The hospital sector made substantial progress reducing adverse events and cultivating a culture of safety over the past decade, according to a report the Leapfrog Group released Wednesday.
Data from before the COVID-19 pandemic show promising improvements in hospital-acquired infection rates. Central line-associated bloodstream infections decreased 43%, MRSA cases declined 22% and Clostridioides difficile cases went down 8% between 2012, when the Leapfrog Group began grading hospitals on these measures, and 2019.
Over those same years, incidents of falls and trauma dropped 27.1% and incidents of objects unintentionally left in patients' bodies after surgeries declined 28.9%.
“We were pleasantly surprised to see that there have been dramatic improvements in safety where we did measure it,” Leapfrog Group President and CEO Leah Binder said. “We are cautiously optimistic that, in the past decade, there has been traction in improving patient safety.”
The strains of COVID-19 may have set back these successes, however. “My biggest concern is what happened during the pandemic, when we definitely saw some reversal in these trends,” she said.
Transparency has been one of the most critical elements in achieving safety improvements, Binder said. For instance, the Centers for Medicare and Medicaid publicly reports hospital safety measures, which provides a powerful incentive for health systems to improve their operations, she said.
The Leapfrog Group's findings are consistent with other research. A 2022 JAMA study of 3,156 U.S. hospitals revealed statistically significant decreases in annual rates of in-hospital adverse events for adult patients admitted for acute myocardial infarction, heart failure, pneumonia and major surgical procedures between 2010 and 2019.
The Leapfrog Group reports that average hospitals performance improved in intensive care unit physician staffing, safety leadership, and safety measurement, feedback and Intervention between 2012 and 2022.
The adoption of computerized provider order entry, which is used to reduce common medication errors, grew sevenfold between 2012 and 2022. Federal financial support for providers deploying electronic medical records is the most likely reason hospitals were able to achieve that progress, Binder said.
In the new Leapfrog Group report, 30% of hospitals earned an "A," 28% a "B," 36% a "C," 6% a "D," and 1% an "F.” The results are similar to those from the organization's most recent previous report.
New Hampshire is home to the greatest share of hospitals, 53.8%, with "A" grades in the latest findings. Virginia and Utah followed closely behind, with 52.1% and 51.9% at the "A" level, respectively. North Dakota, Vermont and the District of Columbia fared the worst by this measure, with no hospitals receiving "A" grades.