When two assessments of patient safety at hospitals nationwide were released this month, Wilkes Medical Center received a “D” letter grade in one and was recognized for being among the best in the other.

One assessment was by the Leapfrog Group, which gave the North Wilkesboro hospital a “D” in a report that included all but the smallest hospitals nationwide.

Wilkes Medical Center was included among the top 10 percent of short-term acute care hospitals in the other report, released by a company called Healthgrade.

These two differing appraisals illustrate the subjectivity of gauging patient care quality, especially considering that some of the same factors were considered in the two assessments.

All data considered by Healthgrade and much of the data used by the Leapfrog Group is from patient outcomes and other information hospitals must report to the Centers for Medicare and Medicaid Services. 

Leapfrog also uses data provided through surveys it distributes to hospitals, but participation is optional.

If a hospital doesn’t participate in the survey, its grade is determined solely by outcomes and other data reported largely to the Centers for Medicare and Medicaid Services.

Some critics have said hospitals that don’t participate in the optional Leapfrog surveys are penalized, either intentionally or by the fact that they miss opportunities to skew data in their favor. An independent study in 2017 found that data obtained through the surveys was skewed in favor of self-reporting hospitals.

This year’s Leapfrog report said Wilkes Medical Center didn’t respond to questions on the survey pertaining to blood, MRSA, urinary tract and clostridium difficile infections, as well as for infections after colon surgery.

Healthgrade reported that Wilkes Medical Center performed statistically the same as predicted for bloodstream infections related to catheter use and also following surgery.

Hospital officials have criticized assessments such as those produced by Leapfrog and Healthgrade for being too simplistic for something as complex as healthcare. They tend to inaccurately label hospitals based on what could be a few isolated incidents.

Assigning letter grades also tends to unfairly characterize hospitals.

The biggest problem is the lack of a standardized quality measurement in the hospital industry.

Without that, entities like Leapfrog and Healthgrade that attempt to gauge and report levels of quality are faced with having to decide which metrics to include, from what sources and for which time frames.

Without standardization, there are too many differing variables and patients are left with no reasonable way of knowing which assessments of patient care are most accurate.

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