seriously, and this is positively reflected in our quality recognitions from multiple other organizations.”
Other area hospitals improved or maintained grades.
Baptist Health Bethesda Hospital East in Boynton Beach was given a B grade, a level it has maintained since the start of 2022 after C grades the previous two years.
Bethesda West in Boynton Beach was assigned a B, up from C in the first part of 2023.
Based on surveys, Florida ranked among the five states with the sharpest declines in scores for nurse and doctor communication, staff responsiveness, communication about medicines and discharge information, Leapfrog found.
“In talking with hospital leaders, we believe staffing shortages are one key reason for the continued decline,” said Leah Binder, president and CEO of The Leapfrog Group.
“Many hospitals are innovating to help make patient experience better, which is critical because these results are disheartening and unsustainable.”
Florida Hospital Association President and CEO Mary C. Mayhew addressed the findings in a statement.
“FHA member hospitals are steadfastly committed to enhancing the patient experience,” she said. “We recognize the recent challenges in various aspects of patient care, such as communication with nurses and doctors, staff responsiveness, and clarity regarding medications and discharge procedures, and agree the results are disheartening.
“These significant concerns stem from the unsustainable workforce challenges that have impacted hospitals nationwide, including staffing shortages and an increased reliance on contracted and temporary staff.”
Patients and families deserve to be fully informed about their conditions and care, she said.
“Efforts are being made to address these challenges,” she said. “By leveraging innovative technology, adopting best practices, and utilizing effective tools, we are focused on improving the quality of patient care. Florida’s hospitals are more than health care providers; they are community partners committed to making sure Florida has the high-quality health care system it deserves.”
Some medical centers in the state managed tough conditions well. Florida’s 38% ranked among the 10 states with the highest percentage of hospitals receiving A grades.
As a group, hospitals across the country tended to see a lower rate of “health care-acquired” infections coming out of the COVID pandemic in 2023, the organization found.
Specific infections measured include Methicillin-resistant Staphylococcus aureus (MRSA), central line-associated bloodstream infections (CLABSI) and catheter-associated urinary tract infections (CAUTI), Leapfrog said.
In some places, such as southern Palm Beach County, there remains room to improve, if the grades are any indication.
“Now that we have pre- and post-pandemic data for patient safety measures, we are encouraged by the improvement in infections and applaud hospitals for reversing the disturbing infection spike we saw during the pandemic,” Binder said. “However, there’s still more work to be done. It’s deeply concerning that patient reports about their health care experience continues to decline.”
To see fall 2023 Hospital Safety Grades from The Leapfrog Group, go to https://www.hospitalsafetygrade.org/
Grading care
The Leapfrog Group looked at nearly 3,000 hospitals nationwide, reviewing measures of how well the hospitals prevent medical errors, accidents and infections. Here are its fall 2023 grades for hospitals in southern Palm Beach County (and any change from the first part of the year):
B
Baptist Health Bethesda Hospital East, Boynton Beach (stayed the same)
Baptist Health Bethesda Hospital West, Boynton Beach (up from C)
C
Delray Medical Center (stayed the same)
West Boca Medical Center (stayed the same)
D
Baptist Health Boca Raton Regional Hospital (stayed the same)
HCA Florida JFK Hospital, Atlantis (down from C)
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