Employers Can Do Something About Hospital Medical Errors

By Cristie Travis

Did you now that hospital errors and infections are the third leading cause of death in America? Millions more suffer harm or disability.

As an employer you pay for this problem, both in terms of the impact on the lives and health of your employees and their families, and in added costs to your health benefit plan. The Leapfrog Group (www.leapfroggroup.org) estimates that employers pay an average of $8,000 per hospital admission for preventable errors and infections.

You don’t have to just accept this situation. There are specific actions you can take, supported by resources and others engaged in this work, to protect your employees and their families and lower these unnecessary costs in your health benefits.

Connect yourself to the safety issue

Use the Leapfrog Lives and Dollars Lost Calculator to estimate how many of your employees and their family members are personally impacted by medical errors and how much this is costing your company. Get the calculator at https://www.leapfroggroup.org/employers-purchasers/lives-dollars-lost-calculator.

Understanding your own data shows how personal this issue really is to your organization. To lose a colleague or a colleague’s family member to a preventable medical mistake has a ripple effect throughout your whole team and impacts them emotionally as well as their ability to focus on their work and productivity.

Watch Bleed Out, the HBO Documentary, that follows the 10-year journey after what was supposed to be a “routine operation” leaves the filmmaker’s mother in a coma with brain damage. The journey includes several preventable medical mistakes; the challenges faced by the family and impact on work; the emotional toll; and a view of the system that was clearly broken on many levels. The film reminds all of us of the personal toll preventable medical mistakes take even when death is not the outcome. Consider sharing this documentary with your employees. Learn more at https://www.hbo.com/documentaries/bleed-out

Familiarize yourself with network hospital performance

You are incentivizing your employees to use your network hospitals. Be sure these hospitals are providing safe care. Track and monitor performance over time for those hospitals your employees use most so you can stay on top of improvements or any problems that are beginning to emerge.

Let’s use the Memphis, Tennessee market as an example so you can see the power of the information.

Here are the results of the fall 2019 Leapfrog Hospital Safety Grade release for Memphis.

Hospital Safety Grade	Memphis-area Hospital
A	Methodist LeBonheur Germantown Methodist University Hospital Saint Francis Hospital – Bartlett Saint Francis Hospital — Memphis
B	Methodist North Hospital Methodist South Hospital
C	Baptist Memorial Hospital Collierville Baptist Memorial Hospital De Soto Baptist Memorial Memphis Regional One Health
D	None
F	None

The good news in Memphis is that the percentage of hospitals with an “A” (40%) continued to surpass the national average (33%)! And, the percentage of Memphis hospitals with an “A” and “B” (60%) also surpassed the national average (58%).  Just two years ago, only 10% of Memphis area hospitals received an “A” and only 20% received an “A” and “B”. 

Three hospitals — Methodist University, Methodist South, and Regional One — increased their grades from the spring 2019 release.  Note: Methodist Olive Branch did not have sufficient information to receive a grade.

Although there has been continued momentum in improvements in Hospital Safety Grades in Memphis, the market still has a cluster of four hospitals in the “C” category. It is our goal to have all Memphis hospitals with an “A” or a “B”.  A study conducted by Johns Hopkins Medicine’s Armstrong Institute for Patient Safety and Quality found that compared to an “A” hospital your risk of dying in a “B” hospital is almost 35% higher and almost 88% higher in a “C” hospital. Moving all hospitals to at least a “B” will result in significant reductions in unwarranted deaths.

Leapfrog Hospital Safety Grade information is available free and is quickly analyzed to give a snapshot of overall safety in your community and hospital network. If you have employees in several markets, work with your consultants to perform a similar analysis for areas where you have the highest concentration of employees. You can get Hospital Safety Grades for 2,500 hospitals at www.hospitalsafetygrade.org.

Communicate with your network hospitals

The more hospitals hear from employers, especially in your role as purchasers of health benefits, the more they will prioritize safety. We have found that the media tends to focus on the low performers in a market, failing to recognize the hard work it takes to get an “A”. Be sure to thank those hospitals that performed well to reinforce your support for their commitment to safety.

For low performers in your network, and especially for those your employees use most often, schedule a meeting to better understand what their plans are for improvement and to reinforce your concern for your employees, their families, and for the additional cost you are paying for poor care.

If there is a Leapfrog Regional Leader in your market, contact them and coordinate your communications with the hospitals. Consider asking them to join you in a meeting. They have a deep knowledge and understanding of the Hospital Safety Grade and can help facilitate the meeting. You can get a list of Regional Leaders at https://www.leapfroggroup.org/regional-leaders/regional-leader-markets.

Expect your health plan to prioritize safety

Signal your priority on hospital safety by asking key questions about hospital networks when you go out for bid. For example, in your RFP, include questions about the number of hospitals in each grade category and get geo-access to “A” and “B” hospitals based on where your employees live and work. Score plans that are heavily weighted in “A” and “B” hospitals higher than plans with poorer performers.

In addition, when contracting with a health plan, require that they incentivize their network hospitals to voluntarily report on the Leapfrog Hospital Survey which provides critical information used in the Hospital Safety Grade.   

Inform your employees

Help your employees better understand that there is variation in the quality and safety of care in hospitals. The Leapfrog Group has a number of employee education tools at https://www.leapfroggroup.org/employers-purchasers/value-tools. These tools range from talking points, newsletter articles, social media posts, posters and short videos all in language and presentation that your employees will understand.

Once this foundation is laid, share the actual results with your employees so they can use the Hospital Safety Grade as one component of their hospital selection process.

Why now?

The fall 2019 Hospital Safety Grade release coincides with the 20th anniversary of the Institute of Medicine’s To Err is Human report which focused the nation’s attention on the nearly 100,000 deaths a year due to preventable medical mistakes. A recent analysis from The Johns Hopkins Armstrong Institute for Patient Safety and Quality found that 45,000 fewer deaths occurred in 2018 compared to 2015, based on the prevalence of safety problems in hospitals receiving a Leapfrog Hospital Safety Grade.

Yes, there has been significant improvement, but it has taken 20 years to get to this point, and we still have significant improvements to make. As purchasers of health benefits for over 100 million, employer purchasing policies. processes, and employee communications are essential to build the faster momentum we need to see progress sooner.