How safe are metro-east hospitals for patients? See latest grades from watchdog report

A national watchdog group recently scored some southwestern Illinois and St. Louis area hospitals below average for safety metrics, including medication administration, infections and patient falls.

Several metro-east hospitals also scored below average for having enough specially trained doctors caring for patients in the intensive care unit.

The Leapfrog Group is a nonprofit organization that provides ratings and safety data for hospitals, and it recently released grades for nearly 3,000 short-term, acute care hospitals across the country. The organization updates grades twice each year, once in the spring and once in the fall.

“The goal is to help consumers protect themselves and their families from the errors, injuries, accidents or infections that they might experience during a hospital stay,” Alex Campione, program analyst for Leapfrog hospital safety grades, said in an interview with the News-Democrat.

The spring 2024 grades report a reversal of an “alarming trend” of increasing health care-associated infections across the U.S., which were at a six-year high for the fall 2023 ratings.

Those infections have now returned to pre-pandemic levels, Campione said, and another safety measure also improved nationally this spring.

Patient experience metrics, which assess quality of nurse communication, doctor communication, hospital staff responsiveness, communication about medicine and discharge information, significantly improved in the spring 2024 grades across the U.S., though they remain “far from pre-pandemic levels,” according to Leapfrog.

“I actually think the patient experience measures are the most important,” Campione told the News-Democrat.

Patient experience metrics show first-hand whether patients are getting enough time to discuss concerns with their doctors and whether they’re experiencing any neglect, Campione added.

Out of eight hospitals in the metro-east and St. Louis region, two saw their safety grades improve, while one saw worsened performance. OSF Saint Anthony’s Health Center in Alton was among the 2% of hospitals across the U.S. to improve their performance by two grades, jumping from a C to an A.

Five local hospitals received Bs, while one got an A, one got a C and one received a D.

Leapfrog uses 22 metrics to evaluate a safety grade, including seven that are self-reported through the organization’s survey. Seven of the eight hospitals declined to respond to Leapfrog’s survey, while OSF Saint Anthony’s did respond.

“The survey is an extensive process, it’s a commitment that hospitals have to make to complete the survey. It’s not short,” Campione said.

Three-fourths of hospitals that are graded complete Leapfrog’s survey, Campione continued. Grades for the hospitals that don’t respond are calculated by using past data or a model that estimates how they might have performed if they did submit the survey. Federal, publicly reported data is available for all of the hospitals and is used in the grading, and self-reported data goes through a multi-layer verification process to ensure accuracy.

Here’s how metro-east hospitals performed in Leapfrog’s grading, plus how to interpret ratings and which areas should be most heavily considered.

Memorial Hospital Belleville

Spring 2024 grade: B

Fall 2023 grade: C

Spring 2023 grade: B

Here are the areas in which Memorial Hospital Belleville scored below average this spring:

• Infection in the blood

• Infection in the urinary tract

• Patient falls and injuries

• Falls causing broken hips

• Collapsed lung

• Safe medication administration

• Hand washing

• Specially trained doctors care for patients in the ICU (Memorial Hospital Belleville received a 5 out of 100 for this metric, the lowest score given to any hospital.)

Memorial Hospital Belleville officials declined to report metrics for “staff work together to prevent errors,” “effective leadership to prevent errors” and “nursing and bedside care for patients.”

Barnes-Jewish Hospital

Spring 2024 grade: C

Fall 2023 grade: C

Spring 2023 grade: B

Here are the areas in which Barnes-Jewish Hospital scored below average this spring:

• C. diff infection

• Infection in the blood

• Surgical site infection after colon surgery

• Surgical wound splits open

• Kidney injury after surgery

• Safe medication administration

• Hand washing

• Specially trained doctors care for patients in the ICU (Barnes-Jewish Hospital received a 5 out of 100 for this metric, the lowest score given to any hospital.)

Barnes-Jewish Hospital officials declined to report metrics for “staff work together to prevent errors,” “effective leadership to prevent errors” and “nursing and bedside care for patients.”

“All BJC HealthCare hospitals are committed to patient safety, and we support efforts to make quality outcomes data available to patients and to the public. We encourage people to seek out data on Medicare’s Care Compare site and we are also committed to transparency by providing links to this information on the BJC website.”

“The Leapfrog analysis is based on a methodology that is a composite of process and outcome measures, with most of the process data obtained from hospitals’ responses to a burdensome, self-reported survey. We have concerns about relying on methodologies that utilize self-reporting on questionnaires, which in this case can carry a significant impact in the overall results. For these reasons, BJC HealthCare hospitals have never participated in the Leapfrog survey.”

“We believe our approach – based on methodical study and careful ongoing evaluation of outcomes – is a more effective means of improving patient safety and that our rigorous discipline and process over the years has made a significant impact on improving quality of care. BJC HealthCare is committed to providing the highest standard of care every day for every patient,” BJC HealthCare spokesperson Laura High said in an emailed statement.

HSHS St. Elizabeth’s Hospital in O’Fallon

Spring 2024 grade: B

Fall 2023 grade: B

Spring 2023 grade: A

Here are the areas in which HSHS St. Elizabeth’s Hospital in O’Fallon scored below average this spring:

• Surgical wound splits open

• Blood leakage

• Serious breathing problem

• Harmful events

• Collapsed lung

• Dangerous blood clot

• Safe medication administration

• Hand washing

HSHS St. Joseph’s Hospital in Breese

Spring 2024 grade: B

Fall 2023 grade: B

Spring 2023 grade: B

Here are the areas in which HSHS St. Joseph’s Hospital in Breese scored below average this spring:

• C. diff infection

• Doctors order medications through a computer

• Safe medication administration

• Hand washing

HSHS officials declined to report metrics for “staff work together to prevent errors,” “effective leadership to prevent errors” and “nursing and bedside care for patients.” HSHS St. Joseph also declined to report for “specially trained doctors care for ICU patients.”

Scores were not available for nine metrics for HSHS St. Joseph’s, including MRSA infection, infection in the blood and others. Data being unavailable does not denote a lack of safety.

“HSHS takes quality and safety seriously and we stand by the care we provide to our patients. Our internal metrics do not align with external ratings from organizations whose surveys we do not participate in. We continue to proactively manage and measure internal quality improvement initiatives that lead to positive patient outcomes.

“There are a variety of healthcare quality rating organizations (e.g. Leapfrog, HealthGrades, US News) that review and publish hospital quality scores. No two organizations rely on the same criteria for their ratings, which may include publicly reported data, such as data from the Centers for Medicare and Medicaid (CMS) and state databases; their own proprietary quality measures; or a mixture of both.

“Both HSHS St. Elizabeth’s Hospital in O’Fallon and HSHS St. Joseph’s Hospital in Breese support the collection and publication of hospital quality data to help consumers make informed decisions about their health care. Since each rating organization relies on different metrics to create a quality ranking, grade or score for each hospital, it can be difficult to discern which ranking is most accurate.

“HSHS utilizes its internal quality teams to manage and measure a robust set of data and metrics, with the goal to continuously improve the standard of care. We have organized shared clinical quality governance councils to empower colleagues to have a voice in how to ensure our patients receive quality, safe and effective care. We also encourage patients and families to discuss individual care plans with their physician and care teams as part of their decision-making when choosing a hospital,” HSHS spokesperson Kelly Barbeau said in an emailed statement.

Gateway Regional Medical Center

Spring 2024 grade: D

Fall 2023 grade: C

Spring 2023 grade: D

Here are the areas in which Gateway Regional Medical Center scored below average this spring:

• C. diff infection

• Infection in the urinary tract

• Safe medication administration

• Hand washing

• Communication about medicines

• Communication about discharge

• Communication with doctors

• Communication with nurses

• Responsiveness of hospital staff

Gateway Regional Medical Center officials declined to report metrics for “staff work together to prevent errors,” “effective leadership to prevent errors” and “nursing and bedside care for patients.”

Scores were not available for six metrics, including MRSA infection, sepsis infection after surgery and others. Data being unavailable does not denote a lack of safety.

Gateway Regional Medical Center officials were not immediately available for comment.

Anderson Hospital

Spring 2024 grade: B

Fall 2023 grade: B

Spring 2023 grade: B

Here are the areas in which Anderson Hospital scored below average this spring:

• Accidental cuts and tears

• Safe medication administration

• Hand washing

• Specially trained doctors care for ICU patients (Anderson Hospital received a 5 out of 100 for this metric, the lowest score given to any hospital.)

Anderson Hospital officials declined to report metrics for “staff work together to prevent errors,” “effective leadership to prevent errors” and “nursing and bedside care for patients.”

“Leapfrog is an independent organization that collects and reports one-of-a-kind data. There are many similar organizations, all using public information with differing methodologies.

“Anderson Hospital just completed its triennial accreditation with the Joint Commission, which is the gold standard of accreditation. For the 3rd year in a row, Anderson Hospital ranked in the top 6% of hospitals in the United States through another independent study done by Newsweek.

“Anderson Hospital participates in reporting quality information so it is available to the public. Links to national and state programs and organizations that provide these reports are readily available on our quality page on our website,” Anderson Healthcare spokesperson Natalie Head said in an emailed statement.

OSF Saint Anthony’s Health Center in Alton

Spring 2024 grade: A

Fall 2023 grade: C

Spring 2023 grade: C

Here are the areas in which OSF Saint Anthony’s Health Center in Alton scored below average this spring:

• C. diff infection

• Surgical wound splits open

• Harmful events

Scores were unavailable for four metrics, including MRSA infection, infection in the urinary tract infection and others. Data being unavailable does not denote a lack of safety.

“Patient safety is always at the forefront of patient care that takes place at OSF HealthCare Saint Anthony’s Health Center. Our physicians, nurses and staff are dedicated to providing the safest, high-quality care to those we serve every day. Receiving the highest grade from The Leapfrog Group is validation of the diligent patient-centered work of our Mission Partners and we support the transparency about quality and safety that the Leapfrog grades provide. The Leapfrog Hospital Safety Grade uses national performance measures. While we humbly accept this demonstration of our accomplishment, our team at OSF Saint Anthony’s also understands and embraces our need for continuous improvement. We know our journey to excellence is never done,” OSF Saint Anthony President Jerald Rumph said in an emailed statement.

SSM Health St. Mary’s Hospital in Centralia

Spring 2024 grade: B

Fall 2023 grade: B

Spring 2023 grade: B

Here are the areas in which SSM Health St. Mary’s Hospital in Centralia scored below average this spring:

• Dangerous blood clot

• Doctors order medications through a computer

• Safe medication administration

• Hand washing

• Specially trained doctors care for ICU patients (SSM Health St. Mary’s received a 5 out of 100 for this metric, the lowest score given to any hospital.)

Scores were unavailable for five metrics, including MRSA infection, infection in the blood and others. Data being unavailable does not denote a lack of safety.

SSM Health St. Mary’s officials declined to report metrics for “staff work together to prevent errors,” “effective leadership to prevent errors” and “nursing and bedside care for patients.”

SSM Health officials were not immediately available for comment.

How are hospital grades calculated?

Safety grades are calculated using up to 22 national safety measures from the Leapfrog survey, U.S. Centers for Medicare and Medicaid Services and other data sources. The full methodology is available online and is peer-reviewed and published by the Journal of Patient Safety.

Grades are composed 50% by process and structural measures and 50% by outcome measures. The scoring scales differ by the chosen measure.

In the spring 2024 grades, 29.13% of hospitals nationwide received As, while 25.9% got Bs, 37.2% received Cs, 7.4% received Ds and less than 1% were given Fs.

Illinois ranked 30th in the U.S. for the highest percentage of hospitals receiving A grades, while the St. Louis metro area ranked 64th.

How should you use these scores?

Leapfrog emphasizes you should not refuse emergency care based on hospital ratings. The group intends the scores to be used when planning things like childbirth, surgery referrals or chronic illness treatment.

The areas you should pay most attention to when choosing a hospital include hand washing, infection in the blood and patient falls, Leapfrog’s website says.

Leapfrog’s hand washing grade measures how well hospitals use five “best practices,” including:

• “Monitoring, including monitoring proper hand hygiene technique

• Feedback, including evaluation and use of compliance data

• Training and Education, including demonstrations of technique

• Infrastructure, including hand sanitizer dispensers

• Culture, including leadership buy-in”

You should also consider how far off your hospital was from the average for any given standard. When evaluating a hospital, you can see the highest and lowest scores given, which helps in weighing a value. The “below average” category can include hospitals that scored 0.01 points under goal, along with facilities with the lowest possible score.

For hospitals that responded to Leapfrog’s survey, there’s often information available about which areas the hospital has improved in and which areas are not going in the right direction.

A hospital being ungraded does not denote a lack of safety. Ratings are often unavailable for facilities that decline to self-report, as well as smaller providers, children’s hospitals, surgical centers and critical access hospitals.

Where can you find more hospital ratings?

Leapfrog allows you to search for hospitals by name, location or state. There’s an online search tool where you can find information about more hospitals.

Do you have a question about health care in the metro-east for our service journalism team? We’d like to hear from you. Fill out our Metro-east Matters survey below.