The Leapfrog Group on Tuesday released its spring 2022 Leapfrog Hospital Safety Grades, giving roughly one-third of hospitals an "A" for their ability to shield patients from preventable errors, accidents, injuries, and infections.

Cheat sheet: See how Leapfrog calculates its ratings

Methodology

For the latest report, Leapfrog assigned "A" to "F" letter grades to nearly 3,000 general acute-care hospitals based on 22 evidence-based measures of patient safety, including data from CMS Medicare PSI 90 Patient Safety and Adverse Events composite.

The ratings, which are updated twice a year, do not cover facilities such as military or VA hospitals, critical access hospitals, specialty hospitals, children's hospitals, or outpatient surgery centers because of missing data.

Along with the safety scores, Leapfrog issued a separate report highlighting inpatient patient experiences, analyzing data from CMS' Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey.

How hospitals performed

In the latest report:

• 932 hospitals earned an "A"
• 679 hospitals earned a "B"
• 1021 hospitals earned a "C"
• 194 hospitals earned a "D"
• 17 hospitals earned an "F"

Overall, 20.3% of hospitals earned higher safety scores this spring when compared with last spring's scores. However, 22.4% of hospitals received lower grades than they did last year. Still, 57.2% of hospitals earned the same grade in 2021 and 2022.

In Leapfrog's spring 2022 rankings, 59.8% of North Carolina hospitals earned "A" grades—the highest share of any state—followed closely by Virginia and Utah, with 59.2% and 55.6% of hospitals with "A" grades, respectively.

In total, eight states had 50% or more of its hospitals receive an "A" grade. However, Leapfrog did not give an "A" grade to any hospitals in Wyoming, West Virginia, North Dakota, or the District of Columbia.

See how your hospital fared.

For its report on patient experience, Leapfrog noted declines between survey periods in the average percentage of hospital patients who gave the most favorable responses for nine of the 10 HCAHPS measures. The greatest decline was seen among patients' experiences with hospital staff responsiveness (a 3.7 percentage point decrease), followed by communication about medicines (a 3.1 point decrease), and cleanliness of the hospital (a 2.9 point decrease), Fierce Healthcare reports.

Commentary

According to Nidia Williams, VP of quality and safety for Lifespan Health System, most health systems do not have sufficient information to determine how well their safety systems have performed during the ongoing pandemic, which accounts for lower grades at some facilities.

"We didn't realize that the patient population was different, and required an awful lot of care, treatment, time, energy and resources that we weren't necessarily prepared for," said Williams, who also serves as president-elect of the National Association for Healthcare Quality's board of directors.

Several factors likely contributed to the fluctuation in hospitals' safety grades during this period, said Nancy Foster, VP of quality and patient safety policy at the American Hospital Association (AHA). For example, Foster noted that travel nurses may not be fully trained on a hospital's safety practices and infection controls.

In addition, Akin Demehin, AHA's senior director of policy, noted that patients who delayed care because of the pandemic often arrived sicker and required interventions like ventilators or catheters that pose a risk of infection and other adverse effects.

Still, many hospitals tried to diligently track the pandemic's impact on hospital safety, Demehin said. In fact, over 90% of hospitals continued to submit health care-associated infection reports after CMS made them optional, according to Demehin.

"Despite a general decrease in patient experience ratings, spring Grades continue to show significant variation in safety performance across U.S. hospitals," said Leapfrog Group president and CEO Leah Binder. "This variability is a constant reminder that the public must have access to information on which hospitals are safer so patients can make the best decision for themselves and their loved ones."

"We commend the workforce for their heroic efforts these past few years and now strongly urge hospital leadership to recommit to improved care—from communication to responsiveness—and get back on track with patient safety outcomes," Binder added. (Leapfrog Group "About the Grade", accessed 5/11; Leapfrog Group "Explanation of Hospital Safety Grades," accessed 5/11; Leapfrog Group press release, 5/10; Muoio, Fierce Healthcare, 5/10; Bean, Becker's Hospital Review, 5/10; Dean, The News & Observer, 5/10; Devereaux, Modern Healthcare, 5/10)