On the Internet, hospital performance on the Safe Practices Survey is ranked by quartiles, which may suggest to consumers that hospitals in higher quartiles are safer than hospitals in lower quartiles. In this first study of the relationship between survey scores and hospital outcomes, we studied a national sample of hospitals and found no relationship between quartiles of score and in-hospital mortality, regardless of whether we adjusted for expected mortality risk and certain hospital characteristics.
The measures surveyed included, but were not limited to: (1) creating a safety culture, (2) ensuring an adequate nursing workforce, (3) ensuring that a pharmacist is active in medication use, (4) not providing patient care summaries from memory, (5) providing patient care information and orders to all clinicians, (6) requiring patient readback of informed consent, (7) documenting resuscitation or end-of-life directives, (8) preventing mislabeled radiographs, (9) providing risk assessment and prevention for deep vein thrombosis/venous thromboembolism, (10) providing anticoagulation services, (11) preventing aspiration, (12) preventing central venous line sepsis, and (13) requiring hand washing.
Public reporting has hospitals scrambling to do all sorts of things to buff their profiles. Unfortunately these “improvements” are largely cosmetic and have little beneficial impact on patient outcomes. That’s just one reason the performance movement is a failure.