It’s report card time again for area hospitals and the big winner in this spring’s LeapFrog safety grades is HCA Florida Lawnwood Hospital, Vero’s closest trauma center, which raised its overall grade from a B to an A.
Both Cleveland Clinic Indian River Hospital and Steward Sebastian River Medical Center again earned overall ratings of B for 35 categories of patient safety statistics, and for how much the hospital’s culture promotes practices that improve patient safety.
LeapFrog grades are calculated and released twice a year in the spring and fall.
For the past two years, Cleveland Clinic Indian River Hospital has endured much criticism about its grade for what seems like a very simple, almost zero cost practice. In the Fall of 2022 and Spring of 2023 the hospital scored 15 out of 100 points in the Hand Hygiene category. Then last fall that rose to a still-failing grade of 40 out of 100.
Hospital leadership publicly promised that grade would improve, but in the grades that came out this week, the score was still a dismal 40. The national mean score for Hand Hygiene is 78.65.
LeapFrog Hospital Safety Grades Analyst Alexandra Campione Campione, who keeps an eye on hospitals here because she has relatives who live in John’s Island, explained that the Hand Hygiene score is not simply a matter of how often clinical staff wash their hands with soap and water or use alcohol-based hand sanitizer throughout the workday or before and after patient contact.
She said each hospital is graded on the training it has in place regarding hand-washing, and whether doctors, nurses and health aides are provided ample and convenient access to hand sanitizer or soap dispensers that are kept consistently full of product and operational.
Vero’s hospital also saw a few marked increases in infection rates associated with certain medical and surgical procedures.
The number of infections after colon surgery doubled from Fall 2023 to Spring 2024.
The incidence of respiratory failure after surgery rose 127 percent over the past six months.
The rate of improper wound healing increased between 150 percent between fall and spring.
The rate of antibiotic-resistant MRSA infections has been an issue for the hospital to some extent since the pandemic, and for the spring grades that number improved by 10 percent.
Unfortunately, however, Cleveland Clinic Indian River still has about twice the incidence of MRSA infection as the national mean.
The data in most of the infection categories is collected through the Centers for Medicare and Medicaid Services, so those categories only include statistics for Medicare and Medicaid recipients, not the broad patient base in the hospital.
On a positive note, Cleveland Clinic had zero foreign objects left in patients after surgery, zero air embolisms, and very low occurrences of infection after the insertion of a central line or a catheter.
The number of falls and trauma was also about four times lower than the national average.
Communication is another important part of patient safety, so it figures prominently in the LeapFrog grades.
In four out of five communication categories – nurse communication, doctor communication, discharge instructions and staff responsiveness – Cleveland Clinic scored a solid B.
The hospital slipped into the D-zone scoring a 69 for not clearly communicating about medicines patients are taking or being given.
The bright spots for Cleveland Clinic Indian River were excellent, near-perfect or perfect scores for ICU Physician Staffing, Barcode Medication Administration, Computerized Physician Order Entry, Leadership Structures and Systems and a category called Culture Measurement, Feedback and Intervention.
