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Hospital safety practices unrelated to outcomes

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NEW YORK (Reuters Health) - Whether or not trauma centers meet national safety standards says little about a patient's risk of dying or getting an infection while there, according to new research.

The findings add to evidence that quality measures meant to improve hospital outcomes may not be as effective as hoped.

Earlier this month, for instance, another study found that hospitals scoring high for their treatment of children with asthma aren't better at preventing those kids from ending up in the emergency room with asthma attacks (see Reuters Health story of October 4, 2011).

The latest results, published in the Archives of Surgery, show that hospital scores on the so-called Leapfrog Safe Practices Survey weren't linked to either death rates or hospital-associated infections.

The survey asks hospitals about how they staff their intensive care unit, among other things, and how they try to avoid blood stream infections from catheters.

The Leapfrog Safe Practices have been adopted by the National Quality Forum, a non-profit organization that receives government as well as private funding, to try to improve patient safety and health care quality.

According to a 1998 report from the Institute of Medicine, 98,000 Americans die each year from preventable medical errors at hospitals.

The new study is based on data on more than 42,000 patients from 58 trauma centers across the country.

Dr. Laurent G. Glance, who led the work, said its findings were preliminary and don't mean the safety practices themselves aren't effective. Rather, he suggested in a telephone interview, the Leapfrog survey is falling short.

"You can't just rely on what the hospital executive says," Glance, of the University of Rochester School of Medicine in Rochester, New York, told Reuters Health. "You'd probably also need to have some sort of auditing in place."

He also called for studies following hospitals over time, to make sure that those with high scores aren't just the ones that had bad outcomes and therefore decided to up their game.

"We need additional studies to look at whether or not these safety practices are beneficial for trauma patients," Glance said.

SOURCE: http://bit.ly/psguZq Archives of Surgery, October 17, 2011.

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