Ebola raises concerns about the safety of American hospitals, a subject at the center of Leapfrog’s agenda since our inception in 2000. As a result, we have been asked to comment on this crisis, and we offer the following observations and recommendations.
While Leapfrog assesses and publicly reports on hospital safety, we do not and cannot assess any hospital’s preparedness for the threat of Ebola. Ebola requires the highest level of preparedness from the American healthcare system and public health authorities. This includes sophisticated methods of infection control, training, triage, and isolation. These means of preparedness are far outside the scope of the routine safe practices that Leapfrog monitors in American hospitals.
Using data from national safety performance measures, Leapfrog’s Hospital Safety Score assigns a letter grade to more than 2,500 U.S. hospitals, demonstrating how well they protect their patients from errors, injuries, accidents, and infections. These preventable hazards kill more than 1000 people every day, and injure many more. The Score offers an A, B, C, D, or F grade gauging whether the hospital is safer than other hospitals at preventing these common dangers, but it cannot predict preparedness for a specialized threat like Ebola. For instance, Texas Health Presbyterian in Dallas received an A on our Hospital Safety Score because it has a better record than other hospitals in patient safety, though the hospital was clearly not prepared for Ebola.
We offer the following support and recommendations:
- We call for the CDC to continue to select the most capable hospitals for triage of patients. The CDC should continue its work devising and deploying a system of triage which will both designate and equip specific hospitals as approved Ebola treatment centers, as well as form intervention teams to swiftly deploy to hospitals when Ebola is suspected. If an outbreak occurs, this system will ensure that infected patients be transported quickly and safely to hospitals equipped to deal with the disease. This will protect communities, patients, and healthcare workers.
- We call on all hospitals to review and reinforce their existing training and personal protective equipment procedures and infection control policies. Doing so would have beneficial effects not only for identification and protection of staff from Ebola, but could also improve staff performance on infection control of other communicable diseases.
- We pledge our support, in every way possible, for America’s health care workers. When patients are endangered, so too are the workers who care for them. For too long, the standard practice in many hospitals has been to assign infection control to just a few specialists. Ebola reminds us that infections don’t announce themselves at the hospital door and an infectious disease specialist may not be available or nearby. Everyone in the hospital—from housekeepers to dieticians to nurses to physicians—needs to have enough awareness to protect themselves and their patients and prevent the spread of infection. Leapfrog has always emphasized the importance of hospitals demonstrating a strong culture of safety, respect for nursing leadership, and board leadership that sets high standards for workplace safety. We will continue to recognize the importance of hospital workers in common cause with patients and communities to keep us all safe.
William H. Finck, Board Chair
Leah Binder, President and CEO