Two San Antonio-based hospitals earned spots on a nationwide list of top general hospitals for 2021, while University Health System finally worked its way off the list of hospitals penalized for high complication rates.

Those determinations were part of the semi-annual Hospital Safety Grade report, published by the nonprofit Leapfrog Group. The report, which rates nearly 3,000 hospitals nationwide on safety practices, gives potential patients a quick way to evaluate the relative safety of hospitals.

Leapfrog uses safety data from the federal Centers for Medicare and Medicaid (CMS), the results of its own hospital survey plus other data sources to come up with its letter grade ranking system.

Grades range from A to F; of San Antonio’s 15 hospitals, none rated lower than a C in this most recent report.

North Central Baptist Hospital and Resolute Health Hospital of New Braunfels, both members of the San Antonio-based Baptist Health System, each were named top general hospitals nationwide for 2021; they were the only hospitals in Texas to make the list. Both hospitals maintained A grades for the past two years.

“We constantly monitor quality, safety and patient experience metrics so that we may drive improvement through the work of our physicians and employees,” wrote the Baptist Health System in a statement. “We are so proud of our teams for this amazing achievement on behalf of the patients we care for and the communities we serve.”

At the other end of the spectrum, high infection, injury and complication rates led the federal government to cut payments by 1% to two San Antonio hospitals this year, including the C-graded Texas Vista Medical Center and the Texas Center for Infectious Disease, a state public health facility that treats tuberculosis which was not included in the Leapfrog report.

University Health, which had been penalized every year since 2015 for patient complications such as infections acquired during hospital stays, dropped off the list.

Holding hospitals accountable via financial penalties can improve quality of health care, said Missy Danforth, vice president of health care ratings at the Leapfrog Group. The threat of losing money elevates the issue in many hospitals to the attention of directors and owners. 

“The fact that everyone’s talking about it, from front-line nurses to boards of directors, is positioning patient safety where it should be, which is at the forefront of everyone’s minds,” said Danforth.

“We’ve actually been working on improving those data for quite some time,” said Dr. Bryan Alsip, chief medical officer at University Health. “The fact that we’ve come now below the penalty threshold really represents several years work.”

Alsip said the hospital in 2018 implemented a reward system for inpatient units to prevent hospital-acquired infections.

“Several units have not only prevented more than one infection, they’ve done so for several years in a row, which is a testament to their commitment to patient safety,” he said.

Also notable in this spring’s data, Christus Santa Rosa Health Care at the Medical Center improved its D grade from last fall to a C this spring. 

The D grade came during the first wave of COVID-19, wrote Gloria Madera, public relations specialist for the Christus Health System in a statement to the San Antonio Report. We … sent a team to our hospital to help put solutions into place to mitigate further risk.”

The most recent C grade “was measured during the second wave of COVID cases,” Madera wrote. “We continue to see improvements in [the hospital] for the next measurement period and feel confident of a stronger grade next time.”

St. Luke’s Baptist Hospital, also part of the Baptist Health System, fell from the A grade it has held since 2019 to a B this spring. The report noted areas that need improvement include reducing infections after colon surgery, reducing methicillin-resistant Staphylococcus aureus (MRSA) infections, better wound care following surgeries, reducing patient falls and better communication about medicines and discharge. 

Baptist Health System officials did not address the St. Luke’s rating drop in its statement.

Overall, most local hospitals’ grades remained the same as last fall.

Baptist Medical Center, Metropolitan Methodist, Methodist Texsan Northeast Baptist, and Methodist Specialty & Transplant Hospitals all kept their A grades.

These hospitals excelled in most safety measures, including low rates of harmful events, such as dangerous bed sores and blood clots; high rates of safe medication administration, and having enough qualified nurses and specially trained doctors for intensive care units.

But even top-rated hospitals have room for improvement, the report shows.

Common areas that need improvement, even among A-rated hospitals, included surgical wound complications and serious problems after major surgery, death from treatable serious complications, communication about medicines, discharge and communication with nurses and doctors. Hospital staff responsiveness was also an area with room for improvement for A-graded hospitals.

Hospitals that maintained B grades include Methodist Hospital, University Health System, Northeast Methodist Hospital and Methodist Stone Oak Hospital. Most B-rated hospitals reported higher rates of infections among patients, including MRSA, surgical site infections and catheter-associated urinary tract infections.

Texas Vista Medical Center, Mission Trail Baptist Hospital and Christus Santa Rosa Hospital at Westover Hills all maintained a C grade. The most common issues across these hospitals included too many MRSA infections, accidental injuries during surgery or procedures and complications resulting from them, inadequate communication about medicines and discharge instructions, and poor communication with doctors. 

Methodist Healthcare Ministries of South Texas, University Health System and Baptist Health Foundation are financial supporters of the San Antonio Report. For a full list of business members and supporting foundations, click here.

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Raquel Torres

Raquel Torres is the San Antonio Report's breaking news reporter. She previously worked at the Tyler Morning Telegraph and is a 2020 graduate of Stephen F. Austin State University.