In this first annual study, HealthGrades identifies pediatric patient safety incidence rates among pediatric patients at children’s hospitals using three years of data (2006 through 2008) from 19 all-payer states where data are publicly available. Additionally, HealthGrades identifies the best-performing hospitals to establish a best-practice benchmark against which other hospitals can be evaluated. These hospitals were recognized with the HealthGrades 2010 Pediatric Patient Safety Excellence Award™. These elite organizations represent the best of the top-performing hospitals and set the quality standard for American hospitals.
Specific results for each of the nonfederal hospitals in these 19 states can be found at www.healthgrades.com.
During the period from 2006 through 2008 in the 19 states studied:
One in 208 children hospitalized experienced a potentially preventable patient safety event.
The most commonly occurring events were selected infections due to medical care, accidental puncture or laceration, postoperative sepsis, and postoperative respiratory failure. These events represented 84.70% of all events.
Pediatric patients who experienced one or more patient safety events had approximately a one-in-sixteen chance of dying (or a 6.15% mortality rate).
Pediatric patients treated at hospitals recognized with a HealthGrades Pediatric Patient Safety Excellence Award had, on average, a 29.48% lower risk of experiencing one or more of the eight pediatric patient safety events studied.
If all hospitals performed at the level of Pediatric Patient Safety Excellence Award hospitals, approximately 6,532 pediatric patient safety events could potentially have been avoided, saving the U.S. health care system nearly $335 million from 2006 through 2008.
To evaluate hospital pediatric patient safety and identify the best-performing hospitals for pediatric patient safety, HealthGrades used all-payer state data and Patient Safety Indicator software from the Agency for Healthcare Research and Quality (AHRQ). Hospitals were evaluated on eight pediatric patient safety indicators.
The following is a brief description of the steps HealthGrades performed to determine the overall pediatric patient safety score and Pediatric Patient Safety Excellence Award recipients.
HealthGrades used the AHRQ software to calculate risk-adjusted rates for each hospital and each pediatric patient safety indicator. Risk-adjustment is necessary to account for patient characteristics that increase an individual’s risk of experiencing an event (e.g., conditions that compromise the immune system).
HealthGrades performed further risk adjustment using the heart surgery volume and Pediatric Case Mix Index (PCMI). This step is necessary to adjust for hospitals that treat sicker or more complex patients.
HealthGrades converted the risk-adjusted rate to a z-score (a statistical measure of the rate). HealthGrades then calculated an overall pediatric patient safety score by taking the average of the z-scores for all the eight indicators. To be considered, a hospital must have a measure in six of the eight indicators.
Of the 2,080 hospitals in the 19 states, 97 had pediatric patient safety scores that were statistically better than all the other hospitals. These hospitals were recognized with a HealthGrades Pediatric Patient Safety Excellence Award.
HealthGrades rates hospitals based on quality outcomes (risk-adjusted inhospital mortality and complication rates). The goal is to provide consumers with objective, comparative information on hospitals so they can make more informed health care decisions.