The Leapfrog Group in its latest Hospital Safety Scores awarded nearly 800 hospitals an "A" grade for safety—but gave more than 1,100 organizations a grade of "C" or below.
Can hospitals game Leapfrog's safety grading system? This study says they could
Methodology
For its latest scores, the Leapfrog Group assigned "A" to "F" letter grades to 2,639 hospitals based on their performance on 15 process/structural measures and 15 outcome measures. The group used data from CMS, the Leapfrog Hospital Survey, and secondary data sources such as the American Hospital Association's Annual Survey.
The Leapfrog ratings focus on acute-care hospitals and exclude facilities such as critical access hospitals, specialty hospitals, and federal hospitals—such as Veterans Affairs hospitals—because of missing data. Leapfrog also did not rate Maryland hospitals because they do not participate in the CMS Inpatient Prospective Payment System.
Report findings
In the latest report:
- 823 hospitals earned an "A";
- 706 earned a "B";
- 933 earned a "C";
- 167 earned a "D"; and
- 10 earned an "F".
Compared with Leapfrog's April 2016 report, 25 more hospitals received an "A" and 69 more hospitals received a "B." And overall 24 fewer hospitals received a "C," "D," or "F." While hospital grades can fluctuate from update-to-update, Leapfrog says 63 hospitals earned a "Straight A" ranking, meaning that they have consistently earned an "A" grade in all of the group's updates since the rankings were launched in 2012.
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In the latest report, Maine had the highest percentage of hospitals (68.8 percent) that received an "A" grade, followed by Hawaii (66.7 percent), Oregon (59.4 percent), Wisconsin (57.9 percent), and Idaho (54.5 percent). No hospital received an "A" grade in Alaska, Delaware, Washington D.C., or North Dakota.
Comments
Michael Bushell—president of Saint Anne's Hospital, one of Leapfrog's "Straight A" hospitals—said, "We're grateful to have earned the Straight A's distinction." He added, "The collective commitment of our staff, physicians, and hospital leadership to high standards of care, through education and consistent communication, means that we're able to implement best practices and troubleshoot challenges as they arise."
Separately, Inova Health System said Leapfrog's rating have been a helpful benchmark to measure its quality improvement efforts. Loring Flint, CMO of Inova, said, "We are proud that three of our five hospitals have been solid 'A' performers—two of them have sustained their 'A' grade since the fall of 2013, and the third one has sustained an 'A' grade since the Fall of 2014." The system's other two hospitals have made steady progress in recent years. Flint said Inova supported "internal and external transparency on our journey to excellence" (Leapfrog Group rankings, accessed 4/12; Leapfrog Group scoring methodology, accessed 4/12; Leapfrog Group explanation of grades, accessed 4/12; Leapfrog Group release, 4/12).
Next steps: Reducing hospital mortality with the help of an EMR
Electronic medical records (EMR) have a role to play in mortality reduction. Computerized practitioner order entry (CPOE) and electronic order sets are the key EMR capabilities that can help reduce hospital mortality, but changes in process, culture, and individual behavior are also necessary.
In this report, we present six hospital case studies to illustrate the impact of EMR on mortality, identify the mechanisms by which EMRs could help reduce hospital mortality, and zero in on the specific functionality that might have the greatest impact.