California Hospitals Lose Ground In Quality Of Care, Report Card Shows -AND- Opioid prescriptions in CA dropped 17 percent since 2013

CAL/AAEM News Service at
Sun May 21 15:32:45 PDT 2017



April 18, 2017


California Hospitals Lose Ground In Quality Of Care, Report Card Shows 



IIztkSiya98sJ1N8JoXDVLBcsAwdg&_hsmi=50863755> California Healthline



By Chad Terhune


Nearly half of California hospitals received a grade of C or lower for
patient safety on a national report card aimed at prodding medical centers
to do more to prevent injuries and deaths.


The Leapfrog Group, an employer-backed nonprofit group focused on health
care quality, issued its latest scores last week. The report card is part of
an effort to make consumers and employers aware of how their hospitals
perform on key quality measures, so they can make better-informed health
care decisions. The scores are updated twice a year, in spring and fall.


After steady improvement in recent years, California hospitals lost ground
in last week's report card. Two years ago, 37 percent of California
hospitals received a C, D or F grade. That increased to 46 percent of the
271 California hospitals rated in the most recent report.


Many California hospitals still struggle to reduce preventable medical
errors and infections in patients, despite industrywide efforts to remedy
those problems. California accounted for 6 of the 10 hospitals nationwide
that received an F grade.


California public health officials track a wide assortment of patient
infections that can be acquired during a hospital stay. A recent state
report noted progress in some areas, while other issues have been harder to


>From 2014 to 2015, 56 California hospitals achieved "significant
improvement" in preventing certain infections, including ones in the blood
and those resulting from surgery, according to the California Department of
Public Health. But diarrheal infections in California hospitals have
increased 8 percent above a national benchmark since 2011.


The state has created an interactive map where the public can check
infection rates by hospital.


Leapfrog, which has issued hospital scores in California and nationwide
since 2012, analyzes information it collects as well as data reported to
Medicare. Erica Mobley, a Leapfrog spokeswoman, said the group's methodology
compares all hospitals to each other on a national scale, so a mix of
factors could be responsible for the lower scores statewide.


"This could represent California hospitals' performance slipping in
comparison to their peers across the country or could also mean that they
may be staying constant in their performance while other hospitals are
progressing," Mobley said.


The percentage of hospitals in the Golden State that got the top rating also
decreased in Leapfrog's latest analysis. Twenty-five percent of California
hospitals, 68 facilities, earned an A grade this year, compared to 43
percent, or 104, in 2015.


California ranked 28th nationally in the percentage of A-rated hospitals.
More than half of the hospitals in states such as Oregon, North Carolina and
Massachusetts achieved the highest score.


In Leapfrog's report card, some performance measures are risk-adjusted for
patient severity and income so hospitals aren't penalized for admitting
sicker, poorer patients.


Some hospital industry officials have criticized Leapfrog's letter grades as
too simplistic for a complex issue and as potentially misleading for


Jan Emerson-Shea, a spokeswoman for the California Hospital Association,
noted there are many different scorecards and said consumers shouldn't put
too much stock in any one ranking.


"While these scorecards often serve as a good starting point for patients to
ask questions of their health-care provider, they should not be viewed as
being a definitive source for determining the quality of care provided by
any hospital," Emerson-Shea said.


The Leapfrog data show that some of the top performers in California include
Chinese Hospital in San Francisco, Mercy General Hospital in Sacramento,
Hoag Memorial Hospital Presbyterian in Newport Beach and Inglewood's
Centinela Hospital Medical Center.


Health giant Kaiser Permanente consistently posts some of the highest scores
and shows little variation across its 35 hospitals in the state.
Thirty-three Kaiser hospitals received A or B grades; two got C grades.


The University of California health system fared well across seven hospital
campuses, with five A ratings and two B grades.


Some large institutions lagged further behind. Providence St. Joseph Medical
Center in Burbank received a D, as did the Zuckerberg San Francisco General
Hospital and Trauma Center.


Leapfrog cited San Francisco General, a public safety net hospital, for
being below average at preventing surgical site infections after colon
surgery and for allowing dangerous objects to be left in a patient's body,
among other factors. Providence's Burbank hospital had a
higher-than-expected rate of patients who developed serious breathing
problems and caught antibiotic-resistant infections, according to Leapfrog.


A spokesman for San Francisco General didn't comment directly on the
hospital's results, other than to say it didn't participate in Leapfrog's
optional survey on safety procedures and training.


Providence said in a statement it takes patient safety seriously and
respects efforts to help consumers make an informed choice. However, "it is
important to understand that health care data are extremely difficult to
compare as each patient is unique," the hospital said. "Often information is
a few years old before it is analyzed and aggregated for the public."


A full list of California hospitals and their scores is available here.


California's Office of Statewide Health Planning and Development also offers
data on hospital quality and patient outcomes. And Medicare posts star
ratings for hospitals nationwide, which are another resource for patients
and policymakers.




May 1, 2017


Opioid prescriptions in CA dropped 17 percent since 2013 



 <> California
Medical Association



The number of opioid prescriptions written by California physicians dropped
17 percent over the past three years (2013-2016), according to new data from
Quintiles IMS. In fact, per capita, California is now tied with Hawaii for
the lowest number of filled opioid prescriptions in the nation. During the
same time frame, physicians nationwide wrote 15 percent fewer prescriptions
for these medications, reflecting the leadership role that the medical
community has played in addressing prescribing practices.


The issue of opioid-related misuse, abuse and overdose continues to be a
major policy issue at the federal, state and regional levels. Like the
nation as a whole, California is faced with a serious health care dilemma:
how to prescribe controlled substances safely and effectively to relieve
pain, while simultaneously reducing the risk of prescription medication
misuse, addiction and overdose. These new statistics show the positive
impact of recent efforts to raise awareness about safe prescribing


The California Medical Association (CMA) supports a well-balanced approach
to opioid prescribing and treatment that considers the unique needs of
individual patients. Opioids have a legitimate role in medical practice and
can be effective when prescribed and used responsibly. Physicians who
prescribe opioids and other controlled substances should have access to
up-to-date information on a wide range of issues, including how to provide
treatment that meets the community standard of care and manage the risks
that can come with prescribing opioids.


CMA urges physicians to review the Medical Board of California's "Guidelines
for Prescribing Controlled Substances for Pain," which are intended to
specifically address the use of opioids in the long-term treatment of
chronic pain. The medical board guidelines also include references to
special patient populations for other types of pain and across other
treatment scenarios, as well as an extensive discussion about the nature and
treatment of pain.


For more information, visit CMA's safe-prescribing resource page at There you will find:


*  Resources on prescribing controlled substances safely and effectively to
relieve pain, while simultaneously reducing the risk of prescription
medication misuse, addiction and overdose.

*  CMA's white papers on prescribing opioids

*  Links to relevant documents in CMA's health law library

*  Continuing medical education courses and webinars

*  Current information on the state's prescription drug monitoring database




Jeff Wells
Deputy Editor, CAL/AAEM News Service


Brian Potts MD, MBA
Managing Editor, CAL/AAEM News Service

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