Dixie Regional Medical Center scores ‘A’ grade for patient safety

ST. GEORGE — Dixie Regional Medical Center has received a glowing report card for the safety of its patients. 

Emergency medical services personnel and members of Dixie Regional Medical Center’s trauma staff train on medical simulation mannequins at Dixie Regional Medical Center, St. George, Utah, May 31, 2018 | File photo by Mori Kessler, St. George News

The hospital received an “A” grade in the Fall 2019 Hospital Safety Grades released by the nonprofit Leapfrog Group. Dixie Regional received especially high marks for the staffing of nurses and intensive care doctors, as well as the priority of safety for hospital leadership. 

“There has been a very deliberate focus on serving one another,” said Dr. Patrick Carroll, medical staff director for Dixie Regional Medical Center. “If we do that, the patient wins.”

The Leapfrog Hospital Safety Grade scores hospitals around the nation on how they protect patients from errors, injuries, accidents and infections. These are the stuff of people’s worst nightmares when it comes to being admitted to the hospital  — scalpels left inside after surgeries, the wrong dosage of medicine or an infection from another patient. 

“Patients in the St. George area should feel great because this means this is a hospital committed to seeing the prevention of harm to patients,” said Erica Mobley, the director of operations of The Leapfrog Group. “Patients don’t deserve to get sicker by going to the hospital.”

The Leapfrog Group was started by a coalition of large businesses in the wake of a 2000 report by the Institute of Medicine that determined that more than 100,000 lives are lost in hospitals every year due to preventable medical errors. The Hospital Safety Grades, which can be found at hospitalsafetygrade.org, came along later as a measurable way to determine how specific hospitals are doing as far as safety.

“When we started the grades eight years ago, our goal was not to point fingers, it was to drive a movement for safety,” Mobley said. “We’ve seen hospitals take that to heart and make a commitment to their community.” 

Making the grade

The grades are determined from a combination of 28 evidence-based, national measures of hospital safety including those from the Centers for Medicare and Medicaid Services, the Leapfrog Hospital Survey and secondary data sources, according to Leapfrog. The data is weighted according to the opportunity for impact and potential for harm and then combined to produce a single score reported as a letter grade.

Among the measures weighed the highest are medication safety and staffing in the intensive care unit. It is no coincidence then that a substantial improvement in ICU staffing is one of the big reasons why Dixie Regional has jumped from a “C” grade a year ago to “A” grades in both the Spring and Fall of 2019.  

Dixie Regional scored a best-possible 100 score for having specially trained doctors care for patients. Last Fall, the same category scored five. The St. George hospital also scored best-possible scores for medication administration, number of qualified nurses, safety leadership, tracking and reducing risks to patients, gas bubbles in blood, hand-washing and MRSA infections. 

Mobley points out that no hospital is perfectly safe. Even with “A” hospitals, mistakes can still happen. With that in mind, Dixie Regional still scored below the national average for death from treatable serious complications, urinary-tract infections, infections after colon surgery, objects left in after surgery, measuring how well staff works together and computer-based ordering of medications. 

Dr. Michael Marsden hugs Kristofer Chesley after being surprised at Redrock Pediatrics at Intermountain Healthcare Dixie Regional Medical Center, St. George, Utah, June 7, 2018 | File photo by Mikayla Shoup, St. George News

Some of the highest marks for Dixie Regional were in the categories for doctors, nurses and hospital staff — where nearly every measure was among the top possible scores. 

According to Carroll, there are huddles every morning among the different levels of employees at the medical center. Goals are set for that day and safety issues are addressed.

“When a problem occurs, it is a process problem not a person problem,” Carroll said.

All employees are aided by a group of consultants who are encouraged not to shy away from reporting mistakes they see.  

“We celebrate safety stories. It’s the mindset of not saying ‘sorry, we found something’ but instead looking at it as another opportunity to be great,” said Kathy Andrus, interim chief nursing officer at Dixie Regional Medical Center. “If a department has a failure, let’s share it.” 

Staff commitment

Leapfrog’s Mobley says one of the big secrets of success for hospitals that score an “A” for safety is the top-to-bottom organizational commitment. That includes building a culture where safety isn’t just a checkmark.

“The people at the top are thinking about safety, and the people sweeping the floor are thinking about safety,” Mobley said. 

Both Carroll and Andrus use the word “caregivers” to describe the collection of doctors, nurses, administrators and other workers who keep Dixie Regional running. As far as safety goes, they give weight to not only those with medical training as caregivers, but also the janitorial staff and the clerks working the register in the cafeteria. 

Safety doesn’t just come from making sure the equipment is sanitary and contaminated garments are properly disposed of. It also comes from reducing the inevitable anxiety that comes from being a patient in a hospital.

Andrus cited one recent example that involved a patient who was rushed into Dixie’s emergency room. Already stressed about their situation, they suddenly realized they had left their trailer unlocked. 

An ER worker heard this and went back and locked the trailer for the patient, allowing them to relax.

Caring about the safety of patients has also become an active part of the hiring process at Dixie Regional Medical Center. Andrus said while the medical staff for a hospital may come from years of school and training to have the technical knowledge for their jobs, caring for patients is not usually worth many units in medical school or covered in journals. 

“We have to hire the right people,” Andrus said. “You can be the best technical person but if you don’t take the time to care about the patient, we don’t want them here.” 

Utah a leading state

Dixie Regional is following a statewide trend for hospital safety. Utah hospitals ranked second in the nation for hospitals receiving A grades, just behind Maine, with 56% of hospitals in the state getting A grades.

An operation taking place at Dixie Regional Medical Center’s Southern Utah Neurosciences Institute, St. George, Utah, June 10, 2013 | File photo courtesy of Dixie Regional Medical Center, St. George News

Cedar City Hospital also scored an “A” for the first time in two years. Cedar City, which like Dixie Regional is part of Intermountain Healthcare, had three straight “B” grades. 

Of the 11 Intermountain Healthcare facilities in Utah receiving a grade, nine received an “A.” As a comparison, among the 13 hospitals in the nearby Las Vegas metropolitan area, only two — Henderson Hospital and Mountainview Hospital — received “A” grades. 

As a center of the community, Dixie Regional’s success has also drawn praise from City Hall. 

St. George Mayor Jon Pike says health care plays a big role when people choose what city they want to call home.

“That’s a good signal this is a great place to live and visit. When you consider living in a place, you’re looking at health care, education and transportation, so that is one of the legs of the community,” Pike said. “When people call and employers ask if they should consider coming here, it’s an easier sell.”

Once you reach the top, the saying goes it is easy to go back down. Mobley said that the eight years of the survey has seen its share of “A” hospitals fail to make the grade later. But that is something Andrus says won’t be the case for Dixie Regional Medical Center. 

“We didn’t start a program. This is how we do things. This is the culture,” Andrus said. “We will stay on this.”

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