The Honolulu Star-Advertiser recently reported that more than half of Hawaii’s hospitals were rated average or worse in the Hospital Safety Scores published by a national organization known as the Leapfrog Group ("Isle facilities rank low in patient safety," Star-Advertiser, June 6).

While Straub Clinic & Hospital and Kaiser Foundation Hospital earned well-deserved A ratings from Leapfrog, we believe the study’s methods shortchanged the performance of other Hawaii hospitals.

Leapfrog’s letter grades reflect 26 measures of hospital safety. They include safe care practices (like hand washing), preventing adverse events (like getting an infection while in the hospital), using the best surgical protocols (like giving patients an antibiotic at the right time) and using advanced technology to safeguard patients (like using a computer program to spot medication errors).

HMSA strongly supports efforts to measure and improve hospital quality. In fact, almost two years ago we introduced our Advanced Hospital Care program that provides hospitals with significant financial rewards for delivering high-quality care to patients, as opposed to just paying for volume or number of services provided.

HMSA uses the same measures for proper surgical protocol in our Advanced Hospital Care program as Leapfrog. We have more recent data for seven Hawaii hospitals than Leapfrog used and each of these hospitals has improved over the score reported by Leapfrog. We expect to find that the other hospitals have improved when their latest scores become available.

For an important measure of infections acquired in a hospital, data from the Centers for Medicare and Medicaid Services show that Hawaii has the lowest overall infection rate of any state. We can all be proud of that record, which resulted in part from a program that all Hawaii hospitals and HMSA collaborated on called Stop Blood Stream Infection.

Unfortunately, seven of the 12 Hawaii hospitals that Leapfrog graded were denied their top scores on this measure due to the way Leapfrog dealt with the data on this measure. We think that’s unfair.

Similarly, a number of Hawaii hospitals didn’t respond to the Leapfrog survey that was used to rate their safety practices. Because Leapfrog lacked full information on safety practices for those hospitals, it appears the organization gave several hospitals lower scores than they deserved. Once again we think that’s unfair — especially since the hospitals weren’t told that the Leapfrog survey would be used to publish safety grades.

Publishing comparative information on hospital quality can play an important role in improving health care in our community. Further, HMSA supports transparency to help consumers make informed choices among providers. But it’s important to measure quality using valid and consistently applied metrics, and Leapfrog’s initial Hospital Safety Scores did not quite measure up to that standard.

While we believe there is still room for improvement in quality at Hawaii hospitals, we commend the hospitals for their commitment to quality, safety and transparency, and for the progress they have made to date.