New Hospital Quality and Safety Ratings Released, Show Improvements from 2016

By Christina Thielst via Multibriefs

The Leapfrog Group, which represents employers and other purchasers of healthcare services, has released its new spring 2019 Leapfrog Hospital Safety Grades. Overall, there has been a significant improvement in 2019 (160,000) from its 2016 estimate (205,000) of lives lost from avoidable medical errors.

The Leapfrog Group’s membership is interested in helping consumers understand how safe hospitals are for patients. Through its affiliation with the Johns Hopkins Armstrong Institute for Patient Safety and Quality, it has also updated its estimate of deaths due to errors, accidents, injuries and infections at “A,” “B,” “C,” “D,” and “F” hospitals.

The assigned grades provide consumers information on the relative risk of an “A” hospital, compared to those hospitals receiving a lower grade. The new findings show hospitals with the lowest ranking are even more risky. When compared to “A” hospitals:

• Patients at “D” and “F” hospitals face a 92% greater risk of avoidable death
• Patients at “C” hospitals on average face an 88% greater risk of avoidable death
• Patients at “B” hospitals on average face a 35% greater risk of avoidable death

It is estimated that 50,215 lives could be saved each year if all hospitals perform at the same level as “A” hospitals. The estimates reflect the average hospital performance in each category; although individual hospital performance within each letter grade may vary. In addition, while estimates of death from patient safety events do not capture other comorbidities that could have an impact on outcome, they do offer an objective measure from which to begin conversations.

Like other hospital rating systems, the grades can be viewed as triggers for asking questions for more informed patients.

For example, can grades for individual performance measures translate to other measures or areas in the hospital? Have there been improvements since the data was collected? How tolerant am I, as a patient, to receive care from a hospital still working on improvement from failing grades?

Each grade assigned is a reflection on the leadership and culture of the organization and its established priorities. Likewise, average grades for each state could reflect on the strength of a state’s oversight and/or the general health status of the population. The ratings can be viewed for any point (period) of time; or historically.

Across all states, additional Leapfrog Hospital Safety Grade findings for spring 2019 include:

• Of more than 2,600 hospitals graded, 32% earned an “A,” 26% earned a “B,” 36% earned a “C,” 6% a “D” and just under 1% an “F.”
• The top five states with the highest percentages of “A” hospitals are: Oregon (58%), Virginia (53%), Maine (50%), Massachusetts (48%), and Utah (48%).
• There are no “A” hospitals in Wyoming; Alaska; Washington, D.C.; Delaware; or North Dakota.
• Impressively, 41 hospitals nationwide have achieved an “A” in every grading update since the launch of the Safety Grade in spring 2012.

In 2019, the survey was expanded to include questions about outpatient surgery in addition to its traditional content on the quality and safety of inpatient care. Leapfrog is also launching the new Leapfrog ASC Survey, open for ambulatory surgery centers (ASCs).

Referral sources and consumers can use these and other ratings as a gauge to decide the best place for them to seek care. Hospitals and their trade associations will respond that they have improved, or improvements are being made. But, the findings still demonstrate opportunities to improve do exist.

Each patient will want to consider the totality of information available and whether they are willing to be a patient while the work is still in process.

Image: The Leapfrog Group

Christina Thielst, FACHE, is a skilled and innovative hospital and healthcare administrator and entrepreneur with a deep desire for continually improving the health of the community being served. Christina is also the author of "Applying Social Media Technologies in Healthcare Environments."