Methodology

For the 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, nearly 30% of hospitals received an "A" grade, while 26% received a "B," 37% received a "C," 7% received a "D," and less than 1% received an "F." Roughly 1,880 hospitals maintained their safety grade from the fall 2023 report, while 18 hospitals fell by two grades and 35 increased by two grade levels.

Leapfrog saw improvements in hospitals' average standard infection ratio of central line-associated bloodstream infections (CLABSI), which dropped by 0.17 percentage points between the fall 2023 and spring 2024 reports. In addition, average ratios of methicillin-resistant Staphylococcus aureus (MRSA) cases and catheter-associated urinary tract infections (CAUTI) dropped by .14 and .12 percentage points, respectively.

Leapfrog also found that, since the company reported on Hospital Safety Grades in fall 2022 when hospital-acquired infections were at a six-year high, 92% of hospitals have seen improvements on at least one of three dangerous preventable infections.

Specifically, Leapfrog found that:

• CLABSI decreased by 34%
• CAUTI decreased by 30%
• MRSA decreased by 30%

In addition, Leapfrog released the top 10 states and the top 25 metropolitan areas with the highest percentage of "A" hospitals.

According to Leapfrog, the states with the highest percentage of "A" hospitals are:

1. Utah (57.7%)

2. Virginia (56.3%)

3. New Jersey (44.8%)

4. Colorado (44.4%)

4. Rhode Island (44.4%)

6. Alaska (42.9%)

7. Pennsylvania (42.7%)

8. North Carolina (42.2%)

9. South Carolina (42%)

10. Maine (41.2%)

Meanwhile, the metropolitan areas — based on core-based statistical areas used by the U.S. Census and determined by the Office of Management and Budget — with the highest percentage of "A" hospitals are:

1. Allentown-Bethlehem-Easton, PA-NJ (72.7%)

2. Winston-Salem, NC (71.4%)

3. New Orleans-Metairie, LA (68.8%)

4. Boise City, ID (66.7%)

4. Chattanooga, TN-GA (66.7%)

4. Provo-Orem, UT (66.7%)

7. Raleigh-Cary, NC (62.5%)

7. Charleston-North Charleston, SC (62.5%)

9. Orlando-Kissimmee-Sanford, FL (61.9%)

10. San Jose-Sunnyvale-Santa Clara, CA (60%)

10. Virginia Beach-Norfolk-Newport News, VA-NC (60%)

10. Knoxville, TN (60%)

13. Jacksonville, FL (57.1%)

13. Harrisburg-Carlisle, PA (57.1%)

13. North Port-Sarasota-Bradenton, FL (57.1%)

16. Tampa-St. Petersburg-Clearwater, FL (55.2%)

17. Austin-Round Rock-Georgetown, TX (53.3%)

18. San Diego-Chula Vista-Carlsbad, CA (52.6%)

19. Denver-Aurora-Lakewood, CO (50%)

19. Grand Rapids-Kentwood, MI (50%)

19. Hartford-East Hartford-Middletown, CT (50%)

19. Deltona-Daytona Beach-Ormond Beach, FL (50%)

23. San Antonio-New Braunfels, TX (47.4%)

24. Charlotte-Concord-Gastonia, NC-SC (47.1%)

25. Richmond, VA (45.5%)

25. Dayton-Kettering, OH (45.5%)

Commentary

Leah Binder, president and CEO of Leapfrog, said, "Patient experience is very difficult to influence without delivering better care, so these findings are encouraging."

Binder added that Leapfrog is "pleased to see the decrease in preventable infections, which cause terrible suffering and sometimes death. When we look at these positive trend, we see lives saved — and that is gratifying." 

Binder also noted that while the results of the safety grades are promising, "patient safety remains a crisis-level hazard in health care. Some hospitals are much better than others at protecting patients from harm, and that’s why we make the Hospital Safety Grade available to the public and why we encourage all hospitals to focus more attention on safety."

This edition of the Hospital Safety Grades report was supported by hospitals' efforts to improve patients' care experiences and made possible by facilities' performance on safety measures returning to pre-pandemic levels, Modern Healthcare reports.

"Hospitals never want to be in a position again where they're putting patients last on their list of priorities," Binder said. "Many felt they had to do that during the pandemic."

Binder added that hospital leaders have been more focused on patient satisfaction over the last two years, working to close gaps in patient communication through multidisciplinary rounds and regular visits from clinical staff. As a result, the industry has seen higher patient experience scores.

Now that infection control and patient experience scores have generally returned to pre-pandemic levels, it's important that hospitals keep the momentum and achieve even better outcomes, Binder said.

"The discipline of understanding how to create a better patient experience and a safer one is going to pay off for hospitals," she said. (Leapfrog Group press release, 5/1; Leapfrog Group "About the Grade," accessed 5/1; Devereaux, Modern Healthcare, 4/30)

Writing in Modern Healthcare, Mari Devereaux explains how St. Bernard Hospital in Chicago improved its patient safety grade from an "F" to an "A" in just under two years — something health experts called an "extremely rare" feat.