The goal, the group says, is to provide patients with an easy-to-use metric that shows which hospitals are most likely to have issues with avoidable harm, such as medication errors and healthcare-associated infections.
Of the 2,514 hospitals covered in this most recent update, 780 received an A; 638 received a B; 932 received a C; 148 received a D; and 16 received an F. Letter grades for nearly 74% of hospitals stayed the same as last time, while 1.9% of hospitals saw big changes—up or down two or more grades—in their scores, the Washington-based not-for-profit safety group said in a conference call.
Larkin Community Hospital, a 146-bed facility in South Miami, Fla., saw its grade jump from D to A, for instance, while 148-bed Tuality Healthcare, Hillsboro, Ore., went from an A to a C.
No news is not good news, said Leah Binder, Leapfrog's president and CEO, in an interview. Despite some incremental movement upward, hospitals still have a long way to go, she said.
“We'd like to say we've seen dramatic improvement, but we haven't,” said Binder, although she did cite some promising trends, such as hospitals' increasing use of computerized physician-order entry systems, a tool Leapfrog has touted for reducing errors.
Leapfrog Group derives its grades based on hospitals' performance on 26 quality measures: 15 process and structural measures, including antibiotics within one hour of surgery, and 11 outcomes measures, such as air embolisms and late-stage pressure ulcers.
The safety-score program includes hospitals that complete the Leapfrog annual survey and hospitals that do not, although Leapfrog has less information on hospitals that don't voluntarily submit data.
This latest round of scores also reflects recent changes to the group's grade-setting methodology, including an effort to better align reporting requirements among different sources. Leapfrog also put safeguards in place to ensure no single measure dominated hospitals' safety scores, said Missy Danforth, senior director of hospital ratings, during the conference call.
Those changes were recommended by Leapfrog's nine-member expert panel, which includes patient-safety heavy-hitters like Dr. Peter Pronovost, head of the Armstrong Institute for Patient Safety and Quality at Johns Hopkins Medicine, Baltimore; and Dr. Robert Wachter, chief of the division of hospital medicine at UCSF Medical Center, San Francisco.
The grades have generated plenty of controversy and pushback since their first release nearly a year ago, particularly from some hospitals that said the program represented an effort to pressure them into reporting data to Leapfrog Group. In a five-page letter, sent in June 2012, the AHA sharply criticized the safety ratings, calling the methodology “unfair and unreliable,” and urging consumers not to use the grades as tool to choose sites of care.
But Binder says she believes the grades are serving as an important decision-making tool for patients and are pushing hospitals to look more closely at improving safety.
“The safety score has indeed made hospitals more motivated,” she said.
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