Fewer hospital-associated infections, better hand hygiene and improved medication safety enabled a number of hospitals to earn higher safety grades from The Leapfrog Group.
Nuvance Health, based in Danbury, Connecticut, was among them. Its hospitals earned three "C's" and three "B's" in fall 2023. In the most recent safety grades from the hospital safety watchdog organization, released Friday, the hospitals earned five "A's" and one "B."
Related: How the Leapfrog Group changed its 2024 hospital survey
"There is no one metric that's going to get you to an 'A,'" said Dr. Diane Kantaros, chief quality officer for Nuvance Health. "You really have to improve in everything."
Kantaros said improving medication safety was the system's largest obstacle.
"We had multiple people who are [specializing in work involving] barcode scanning to figure out all of the places where things could go wrong [or were] preventing that score from being consistently above 95%," Kantaros said. "We had all of our hospitals work on quality improvement projects within pharmacy and we had our entire pharmacy IT teams, pharmacy teams [and quality team] collaborate this year to work on our computer entry for medication safety."
Leapfrog said there were overall improvements since its spring report in medication safety, both in terms of computerized provider order entry and bar code medication administration, which tracks if a medication is correctly matched to a patient.
Also compared with its spring report, central-line-associated bloodstream infections decreased by 5.9%; catheter-associated urinary tract infections dropped by 8.13% and methicillin-resistant staphylococcus aureus infections fell by 5.92%.
Nearly 32% of hospitals graded earned an “A,” 24% a “B,” 36% a “C,” 7% a “D,” and less than 1% an “F.” A total of 1,788 hospitals, or a little more than two-thirds of those graded, maintained their grade from the spring report. Also, 45 hospitals fell by two grades, and 62 increased by two grades.
Other health systems that saw significant improvements in their fall grades included Sutter Health, HCA Healthcare and CommonSpirit's Dignity Health hospitals.
Sutter had 16 hospitals earn an "A" grade and four hospitals earn a "B," compared with only three hospitals receiving "A's" last year, said Dr. William Isenberg, Sutter’s chief medical & quality officer.
Isenberg said communication pitfalls are the biggest hurdle to overcome for hospitals looking to improve their patient safety scores.
"Communication is really the goal and the ability to speak up and not feel like you're going to be thwarted if you say something is really one of the key success factors," Isenberg said. "When I'm in the operating room, for example, if something doesn't look right, I don't want the nurse to hand me the scalpel to make the incision. It's really important that everybody in that team feel that we're good to go. If you're not focusing on the team's performance, you're missing out on the opportunity to get an 'A.'"
Leapfrog made several changes to its process earlier this year that was incorporated into the fall grading, including removal of an elective deliveries measure, the collection of nurse staffing data from mixed patient units, the addition of questions on diagnostic error prevention and an expanded bar code medication administration standard.