Preventable hospital deaths’ terrible toll: at least 160,000 lives each year

Although the fatalities have declined, preventable hospital deaths kill more than 160,000 Americans annually — four times as many lives as were lost to vehicle wrecks in 2017, more than twice the deaths attributable to opioids and drug overdoses that year, and more than the toll of stroke or Alzheimer’s disease.

The disturbing new report on hospital deaths comes from Johns Hopkins Medicine’s Armstrong Institute for Patient Safety and Quality and the Leapfrog Group, a national nonprofit founded by large employers and others concerned and focused on safety and quality in health care.

The organizations’ data should be even more concerning for residents in and around the nation’s capital because researchers highlighted the heightened risks to patients of poor performing hospitals.

Leapfrog is one of several groups that issues sometimes controversial ratings, giving hospitals letter grades that summarize data on matters such as: How often institutions give patients recommended  treatment for a given medical condition or procedure? How responsive are their staff members to patient needs? How up to date are their technologies? How well are they doing in averting errors in drug orders, or in ensuring foreign objects aren’t left in patients during operations? How well are they doing in keeping their already sick and injured patients from acquiring infections while hospitalized?

The advocacy group and the Johns Hopkins researchers reported finding that “D and F [rated] hospitals carry nearly twice the risk of mortality of A hospitals. Over 50,000 lives could be saved if all hospitals performed at the level of A graded hospitals.”

But in the District of Columbia, hospitals — as has been the case, sadly, for awhile now — get bottom-scraping Leapfrog scores: United Medical Center is rated an F, while D rankings went to Howard University Hospital and MedStar Washington Hospital Center. Leapfrog said 168 institutions nationwide were given failing or near-failing ratings. DC and four other states were at the bottom (47^th) of Leapfrog’s state-by-state rankings. George Washington University Hospital eked out a C, while MedStar Georgetown University Hospital received a B.

Virginia rated No. 2 overall in Leapfrog’s state-by-state hospital rankings, with 53% of its institutions receiving A ratings. These included: Virginia Hospital Center–Arlington Health System, Inova Alexandria Hospital, Inova Fairfax Hospital, and Inova Mount Vernon Hospital.

Maryland, No. 30 in the state-by-state rankings, had both A-ranked facilities like The Johns Hopkins Hospital and D-rated facilities like St. Agnes Hospital.

To view Leapfrog rated facilities in the area, click here.

To be sure, hospitals howl about ratings, especially those that patient advocates have sought to simplify and clarify into easy-to-comprehend letter grades. Hospitals say they’re working hard on safety and quality concerns. They object to how ratings are put together and won’t work with Leapfrog, contending that grades fail to give a fair shake to institutions that treat the most sick, poor, and chronically ill or seriously injured patients. Hospitals’ complaints jammed up updates to Uncle Sam’s national star-rating system, whose criteria still are under fire and subject to revision. The firm has posted a handy map-based system showing the rankings of hospitals, which you can see by clicking here.

In my practice, I see the harms that patients suffer while seeking medical services, including and especially the injury that can be inflicted on them while they are hospitalized. Leapfrog and Johns Hopkins researchers expressed guarded optimism about their latest data on hospital deaths, noting they fell from more than 200,000 annually in their study three years ago.

That may be a good sign. It’s still unacceptable that almost 455 patients die each day due to preventable causes in hospitals. Patients, regulators, and politicians need to visualize that carnage and show even greater urgency in addressing its causes. Just imagine the resources that would be mustered, say, if the 300 or so players in the National Basketball League all died in a single day due to preventable circumstance? What outcry would there be if more three times the number of the tour-card holding members of the Professional Golf Association died in a day? That is the comparable patient toll that occurs each year, quietly and with persistent promises by doctors and hospitals that, well, they’ll do better.

Let’s keep in mind, too, that the Leapfrog-Johns Hopkins data focuses on preventable hospital deaths — and the experts concede at the outset that their estimates are conservative. This toll also is a part, a significant one, of the estimated 250,000 annual deaths attributable to the broader ill of preventable medical error. That figure, too, was developed by Johns Hopkins research, and it means this method of mortality ranks as the third leading cause of death in the U.S., behind only heart disease and cancer.

We’ve got huge work to do.