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Effective communication means better patient safety

Monday May 28, 2012
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A new report on patient safety and satisfaction rates in hospitals across the United States found that hospitals with the highest patient ratings in physician and nursing communication on average have fewer patient safety events.

The analysis of patient safety data for hospitalizations between 2008 and 2010 was conducted by HealthGrades, the self-proclaimed leading provider of information to help consumers make an informed decision about a physician or hospital.

Among the report’s key findings:

• 27% more overall patient safety events occurred in hospitals performing in the bottom 10% for nursing communication, compared to the top 10%;

• 15% more overall patient safety events occurred in hospitals performing in the bottom 10% for physician communication, compared to those in the top 10%;

• 13% more patients at hospitals performing in the top 10% for patient satisfaction reported they received instructions on what to do when they left the hospital, compared to the bottom 10% — key guidance that underscores the importance of communication, according to the report.

HealthGrades conducted the analysis as part of its process for identifying the HealthGrades Patient Safety Excellence Award and HealthGrades Outstanding Patient Experience Award recipients. This year, 263 hospitals received the Patient Safety Excellence Award (http://bit.ly/JDRf3e) and 332 received the Outstanding Patient Experience Award (http://bit.ly/JIHBly), with 47 receiving both.

"We have reached a point where Americans must acknowledge the connection between communicating with their healthcare provider and their own safety and satisfaction as patients," Kristin Reed, MPH, the author of the study and vice president of clinical quality programs for HealthGrades, said in a news release. "Our research revealed some shocking disconnects."

For example, Reed said, catheter-related bloodstream infections were about 56% more common in hospitals with poor nursing or physician communication.

To identify the 2012 Outstanding Patient Experience Award recipients, HealthGrades analyzed HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) hospital survey data obtained from the Centers for Medicare and Medicaid Services between April 2010 and March 2011. Award recipients performed in the top 10% in the nation for patient satisfaction, based on survey responses from patients treated at those facilities. Hospitals had to meet bed size, survey-response size and clinical-quality thresholds to be eligible.

To identify the best-performing hospitals in patient safety, which represent the top 5% of all U.S. hospitals and this year’s HealthGrades Patient Safety Excellence Award recipients, HealthGrades analyzed approximately 40 million Medicare hospitalizations in 5,000 hospitals from 2008 to 2010. The analysis was conducted using a method developed by the Agency for Healthcare Research and Quality to calculate event rates for 13 indicators of patient safety.

HealthGrades identified the implications of patient-provider communication on patient safety by grouping hospitals in three tiers according to their HCAHPS patient satisfaction survey results, and comparing the average patient safety scores for these groups. The groups were: the 10% that received the highest ratings in patient satisfaction, the 10% that received the lowest ratings and the 80% in the middle.

In analyzing patient safety from 2008 to 2010, HealthGrades found that 254,000 patient safety events among Medicare patients could have been prevented; 56,367 Medicare patients who died experienced one or more of these events; and patients at hospitals receiving the HealthGrades Patient Safety Excellence Award were 48% less likely to experience a patient safety event when compared with those in the bottom 5%.

When compared to hospitals performing in the bottom 10% for patient satisfaction, hospitals receiving the HealthGrades Outstanding Patient Experience Award had 50% more patients give them an overall rating of 9 or 10; 27% more patients report that staff always explained their medication prior to administration; and 52% more patients report they would definitely recommend the hospital to their family or friends.


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