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Leapfrog Group issues safety scores for hospitals

Wednesday November 28, 2012
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The Leapfrog Groupís latest update to its Hospital Safety Score shows hospitals are making some progress, but many still have a long way to go to reliably deliver safe healthcare.

For the first time, the Hospital Safety Score identifies "D" and "F" hospitals that represent the most hazardous environments for patients in need of care. The Hospital Safety Score was compiled under the guidance of the nationís leading experts on patient safety and administered by Leapfrog, an independent, national nonprofit organization.

The latest Hospital Safety Score release accounts for the data updated over the last six months, most covering hospital performance in 2011, and uses a modified methodology based on research and public comments.

"Everybody has a role in improving this terrible problem with safety in American hospitals," Leah Binder, president and CEO of The Leapfrog Group, said in a news release. At least 180,000 patients are killed every year from errors, accidents, injuries and infections in American hospitals, according to the news release.

Key findings

Of the 2,618 general hospitals issued a Hospital Safety Score, 790 earned an "A," 678 earned a "B," 1,004 earned a "C," 121 earned a "D" and 25 earned an "F."

About 58% of hospitals maintained the same grade level as they had in scores issued in June. Another 34% of hospitals rose or fell by one grade level, and about 8% rose or fell by two or more grade levels.

A wide range of hospitals earned "Aís," with no one class of hospitals more prevalent among those with the highest safety scores. Hospitals earning an "A" include academic medical centers such as NewYork Presbyterian Hospital, Brigham and Womenís Hospital and Mayo Clinic. Many rural hospitals earned an "A," including Geisinger Medical Center and Blessing Hospital.

Hospitals with myriad national accolades, such as Massachusetts General Hospital, Duke University Hospital, and Cleveland Clinic Florida earned "Aís," as did hospitals serving highly vulnerable, impoverished or health-challenged populations, such as Bellevue Hospital Center and Detroit Receiving Hospital.

Massachusetts (83%) and Maine (80%) led in state rankings based on the proportion of hospitals earning "Aís."

Methodology

Calculated under the guidance of The Leapfrog Groupís nine-member "Blue Ribbon Expert Panel," the Hospital Safety Score uses 26 measures of publicly available hospital safety data to produce a single score representing a hospitalís overall success in keeping patients safe from infections, injuries and medical and medication errors.

Among the 26 measures, 15 are process and structural measures: computerized physician order entry, ICU physician staffing, leadership structures and systems, culture measurement and feedback, teamwork training and skill building, identification and mitigation of risks and hazards, nursing workforce, medication reconciliation, hand hygiene, care of the ventilated patient, antibiotic within one hour, antibiotic selection, antibiotic discontinued after 24 hours, catheter removal and VTE prophylaxis.

And 11 are outcome measures: foreign object retained, air embolism, pressure ulcer (stages 3 and 4), falls and trauma, central line-associated bloodstream infection, death among surgical inpatients, iatrogenic pneumothorax, postoperative respiratory failure, postoperative PE/DVT, postoperative wound dehiscence and accidental puncture or laceration.

The panel includes: John Birkmeyer, MD, University of Michigan; Ashish Jha, MD, Harvard University; Lucian Leape, MD, Harvard University; Arnold Milstein, MD, Stanford University; Peter Pronovost, MD, PhD, Johns Hopkins University; Patrick Romano, MD, University of California, Davis; Sara Singer, PhD, Harvard University; Tim Vogus, PhD, Vanderbilt University; and Robert Wachter, MD, University of California, San Francisco.

More information is available at www.hospitalsafetyscore.org.


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