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All Hartford HealthCare Hospitals Earn Straight A’s for Safety

November 15, 2024

For the second time, all seven Hartford HealthCare hospitals received “A” grades for safety from The Leapfrog Group, the nation’s leading independent hospital watchdog.

This is a remarkable achievement that means patients have access to the safest level of care no matter which Hartford HealthCare hospital they choose.

“This is an important recognition — not for us but for our patients and all those we serve. It tells patients they can receive the safest care in the country right here in Connecticut,” says Jeffrey A. Flaks, HHC president and chief executive officer.

“This puts Connecticut on the map as a destination for world-class healthcare and is an important distinction for everyone who trusts us with their care. Safety is at the heart of promise we make to our communities, a commitment that leads to innovation, process improvement and best practices employed across the entire system. There is no safer care anywhere.”

More than ever, patients look to Leapfrog and other rankings to help them make care decisions for themselves and loved ones. Patients at hospitals with D or F grades face a 92% higher risk of avoidable death, according to Leapfrog.

Along with its recognition for its “A” in safety, Hartford Hospital has once again been named a Top Teaching Hospital by the Leapfrog Group, highlighting its nationally recognized achievements in patient safety and quality. In 2023, only 75 hospitals in the country received this designation from Leapfrog.

Focus on safety starts at the top

Hartford HealthCare’s success is rooted in executive support, continuous training and resources for initiatives designed to improve care quality and reduce incidents of hospital-acquired infections, pressure ulcers and human error.

“The differentiator is our intentional focus and commitment to quality and safety,” says Stephanie Calcasola, Hartford HealthCare vice president of quality and safety. “Our entire organization is creating goals around patient safety, utilizing tools to understand performance and with that performance, creating action plans to continuously improve.”

Quality and safety journey

In 2019, Hartford HealthCare committed to becoming a high-reliability organization, a blame-free environment where colleagues feel safe pointing out mistakes to improve patient safety.

Results included:

• Achieving a 39% Serious Safety Event Rate reduction at all hospitals since September 2019.
• Realizing a 40% reduction in hospital-acquired infections (HAIs) across all hospitals.

To become a high-reliability organization, Hartford HealthCare invested in a series of practices and protocols that included in staff training that heightened our focus on key indicators of hospital safety these included:

• Preventing Hospital-acquired infections (HAIs). From MRSA and clostridiodes difficile (C.diff) to catheter-associated urinary tract infections, patients can acquire various infections while hospitalized. Preventive measures that are now part of our standard practice include:

• • Bedside checklists helping clinicians spot infections early enough to quickly and effectively treat.
  • Device removal timeouts stopping work so teams can focus on earlier removal of catheters when safe and appropriate. Earlier removal decreases infection risk.
  • Reducing unnecessary testing and lab work.
  • Embedding team huddles in standard work.
  • Accountability models empowering colleagues to raise concerns.
  • Standardized tools outlining steps to avoid and/or treat infection so care is uniform at every hospital.
  • Including patients on HHC’s Board of Directors Quality & Safety Committee.
  • Consistent hand hygiene. Always a priority at HHC, Calcasola says efforts heightened during the pandemic and have been maintained.
  • Avoiding human error. Checking and double-checking helps curb human error. Examples include:
    • Bar coding medication in the pharmacy. Bedside staff checks medication codes against orders and patients to ensure safe delivery.
    • Creating a process to learn from errors, improve systems and prevent mistakes from happening again.
    • Fostering an environment where all voices matter, encouraging colleagues to speak up if they think something is wrong.

• Avoiding pressure ulcers. Damage to skin caused by lying in one position for too long, can cause serious health issues, even death. Prevention efforts include:

• • Thermal scanning technology to spot skin breakdown before it’s visible.
  • Standard protocols to assess skin condition at admission and periodically during hospital stays.
  • Creation of a nursing council to teach clinical teams how to avoid and treat pressure ulcers.

• Antibiotic stewardship to avoid C.diff and MRSA infection. “We learned there is price to pay for antibiotic over-prescription — adverse side effects, antimicrobial resistance, cost and life-threatening diseases,” explains Ulysses Wu, MD, system director of infectious disease. Over time, he says providers recognized “longer does not equate to better” and limited antibiotic use.

“The cultural work was critical to getting us where we are now,” says Dr. Ajay Kumar, MD, MBA, Hartford HealthCare’s Chief Clinical Officer. “Nothing happens without observation and follow-up, work that will continue as we ensure the safety of our patients.”

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