Infection, collapsed lungs cited among safety concerns in Central Kentucky hospitals

Death from “serious treatable complications,” collapsed lungs and sepsis infections were recently named concerns in some Central Kentucky hospitals, according to the latest safety grades from a national watchdog group.

The Leapfrog Group is a nonprofit organization that provides ratings and safety data for hospitals and it recently released grades for nearly 3,000 hospitals across the country.

Out of seven Central Kentucky hospitals, four saw grades decline from last fall’s ratings.

Baptist Health Lexington received the lowest score given to any hospital for handwashing, and several other area hospitals also scored below average in the category.

Saint Joseph Hospital, Saint Joseph East, Georgetown Community Hospital and Clark Regional Medical Center each received a 5 out of 100 for the metric “specially trained doctors care for (intensive care unit) patients,” the lowest score given to any hospital in the U.S.

All seven Central Kentucky hospitals scored below average for at least one type of infection, and they weren’t the only facilities to struggle.

Across the U.S., Leapfrog reported a “dramatic spike” of health care-associated infections and worsening patient experience during the coronavirus pandemic, a trend that continues in the latest grades.

“The dramatic spike in HAIs reported in this Safety Grade cycle should stop hospitals in their tracks —infections like these can be life or death for some patients,” Leah Binder, president and CEO of The Leapfrog Group wrote in a May 3 statement. “We recognize the tremendous strain the pandemic put on hospitals and their workforce, but alarming findings like these indicate hospitals must recommit to patient safety and build more resilience.”

Leapfrog compared infection data from late 2021 and 2022 (this spring’s grades) to the 2021 safety grades (which covered the period immediately before the pandemic) and found:

• A 60% spike in the average central line-associated bloodstream standard infection ratio

• A 37% increase in the average methicillin-resistant staphylococcus aureus, or MRSA, standard infection ratio

• A 19% increase in the average catheter-associated urinary tract standard infection ratio

The standard infection ratio compares the actual number of health care-associated infections to the predicted number of infections.

Health care-associated infections are among the leading causes of death in the U.S., according to Leapfrog.

“Although MRSA, CLABSI and CAUTI worsened, Clostridioides difficile (C. Diff) improved 15% from spring 2021 to spring 2023 and there was not a significant change for surgical site infections following surgery,” Leapfrog’s press release read.

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

What to know:

• Baptist Health Lexington
• UK Good Samaritan Hospital
• UK Albert B. Chandler Hospital
• Saint Joseph Hospital
• Saint Joseph East
• Georgetown Community Hospital
• Clark Regional Medical Center

Baptist Health Lexington

Spring 2023 grade: A

Fall 2022 grade: A

Spring 2022 grade: A

Baptist Health Lexington scored below average in the following areas this spring:

• Infection in the urinary tract

• Surgical site infection after colon surgery

• Sepsis infection after surgery

• Patient falls and injuries

• Falls causing broken hips

• Collapsed lung

• Handwashing (Baptist Health Lexington received a 15 out of 100 in this category, the lowest score given to any hospital.)

• Effective leadership to prevent errors

“We are proud of our staff and physicians who continuously work to find innovative solutions and make improvements so we can provide the safe, quality care our patients deserve. We continue to focus on initiatives that will reflect the safe, exceptional care we provide our patients every day,” Baptist Health Lexington President Chris Roty wrote in an emailed statement to the Herald-Leader.

UK Good Samaritan Hospital

Spring 2023 grade: C

Fall 2022 grade: B

Spring 2022 grade: C

Here are the areas in which the University of Kentucky Good Samaritan Hospital scored below average this spring:

• Infection in the blood

• Surgical site infection after colon surgery

• Sepsis infection after surgery

• Dangerous object left in patient’s body

• Death from serious treatable complications

• Blood leakage

• Kidney injury after surgery

• Serious breathing problem

• Harmful events

• Dangerous bed sores

• Patient falls and injuries

• Effective leadership to prevent errors

UK Albert B. Chandler Hospital

Spring 2023 grade: C

Fall 2022 grade: B

Spring 2022 grade: B

The University of Kentucky Albert B. Chandler Hospital scored below average on these metrics this spring:

• MRSA infection

• Infection in the blood

• Sepsis infection after surgery

• Dangerous object left in patient’s body

• Death from serious treatable complications

• Blood leakage

• Kidney injury after surgery

• Serious breathing problem

• Harmful events

• Dangerous bed sores

• Patient falls and injuries

• Effective leadership to prevent errors

“Like many academic medical centers, UK HealthCare -- which includes UK Chandler Hospital, UK Good Samaritan Hospital and UK Kentucky Children’s Hospital -- serves a disproportionate number of patients with complex medical needs. As the state’s #1 hospital now for seven years running, providing compassionate, high-quality care for patients from the Commonwealth and beyond is our top priority. We work with a number of organizations on quality rankings, such as U.S. News & World Report and Vizient, where we are a top performer. There is always room to improve, and we will continue to invest in efforts that improve the health and safety of our patients,” spokesperson Allison Perry wrote in an emailed statement to the Herald-Leader.

Saint Joseph Hospital

Spring 2023 grade: C

Fall 2022 grade: B

Spring 2022 grade: C

Here are the areas where Saint Joseph Hospital scored below average this spring:

• Sepsis infection after surgery

• Blood leakage

• Kidney injury after surgery

• Serious breathing problem

• Accidental cuts and tears

• Harmful events

• Dangerous bed sores

• Patient falls and injuries

• Falls causing broken hips

• Collapsed lung

• Handwashing (Saint Joseph Hospital received a 70 out of 100 for handwashing; the average was 71.64.)

• Communication about medicines

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

• Communication with nurses (Saint Joseph scored 0.81 points below average in this category.)

• Responsiveness of hospital staff

Saint Joseph East

Spring 2023 grade: C

Fall 2022 grade: B

Spring 2022 grade: B

Saint Joseph East scored below average in these categories this spring:

• MRSA infection

• Sepsis infection after surgery

• Death from serious treatable complications

• Harmful events

• Dangerous bed sores

• Patient falls and injuries

• Collapsed lung

• Handwashing (Saint Joseph East received a 70 out of 100 for handwashing.)

• Communication about discharge

• Specially trained doctors care for intensive care unit patients (Saint Joseph East received a 5 out of 100 in this category, the lowest score given to any hospital.)

• Communication with doctors

• Communication with nurses

• Responsiveness of hospital staff

“Saint Joseph Hospital and Saint Joseph East continually work on improvement efforts to achieve the highest level of quality and safe care for our patients. We recently transitioned to a new electronic health records system, Epic, as another way to enhance the care provided at our hospitals. There are multiple organizations focused on quality rankings, including Healthgrades and U.S. News & World Report. Both of our Lexington hospitals have received high rankings from these agencies, including a Healthgrades Top 100 Hospitals recognition for Saint Joseph Hospital. There is always room for improvement and our dedicated providers and caregivers continue to focus on quality and safety for the patients we serve,” CHI Saint Joseph Health Chief Medical Officer Dr. Dan Goulson wrote in an emailed statement to the Herald-Leader.

Georgetown Community Hospital

Spring 2023 grade: C

Fall 2022 grade: C

Spring 2022 grade: C

Georgetown Community Hospital scored below average for these metrics this spring:

• C. diff infection

• Infection in the urinary tract

• Serious breathing problem

• Doctors order medications through a computer

• Safe medication administration

• Handwashing (Georgetown Community Hospital scored a 70 out of 100 for handwashing.)

• Communication about medicines

• Communication about discharge

• Effective leadership to prevent errors

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

• Communication with doctors

• Responsiveness of hospital staff

Georgetown Community Hospital officials did not provide comment about the most recent Leapfrog safety grades.

Clark Regional Medical Center

Spring 2023 grade: A

Fall 2022 grade: A

Spring 2022 grade: B

These are the categories in which Clark Regional Medical Center scored below average this spring:

• Infection in the blood
• Accidental cuts and tears
• Collapsed lung
• Safe medication administration
• Specially trained doctors care for ICU patients (Clark Regional Medical Center received a 5 out of 100 in this category, the lowest score given to any hospital.)

Clark Regional Medical Center officials did not provide comment about the most recent Leapfrog safety grades.

How are hospital grades calculated?

Safety grades are calculated using more than 30 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 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.

Across the U.S., 29% of hospitals received an “A,” 26% received a “B,” 39% received a “C,” 6% received a “D” and less than 1% received an “F” in the spring 2023 ratings.

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 handwashing, infection in the blood and patient falls, Leapfrog’s website says.

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 safety grades?

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 Kentucky or Lexington for our service journalism team? We’d like to hear from you. Fill out our Know Your Kentucky form or email ask@herald-leader.com.