Methodology

For the latest  report, Leapfrog assigned "A" to "F" letter grades to nearly 3,000 general acute-care hospitals using up to 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.

How hospitals performed

In the latest report:

• 29% of hospitals received an "A"
• 26% of hospitals received a "B"
• 39% of hospitals received a "C"
• 6% of hospitals received a "D"
• Less than 1% of hospitals received an "F"

The 10 states with the highest percentages of "A" hospitals were:

1.       New Jersey

2.       Idaho

3.       Utah

4.       Pennsylvania

5.       Connecticut

6.       North Carolina

7.       South Carolina

8.       Colorado

9.       Virginia

10.   Massachusetts

According to Leapfrog, there were no "A" graded hospitals in Delaware, Washington, D.C., and North Dakota.

See how your hospital fared.

Leapfrog also found increases in three healthcare-associated infections (HAIs):

• Central-line associated bloodstream infections (CLABSI), which saw an average standard infection ratio increase of 60%
• Methicillin-resistant Staphylococcus aureus (MRSA), which saw an average standard infection ratio increase of 37%
• Catheter-associated urinary tract infections (CAUTI), which saw an average standard infection ratio increase of 19%

Specifically, 32 states saw a significant increase of CLABSI, with the largest increase occurring in West Virginia. In addition, 18 states saw a significant increase of MRSA, with West Virginia seeing the largest increase, and 11 states saw a significant increase of CAUTI, with New Mexico seeing the largest increase.

However, "[d]espite considerable lapses in care quality over the past year, one bright spot was safety improvements made by poorer-scoring hospitals," Modern Healthcare  reports.

Commentary

Leah Binder, president and CEO of Leapfrog, said the spike in HAIs "should stop hospitals in their tracks — infections like these can be life or death for some patients. We recognize the tremendous strain the pandemic put on hospitals and their workforce, but alarming findings like these indicate hospitals must recommit to patient safety and build more resilience."

Binder noted that this report is "the first round of the hospital safety grades where we have data from hospital performance during the height of the pandemic."

"We might have hoped that hospitals would become experts at preventing infections by dealing with an infectious disease outbreak like the pandemic," Binder said. "But the opposite is the case."

According to Akin Demehin, senior director of quality and patient safety at the  American Hospital Association, sicker patients who needed to be on ventilators longer in addition to clinical staff floating to care areas they were unfamiliar with led to more potential infection risks for hospitals.

"Hospitals had to constantly balance influxes and surges of COVID-19 patients while keeping the doors open for others who needed care," Demehin said. "The significant gains that hospitals had made in patient safety and in reducing infections prior to the pandemic were more challenging to sustain."

Going forward, health systems need to address both workforce burnout and patient safety issues, as the two are closely related, Binder said.

"It is clearly something that can affect burnout, workforce shortages, and can affect the very safety of the workforce," she said.

Many hospitals are trying to reinforce infection control and reduction practices by spending time with staff to better understand what resources are necessary and what type of care environment is needed to support change, Demehin said.

"Ultimately, improving quality and safety relies on the talented people who deliver care in our organizations and keeping them engaged and happy," he said. "Giving them the opportunity to help us identify opportunities for improvement is an important part of making progress." (Leapfrog Group "About the Grade," accessed 5/3; Leapfrog Group Hospital Safety Grades methodology, accessed 5/3; Leapfrog Group press release, 5/3; Devereaux, Modern Healthcare, 5/3)

How Hospital Quality Ratings Work

Download quick guides that summarize the methodology and metrics used in hospital quality rating programs.