Duke Hospital receives safety grade of A, climbs from C grade last year

If Duke Hospital can bounce back from a bad grade, then so can you. 

After receiving a C last year, Duke University Hospital’s safety grade rose to an A, as rated by the nonprofit Leapfrog Group. 

Duke’s Leapfrog rating earned above average scores in every measure in two of five sections: Practices to Prevent Errors alongside Doctors, Nurses and Hospital Staff. The staff ratings measure responsiveness, communication and effective leadership, whereas measures for error prevention include handwashing and safe medication administrations.

The Leapfrog Hospital Safety Grade is a service from the non-profit Leapfrog Group that provides a standard measure of safety ratings determined by performance measures, surveys and other data to determine a hospital’s ability to avoid “preventable harm and medical errors.” The organization has been grading hospitals since 2012. 

It rated approximately 2,600 hospitals in Spring 2019, including 79 in North Carolina. Roughly a third of hospitals received an A grade.

In Spring 2018, Duke Hospital’s rating fell to a C after hovering at an A in 2016 and 2017. According to analysis from the Armstrong Institute for Patient Safety and Quality, patients have an 87.7% higher chance of dying at a C-graded hospital than one that has an A grade. 

Duke Hospital President Thomas Owens told The Chronicle at the time that the data used by Leapfrog was three years old, and that Duke Hospital would double its efforts around “infection prevention, hand-washing and high-intensity room cleaning.”

This year, Duke scored well in all measures for safety problems—such as bed sores and risk reduction—except in patient falls and injuries, where it scored worse than average. Although Duke’s rating in dangerous bedsores was better compared to last year’s, its score in patient falls remained below average. 

Duke’s measures for problems with surgery were mixed, with an above average score in four out of seven measures. Superior measurements included collapsed lungs, accidental cuts and tears, serious breathing problems and dangerous objects left in patients. 

However, the below average metrics were related to surgical wounds splitting open, dangerous blood clots and death from serious treatable complications. Accidental cuts and tears and collapsed lung ratings improved from last year, but the score for death from serious treatable complications was lower. 

Duke’s worst section was Infections, where the hospital registered as worse than average on three of five of measurements, including blood infection, surgical site infection after colon surgery and C. diff infection—a common infection in hospitals that causes diarrhea and digestive tract pain. Infection in the urinary tract and MRSA infection ratings were average.

Duke Regional Hospital and Duke Raleigh Hospital also received A’s this year. University of North Carolina Hospitals in Chapel Hill also earned an A, yet WakeMed Cary Hospital and WakeMed Raleigh Hospital scored B’s. 

Overall, hospitals in the Triangle had high safety ratings compared to the state and nation. In North Carolina, 34% of hospitals received an A, earning the state 19th place in the country.

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