The Leapfrog Group has announced its latest Hospital Safety Grades, evaluating how well hospitals are doing with keeping patients out of harm’s way. While many hospitals performed well, changes are in the works that may affect their scores.
Per a news release about the safety grades, this is the fifth year that the patient safety organization has graded hospitals based on the answers they give to the Leapfrog Hospital Survey, as well as publicly available information about patient outcomes from federal databases.
While some debate exists regarding whether self-reported data from hospitals is a valid way to judge patient safety, there’s no doubt that improvement’s been made in several areas since Leapfrog started grading hospitals in 2012. Hospital-acquired conditions have decreased by 21%, and millions of preventable patient harms have been avoided.
Making the grade
Over 2,600 hospitals across the country were ranked and evaluated by the Leapfrog Group this year, with the results published on the safety grades’ website. “As” were earned by 823 facilities, while 706 received a “B.” Most hospitals earned a “C” score – 933 in all. On the lower end of the scale, 167 received “Ds” and 10 earned failing grades.
Certain states performed better than others. The five states that had the highest percentage of A-earning hospitals this time around are Idaho, Oregon, Maine, Wisconsin and Hawaii.
Some facilities have consistently earned high marks through the whole history of the Leapfrog safety grading system: 63 hospitals have earned “A” grades for the entire five years. And Maine is the only state that’s stayed in the top five for the highest percentage of hospitals with “A” grades from 2012 on.
This year’s grades were determined based on responses to the 2016 Leapfrog Hospital Survey. Rankings may be different in subsequent years, however, because Leapfrog’s recently made some big changes to the survey.
For the 2017 Leapfrog Hospital Survey, which was released for hospitals to complete at the beginning of the month, hospitals must report on several new and revised measures, according to a different news release.
One area which has changed significantly is surgery reporting. Per information from the Leapfrog Group, several survival predictor measures for inpatient surgery have been retired because they were based on ICD-9 codes. Since the switch to ICD-10 in October 2015, the data that supported these measures is no longer valid.
So the Leapfrog Group has come up with several new measures to evaluate hospitals’ surgical performance, including minimum surgical volume for 10 high risk procedures such as hip replacement, bariatric surgery, lung resection and rectal cancer surgery. Volume was chosen as the new metric because past research has established a relationship between the frequency a hospital performs a surgery and patient outcomes.
Also, the agency will evaluate how hospitals determine whether surgery’s appropriate for a patient, and whether they’ve taken steps to make sure their established criteria are always followed.
The Leapfrog Group will use data on surgical volume and appropriateness that facilities report this year to come up with standards for grading hospitals in 2018 and beyond.
Other changes include:
- a new measure designed to evaluate how hospitals are doing with medication reconciliation (results won’t be released publicly until 2018)
- several updates to existing maternity care measures (reflecting changes from the Joint Commission, changes to patient sample size and changes to scoring algorithms)
- an updated Never Events Policy Statement that changes notification standards and adds new elements
- two new measures for pediatric care (patient satisfaction scores for children and pediatric CT radiation dosage; results won’t be publicly released until 2018), and
- a reduction in the number of safe practices measured on the survey (from eight to five).
Additionally, the Leapfrog Group’s reduced some of the administrative burden involved in reporting hospital-acquired infections. It’s combined the two sections of the survey dealing with infections into one, and it’s requiring hospitals to join its NHSN Group so it can pull infection data directly from the group’s database.
If your hospital plans to participate in this year’s survey, be sure you’re aware of these changes and how they’ll affect your reporting – and your future safety grades.