Doctors Hospital Safety Report

Updated March 2018

Doctors Hospital in Coral Gables is a non-profit general medical and surgical hospital offering adult care. Its specialties include cancer services, emergency services, endoscopy, international services, neuroscience, rehabilitation services, sports medicine and orthopedic programs, and surgery.

The facility has 126 beds, placing it among the smaller hospitals in the Miami area. In the most recent survey year, the hospital admitted 6,530 patients and had 1,859 outpatient visits. Hospital doctors performed 1,859 in-patient surgeries and 4,594 outpatient surgeries.

Leapfrog General Safety & Ranking – C

The Leapfrog Hospital Safety grade of Doctors Hospital is C, largely due to specific problems with infections, surgical complications, practices to prevent errors, and hospital staff This grade is indicative of a decline in recent years. In previous years, Leapfrog rated the hospital with an A, and in spring 2017, with B.

The Leapfrog Group rates Doctors Hospital’s avoidance in the following categories:

Infections: how well patients avoid hospital-acquired infections

• MRSA infection: below average
• C.diff infection: above average
• Blood infections from ICU stay: above average
• Urinary tract infections from ICU stay: below average
• Infections of the surgical site after colon surgery: average

Problems with Surgery: how well patients avoid surgery-related complications

• Dangerous object left in patient’s body: above average
• Surgical wound splits open: below average
• Death from serious treatable complication: above average
• Collapsed lung: above average
• Serious breathing problem: below average
• Dangerous blood clot: below average
• Accidental cuts and tears: below average

Practices to Prevent Errors: what the medical professionals and staff do to avoid errors

• Doctors order medications through a computer: below average
• Hand washing: declined to report
• Communication about medicines: below average
• Communication about discharge: below average
• Staff work together to prevent errors: declined to report

Safety Problems: how well the patients avoid harm from medical professional’s mistakes

• Dangerous bed sores: above average
• Patient falls: average
• Air or gas bubble in the blood: above average
• Track and reduce risks to patients: declined to report

Doctors, Nurses, and Hospital Staff: the quality of the work of those in the hospital to ensure the best patient care

• Effective leadership: declined to report
• Enough qualified nurses: declined to report
• Specially trained doctors care for ICU patients: below average
• Communication with doctors: above average
• Communication with nurses: average
• Responsiveness of hospital staff: below average

However, for almost all of the categories in which Doctors Hospital ranks below average, the score is only somewhat below the national average, except for one, which is the worst in the country:

• Communication about medicines: The average score is 77.79; Doctors Hospital’s rating is 77.

Doctors Hospital has been ranked as the #6 hospital in the Miami metro area and the #17 hospital in Florida by US News & World Report. Several of its specialties are rated as “high performing.” Those specialties include:

• gastroenterology & GI surgery
• geriatrics
• neurology and neurosurgery
• pulmonology
• urology

Consumer Reports Review

The hospital has also received a score of 51/100 for safety from Consumer Reports. The score is average, and slightly above the average score (47) for the seventeen Miami area hospitals that received ratings.

Consumer Reports ranks Doctors Hospital and Medical Center as above average for:

According to Consumer Reports, Doctors Hospital ranked above average for “avoiding death – medical.” This category is based on the probability that a heart failure, heart attack or pneumonia patient will die within 30 days of being admitted to the hospital.

The hospital also earned top scores for the appropriate use of chest abdominal scans on patients. This means that it had a low percentage of “double scans.” Double scans occur when patients receive two kinds of imaging tests consecutively: one without dye and the other with dye. This needlessly increases a patient’s exposure to radiation. In addition, the hospital earned high marks for avoiding catheter-associated urinary tract infections. It reported having 0 catheter-associated urinary tract infections among its ICU patients with catheters between 4/01/2012 and 3/31/2013.

Avoiding Death — Medical

The rating measures the probability that a patient suffering from a stroke, heart failure, heart attack, pneumonia, or chronic obstructive pulmonary disease will die within a month of hospital admission.

Avoiding Death — Surgical

The rating measures the probability that a patient may die from a serious yet treatable complication.

Appropriate use of abdominal scanning:

• Only 2% of patients at Doctors Hospital received double abdomen scans.

Appropriate use of chest scanning:

• Less than 1% of patients received double chest scans.

As noted above, Doctors Hospital ranks well in multiple specialties, according to US News & World Report. In these specialties, it ranks particularly high when it comes to:

Survival

Each high-ranking specialty received “better than expected” marks for the likelihood of survival 30 days after admissions (adjusted for severity and other risks). The hospital’s neurology department ranked highest of all with a “much better than expected” rating.

Patient Safety

The hospital scored high marks for successfully preventing different common types of in-house accidents and errors, including preventing pressure ulcers, post-surgical inpatient deaths from treatable complications, and post-surgical hip fractures.

Nursing Intensity

The hospital has 48 full-time registered nurses. The relative balance of nurses to patients is high across its “high-performing” specialties.

Advanced Technology

All high-performing specialties scored “high” and “highest” marks for having advanced technology such as diagnostic radioisotope services, image guided radiation therapy, PET/CT scanner and robotic surgery.

Patient Services

All high-performing specialty departments received “high” and “highest” marks for their patient programs such as hospice, pain management, rehabilitation and palliative care.

Doctors Hospital received a neutral rating for avoiding infections. It reported having 1 bloodstream infections among its ICU patients with central lines between 4/01/2012 and 3/31/2013. This is 7% better than national rates. The hospital also received a neutral rating for surgical site infections. It reports having 2 surgical-site infections in 143 surgical procedures conducted between 4/01/2012 and 3/31/2013. This figure is 32% better than national rates.

Avoiding urinary tract infections associated with catheters

• The hospital reported 3 infections over the 4,816 patient days between April 1, 2016, and March 31, 2017. The rate was 19% better than the national average.

Average score for C.difficile infections: 13 reported C.difficile infections during the 29,937 patient days April 1, 2016, and March 31, 2017. The infection rate was 44% better than the national average.

The hospital ranked neutral for “avoiding adverse events in surgical patients.” Adverse events are defined by Consumer Reports as a measure based on mortality or a longer than-expected hospital stays. The rates are compared with predicted averages based on the kinds of patients the hospital cares for and the types of surgeries it performs. In this category, Doctors Hospital had 4% more adverse events than predicted based on nearly 100 surgical procedures. Data is sparse, however, Consumer Reports notes that in the category of knee replacement surgery, the hospital had 19% fewer adverse events than predicted.

Doctors Hospital ranked below average for “avoiding death – surgical.” This category rates how often patients undergoing surgery died in the hospital after developing a serious, treatable complication. Such complications may include pneumonia, deep vein thrombosis/pulmonary embolism, sepsis, shock/cardiac arrest or gastrointestinal hemorrhage/acute ulcer. Conditions such as these should be identified quickly and treated.

Avoiding bloodstream infections

The hospital reported 5 infections during the 3,437 patient days between April 1, 2016, and March 31, 2017. This was 15% worse than national average.

Avoiding MRSA infections

The hospital reported 4 infections during the 29,937 patient days April 1, 2016, and March 31, 2017. This is 231% worse than average.

Avoiding surgical site infections

The hospital reported 2 infections out of 100 procedures between April 1, 2016, and March 31, 2017. This rate was 23% worse than the national average.

Patient Experience

Above Average Ratings:

Doctor-Patient Communication

• 96% of patients thought their doctor communicated well.

Communication between nurses and patients

• 95% patients reported that nurses usually or always communicated with them well.

Control of pain

• 93% of patients reported that their pain levels were usually or always well controlled.

Cleanliness of rooms

• 91% of patients reported that their room and bathroom were usually or always clean.

Quietness of rooms

• 90% of patients reported that the areas near their rooms were usually or always quiet during the night.

Average Ratings:

Assistance from hospital staff members

• 87% of patients reported that staff members usually or always provided help in a timely manner.

Below-Average Ratings:

The hospital received below-average ratings in several areas related to patient satisfaction:

Communication regarding discharge from the hospital

• 84% of patients reported that hospital staff advised them of occurrences to be alert for after they left the hospital.

Communication of information about medications

• 78% of patients reported that hospital staff members usually or always gave explanations regarding new medicines.

Consumer Reports

Consumer Reports found that Doctors Hospital earned an above average rating for patient satisfaction, meaning that overall patients were satisfied with the quality of care they received. Of the patients surveyed:

• 97% said the doctors always or usually communicated well.
• 97% said the nurse always or usually communicated well.
• 94% said their pain was controlled or managed well.
• 92% said their room and bathrooms were always or usually clean

However, the hospital received below average ratings for communication upon being discharge from the hospital or being introduced to new drugs. In particular:

• 80% of patients said they received information about what symptoms and signs to watch for after leaving the hospital.
• 80% of patients said the doctors or nurses always or usually explained about new medication.

U.S. News & World Report Ranking

U.S. News and World Report does not rank Doctors Hospital, but it’s considered “high performing” in the following procedures or specialties:

• Chronic Obstructive Pulmonary Disease
• Heart Failure

The U.S. News & World Report found that 82% of patients would recommend the Doctors Hospital to family and friends. This percentage is both above the state average for hospital recommendations (68%) and the national average (71%). Six percent of patients surveyed said they would probably or definitely not recommend the hospital to others. This percentage is below the state average (8%) and slightly above the national average (5%).

Areas That Are Not Yet Rated:

Hart Bypass Surgery and Maternity Care are not yet rated, as are avoiding death from surgery.

Other Quality Indicators:

Centers for Medicare & Medicaid Services:

Somewhat above average for overall patient experience. The hospital also scored average in avoiding readmission, with Medicare patients having a 15.3% chance of readmission to Doctors Hospital within 30 days.

It is important to note that Doctor’s Hospital has amassed a top notch group of orthopedic doctors and is very well regarded for treating orthopedic injuries.

If you believe you or a loved one suffered an injury or illness due to the neglect of the doctors or physicians at Doctors Hospital call our attorneys today to discuss how how can help you and your family