May 8, 2013

Report ranks Maine hospitals safest in nation

By Matt Hongoltz-Hetling mhhetling@centralmaine.com
Staff Writer

Patients who are fearful of entrusting their health to doctors, nurses, and other hospital workers can breathe a little easier, according to a new report that ranks Maine first in the nation in hospital safety.

click image to enlarge

Inland Hospital nurse Hope Pendexter uses a Computerized Provider Order Entry system that ensures that physician prescribed medications, ordered through a computer system, gets to the correct patient at the Waterville hospital on Wednesday.

Staff photo by David Leaming

Grade breakdown

Sixteen of the 20 Maine hospitals that received a safety score got an A.

In central Maine, Inland Hospital and MaineGeneral Medical Center's Thayer campus, both in Waterville, received A's. Franklin Memorial Hospital in Farmington and MaineGeneral Medical Center's Augusta campus both received B's.

Maine Medical Center in Portland received a B, while York Hospital of Maine received a C, the lowest grade in the state.

Other hospitals receiving an A are Cary Medical Center in Caribou; Central Maine Medical Center in Lewiston; Eastern Maine Medical Center in Bangor; Henrietta D. Goodall Hospital in Sanford; Maine Coast Memorial Hospital in Ellsworth; Mercy Hospital of Portland in Portland; Mid Coast Hospital in Brunswick; Miles Memorial Hospital in Damariscotta; Parkview Adventist Medical Center in Brunswick; Pen Bay Medical Center in Rockport; Southern Maine Medical Center in Biddeford; St. Joseph Hospital of Bangor in Bangor; St. Mary's Regional Medical Center of Maine in Lewiston; and The Aroostook Medical Center in Presque Isle.

According to a hospital watchdog group report released Wednesday, 80 percent of Maine's hospitals earned an A for safety, a larger proportion than any other state, and much larger than most states. Among more than 2,500 hospitals across the country that received grades, only 31 percent got an A.

Of 20 Maine hospitals ranked, 16 earned an A, three got a B, and one -- York Hospital of Maine -- received a C.

Making sure hospitals don't inadvertently violate one of the fundamental ethical principles of medicine -- often summarized in the three-word phrase "do no harm" -- has taken on added importance in the national discussion on American health care in recent years, in part because the federal Medicare system and private insurers are limiting reimbursements for costs associated with preventable errors.

Despite this, preventable hospital errors and accidents continue to be widespread.

A 2010 report from the U.S. Department of Health and Human Services found that one in four Medicare patients leave the hospital with a medical problem they didn't have when they entered. Hospital errors and injuries cause 180,000 deaths each year, according to Leapfrog, the watchdog group.

Leapfrog, a nonprofit group supported by the Robert Wood Johnson Foundation, works to drive down health care costs by identifying avoidable mistakes. Twice a year, it grades hospitals based on 26 measures of hospital safety. Those include whether doctors use computer systems to enter their orders, whether a system is in place to identify and address risks, and patient outcomes, such as preventable blood infections.

The report found Maine's health care providers are less likely to do harm than their counterparts around the country.

In central Maine, Inland Hospital and MaineGeneral Medical Center's Thayer campus, both in Waterville, received A's. Franklin Memorial Hospital in Farmington and MaineGeneral's Augusta campus both received B's.

MaineGeneral's two campuses got different grades despite scoring identically in 25 of 26 measures. The exception was the number of patients who got bloodstream infections associated with "central lines," narrow tubes that doctors sometimes insert into a patient's neck or chest to deliver medication.

According to Leapfrog, the infections are usually preventable and can happen when the tube is not inserted or cleaned properly, in which case they can become entry points for germs and bacteria.

Lisa Simm, administrative director of quality at MaineGeneral, said there was just one such infection at the Augusta campus among the thousands of patient days covered in the report, but that one infection was enough to make the difference.

A separate measure gives points to hospitals that use computer systems to help doctors make better decisions for their patients.

At Inland, Mike Palumbo, vice president of medical affairs, said that when he prescribes medication for a patient, he types the prescription into a computer, which uses a "decision support matrix" to check for allergies or conflicts with other medications, among other things.

Implementation of the system earned Inland a perfect score of 100 on that measure. Each of the MaineGeneral campuses received a 50, while Franklin Memorial received a 5.

Simm said MaineGeneral does use the new technology, but its implementation is unfinished because of a major transition to a new regional health care facility, expected to be completed this fall. So many changes are associated with the move, Simm said, that administrators decided not to push the new technology on all doctors right away.

Despite Franklin Memorial's low score on that measure, the hospital does have the computer system in place, said Ralph Johnson, chief information officer.

(Continued on page 2)

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