HUNTSVILLE, Alabama -- Consumer Reports magazine ranked the two hospitals in Huntsville as the least safe in Alabama. But the magazine's list of hospitals is far from complete.

"We were kind of perplexed at some of what it reported," said Burr Ingram, spokesman at Huntsville Hospital. "When you think about it, it's fashionable for everyone to rate hospitals. And Consumer Reports is the latest to use public data that is available.

"But at times, it's difficult to know how these ratings come about."

The magazine's August edition lists scores in four safety categories. Both Huntsville Hospital and Crestwood Medical Center received low marks for poor communication with patients and for high rates of infection. Both received mediocre marks for high rates of re-admission and unnecessary scans.

Yet the report ranked just 18 percent of hospitals across 44 states. The report relied on safety data and patient surveys available through government and private agencies. Many hospitals choose not report data through such private agencies. So only eight of more than 100 Alabama hospitals were ranked.

Still, concerned emails have reached The Times, one expressing worries over infection rates ahead of a pending baby delivery.

"We take all this stuff seriously," said Jeff Samz, chief operating officer at Huntsville Hospital. "We have some rates that are great. We have areas to improve."

"It's a good thing this is getting attention," said Pam Hudson, CEO at Crestwood, saying it was beneficial to keep a focus on safety. She said at Crestwood she participates in a 10-minute safety huddle each morning to discuss safety concerns and possible changes in practice.

Officials at both hospitals pointed out the data was a year or more out of date. And officials at both hospitals also noted that Blue Cross Blue Shield of Alabama gave them a rating of "excellent" (Huntsville Hospital, Crestwood) on infection prevention.

According to Consumer Reports' ranking system, the highest rated hospital in Alabama is Walker Baptist Medical Center in Jasper. That hospital received a total score of 57 out of 100, and earned a fully positive mark for low infection rates. Overall, Crestwood earned a safety score of 37 out of 100, and Huntsville Hospital was scored at 42.

The magazine expresses its findings this way: "Bad things happen in all hospitals, but they happen a lot in some."

For a look inside some of the ratings, check the federal data at hospitalcompare.hhs.gov. You'll find Huntsville Hospital had relatively poor marks for cleanliness, but scored higher than state or national averages for patients who would recommend the facility. Crestwood had similar results.

Huntsville Hospital reported zero objects left in after surgery and no mismatched blood types, well below national error levels, but Huntsville also had twice the national rate for patient falls and injuries. Again, the same was true of Crestwood.

But at Huntsville Hospital, blood infection rates from a catheter were nearly twice the national average, affecting about 6 in 10,000 patients. Infection rates from urinary catheters were about at the national average. Crestwood's infection rates for both were half the national average.

Many Alabama hospitals, such as St. Vincent's in Birmingham and UAB, declined to respond fully to surveys handled by Leapfrog Group, a private organization that tracks hospital safety.

The survey results on leapfroggroup.org indicate both hospitals had a greater number of central line-associated bloodstream infections than the national average. Most at Huntsville Hospital were related to surgery.

Leapfrog gave Crestwood good marks for practices preventing infections in all areas except staff washing hands. Huntsville Hospital got top marks on washing hands, but lower marks on the other areas, such as preventing catheter infections.

The article in Consumer Reports cites a 2010 report from the Department of Health and Human Services that predicts hospital infections and medical mistakes contribute to the death of 180,000 patients in the United States each year.

"It is a constant goal for hospitals to have zero patient safety events," said Hudson. "That's what we strive for."