The Leapfrog Group has released its fourth round of safety scores, showing that most hospitals made scant progress in addressing preventable medical errors and injuries since the organization issued its last update in May.
The scoring program, launched in June 2012, assigns hospitals a letter grade—A, B, C, D or F—based on publicly available safety data from the CMS' Hospital Compare, the Leapfrog Group's annual hospital survey and the American Hospital Association.
Leapfrog, an employer-backed safety group, says the grades serve as an easy-to-use tool for patients to use when making decisions about where to seek care and as a driver to boost hospital performance.
But the safety scoring program has drawn intense criticism from hospitals, many of which argue the grades don't fairly represent the quality of care their organizations deliver.
This latest update assigned scores to 2,539 hospitals, up slightly from the 2,514 that received grades in the last update. Of those, 813 received an A, 661 received a B, 893 received a C, 150 received a D and 22 received an F.
Leapfrog included two new measures in determining this latest round of grades: rates of catheter-associated urinary tract infections and rates of surgical-site infections for major colon surgery, said Missy Danforth, the group's senior director of hospital ratings.
That brings the total number of quality measures used to determine the scores to 28: 15 process and structural measures, including preoperative antibiotics; and 13 outcomes measures, such as rates of late-stage pressure ulcers and postoperative respiratory failure. Most of the data are from 2012, Leapfrog said.
During a call with reporters, Leah Binder, Leapfrog's president and CEO, said the scores revealed “little improvement in safety overall.”
“I have to admit my disappointment, especially because we know there have been some extraordinary efforts at improving safety,” said Binder, citing initiatives such as HHS' $1 billion Partnership for Patients. “We'll keep at it, though.”
Still, a few hospitals—3.5% of those scored in the latest update—saw their grades jump by two or more levels since May.
Brookwood Medical Center, Birmingham, Ala., for instance, received an A, up from a C in May. Kishwaukee Community Hospital, DeKalb, Ill., saw its grade improve from a D in May to a B in this latest update.
“It can be done,” Binder said. “We just want more than 3.5% to do it.”
Binder referred to a September study in the Journal of Patient Safety estimating that the number of annual deaths attributable to preventable medical harm could be as high as 440,000—far higher than the often-cited 98,000 figure from the Institute of Medicine's landmark “To Err is Human” report.
“We are burying a population the size of Miami every year from medical errors that can be prevented,” she said.
Leapfrog also ranked states according to their percentage of “A” grade hospitals. Maine ranked first, with 80%, or 18, of its hospitals receiving an A. New Mexico ranked last—tied with the District of Columbia—with zero hospitals in the A range.
Jeff Dye, president of the New Mexico Hospital Association, fired back at the data, saying many of the state's hospitals have stopped participating in the Leapfrog survey because they “see it as extortion to obtain a higher score.”
Leapfrog says it calculates scores for all general acute-care hospitals for which there are sufficient safety data, but the group has more available information for hospitals that participate in its annual survey.
Dye said he's not concerned about New Mexico's low standing on Leapfrog's rankings, especially because state hospitals have made dramatic strides in curbing preventable infections, early elective obstetric deliveries and other safety targets through their participation in the Partnership for Patients.
“It's worrisome that patients may use this,” Dye said of the safety grades, “but we'll have to remind them that there are many sources of information.”
Follow Maureen McKinney on Twitter: @MHMMcKinney
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