ST. GEORGE — When it comes to the safety of their patients, the hospitals in St. George and Cedar City are “A” students.

Inside the lobby of Cedar City Hospital, Cedar City, Utah, Oct. 12, 2022 | Photo by Chris Reed, St. George News / Cedar City News

That’s the conclusion of the latest “Hospital Safety Grades” report by the nonprofit Leapfrog Group. 

Both St. George Regional Hospital and Cedar City Hospital earned “A” grades for safety, while for the first time, Utah leads the nation in safety grades for its hospitals in the bi-annual report. 

The Leapfrog Hospital Safety Grade scores 3,000 hospitals around the nation on how they protect patients from errors, injuries, accidents and infections. But Katie Burggraf Stewart, director of health care ratings at The Leapfrog Group, told St. George News that “A” grades aren’t given out like candy and hospitals are not graded on a curve. In fact, she said there is a downward trend among hospitals nationwide in the latest reports and Utah’s hospitals are an aberration. 

“What we love to see with the two hospitals, I’m looking at Intermountain St. George Regional Hospital and Intermountain Cedar City Hospital, is really the consistency in high performance,” Stewart said. “Certainly we want to see hospitals get an ‘A’ and nationally we have 30% of hospitals right now that are getting an ‘A’. We want to see more hospitals.”

As a comparison, among the 12 hospitals with safety grades two hours to the south in Las Vegas, there is one that received an “A” grade: Henderson Hospital. 

The individual safety report card for St. George Regional can be found at this link, while Cedar City’s is here. Smaller local hospitals like Garfield Memorial in Panguitch and Kane County Hospital in Panguitch aren’t included. 

The two local hospitals are part of a state that led the nation in the safety report, with more than 50% of Utah hospitals receiving “A” grades. It’s the first time Utah has topped the report, which has been issued twice a year since 2012.  

Ryan VanderWerff, the director of musculoskeletal, neurosurgery, and spine service lines for the entire Intermountain system, inspects one of the rooms inside the Intermountain Southwest Ortho Urgent Care clinic at St. George Regional Hospital, St. George, Utah, Sept. 8, 2022 | Photo by Chris Reed, St. George News

“Utah is ranked No. 1, which is just an incredible achievement,” Stewart said. “What that says is individuals in Utah have more choices in terms of safer hospitals and the choice of where you go is really important when it comes to patient safety.” 

Stewart said while the typical measures of errors, injuries, accidents and infections can be a deciding factor in the letter grades the hospitals get, the factor that sets the two Southern Utah hospitals apart is patient experience. 

This includes prompt response in hospital rooms when the nurse call button is pressed, a suitable amount of staff and more face-to-face interactions. Stewart said the facilities that had such practices firmly in place before the pandemic have performed better than facilities that did not. 

In the last pre-pandemic report issued in fall 2019, Cedar City had received its first upgrade to an “A” in a long stretch, while what was then Dixie Regional Medical Center was maintaining an “A” grade.  

LeapFrog researchers said most safety measures, especially patient experience, took a steep decline during the pandemic, but the latest data shows a recent improvement. 

Even so, most American hospitals have been especially lacking in the patient experience area. 

“Now that we have pre- and post-pandemic data for patent safety measures, we are encouraged by the improvement in infections and applaud hospitals for reversing the disturbing infection spike we saw during the pandemic,” Leah Binder, president and CEO of The Leapfrog Group, said in a statement. “However, it’s deeply concerning that patient reports about their health care experience continues to decline.”

A patient is helped at the Intermountain Southwest Ortho Urgent Care clinic at St. George Regional Hospital, St. George, Utah, Sept. 8, 2022 | Photo by Chris Reed, St. George News

An August study in the Journal of the American Medical Association said higher-staffed and higher-performing hospitals were more resilient to the conditions of the COVID-19 pandemic, but patients’ experiences of care had declined in most hospitals by late 2021. 

One part of the problem may be an overreliance on telehealth, or remote, services. Stewart says there are benefits to telehealth, but for serious conditions, an in-person interaction is less risky to patient safety. 

“There might be precautionary practices that may have limited patient interaction that might still be in place even after the pandemic,” Stewart said. “Maybe something that could have been done face-to-face may still be done via a phone call.”

Despite being an “A student,” St. George Regional Hospital still had one blemish in the latest report: Foreign objects retained after surgery. That can range from catheters, needles and sponges to surgical instruments like clamps. 

The national average is a score of 0.014, but St. George Regional had a 0.192 foreign object score after three straight reports with a perfect 0 score. 

“There’s always a level for improvement. And one thing about St. George is if you look at the outcomes, they do have a foreign-object retained measure,” Stewart said. “Those are things that should never happen in a hospital. Generally, a hospital has the structures and processes in place to prevent those things.” 

St. George has also had a two-fold increase in the measure of colon infections during surgery and is above the national average.  

Cedar City Hospital now has at least four straight perfect 0 scores in the foreign object category, though that facility has a fraction of the surgeries performed in St. George. There were no measures that showed a substantial downgrade for Cedar City in the fall 2023 report.

The data that determines the grades is a combination of data from 28 safety measures from the federal Centers for Medicare and Medicaid Services and information compiled from surveys conducted by LeapFrog researchers.

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