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In the April 12 release of Leapfrog’s Hospital Safety Grades, several North Bay hospitals received an A, while others ranked a B or C.

Statewide, nearly half of California hospitals received a grade of C or lower and accounted for six of the 10 hospitals nationwide that received an F (complete list: hospitalsafetygrade.org).

But what do the grades actually mean for hospitals and for patients?

Leapfrog says too many patients are dying from preventable errors, and is pushing hospitals to increase their safety measures.

“When we launched the Leapfrog Hospital Safety Grade in 2012, our goal was to alert consumers to the hazards involved in a hospital stay and help them choose the safest option. We also hoped to galvanize hospitals to make safety the first priority day in and day out,” said Leah Binder, president and CEO of Leapfrog. ”So far, we’ve been pleased with the increase in public awareness and hospitals’ commitment to solving this terrible problem. But we need to accelerate the pace of change, because too many people are still getting harmed or killed.”

The Leapfrog Group evaluates hospitals based on safety twice a year. The nonprofit calculates grades of A–F for approximately 2,600 general, acute care hospitals for which sufficient publicly data is available.

North Bay hospitals rating an A in the most recent grading include Kaiser Foundation Hospital in Santa Rosa, Sutter Santa Rosa Regional Hospital, and Petaluma Valley Hospital, Marin General Hospital, Novato Community Hospital, and Kaiser Foundation Hospital in San Rafael. Ukiah Valley Medical Center also received an A rating, as did Kaiser Foundation Hospital in Vacaville.

“The entire Marin General Hospital community is steadfastly dedicated to providing patients with the utmost in care and safety,” said Joel Sklar, M.D., chief medical officer at Marin General Hospital. “To be recognized with an A for patient safety by the Leapfrog Group places us in the top 30 percent of all hospitals nationwide in terms of patient safety and is a testament to the teamwork and tireless efforts of the men and women of Marin General Hospital, their ongoing commitment to the patients they serve, and the outstanding level of care they deliver day in and day out.”

Santa Rosa Memorial Hospital received a B, as did Queen of the Valley Medical Center in Napa. NorthBay Medical Center, St. Helena Hospital and Sonoma Valley Hospital each received a C.

Despite receiving a C, NorthBay scored high in the category of intensive care unit (ICU) physician staffing, jumping from a low score of five in the spring 2016 grading, to 100 in the fall, more than double the national mean. It also was close to or above the national mean measures for many other safety practices.

“It seems every rating system derives a different result,” said Konard Jones, president and CEO of NorthBay Healthcare. “We have received very high scores in some and average scores in others. Of course we review all results because they give us feedback, no matter how inconsistent it may be. Overall, ratings do not guide our quality improvement initiatives. We improve for our patients, not for the ratings. We strive to be better at everything we do, even things for which we are rated highly. Quality improvement here is constant and permanent.”

Leapfrog states that it rates hospitals equally on policies and procedures and the outcome rate of errors that occurred. It goes by 30 national hospital safety measures selected after a careful review of all hospital safety data publicly available at the national level from the Centers for Medicare and Medicaid Services (CMS), The Leapfrog Hospital Survey, and secondary data sources.

Erica Mobley, director of communications and development for The Leapfrog Group, said some of the 30 categories carry more weight than others. Post-surgery complications, especially “a foreign object retained in the patient after surgery” is one of them.

NorthBay, St. Helena Hospital and Sonoma Valley Hospital all scored higher than zero — the optimal score — in that category. The occurrence of an object being left in a surgery patient is extremely rare, but even one incident, as NorthBay said was the case, could weigh down the overall score.

Nationwide, out of 2,600, 823 hospitals received an A. California as a whole has lost ground. Two years ago, 37 percent of California hospitals received a C, D or F grade. That number jumped to 46 percent of the 271 California hospitals rated in the most recent report.

The percentage of hospitals in the state that got the top rating also decreased as well. Twenty-five percent of California hospitals, or 68 facilities, earned an A grade this year, compared to 43 percent, or 104, in 2015.

“This could represent California hospitals’ performance slipping in comparison to their peers across the country or could also mean that they may be staying constant in their performance while other hospitals are progressing,” Mobley said.

Some hospital industry officials have criticized Leapfrog’s letter grades as too simplistic for a complex issue and as potentially misleading for patients.

Jan Emerson-Shea, a spokeswoman for the California Hospital Association, noted there are many different scorecards and said consumers shouldn’t put too much stock in any one ranking.

“While these scorecards often serve as a good starting point for patients to ask questions of their health care provider, they should not be viewed as being a definitive source for determining the quality of care provided by any hospital,” Emerson-Shea told CaliforniaHealthline, an online news source.

Even though Leapfrog disseminates a lot of information, the group realizes it can’t capture everything, Mobley said.

“We’re looking specifically at safety, not the quality of, say, knee surgery. Safety permeates all aspects of the hospital from getting stitches in the emergency room to heart surgery. We want to make it easy for patients to understand how safe a hospital is,” she said.

One of the problems that most hospitals struggle with is infections, and over the years, Leapfrog has added more infection measures.

“Very few hospitals are doing well in that area. It’s a big problem,” Mobley said.

Marin General, for example, even with it’s A rating scored low in one of the five infection areas.

Ultimately, rating systems like Leapfrog might best be used with other ranking systems. If a patient needs knee surgery, for example, a hospital’s safety rating could be measured with other outcome rating systems.

“It’s a very powerful tool to use in tandem with other systems that rate procedure outcomes,” Mobley said. “We want people to know that no hospital is perfectly safe.”

Cynthia Sweeney covers health care, hospitality, residential real estate, education, employment and business insurance. Reach her at Cynthia.Sweeney@busjrnl.com or call 707-521-4259.