How safe is your hospital? Check these Leapfrog Group grades to find out.
Does bigger mean better when it comes to hospital safety?
A new grading of U.S. hospitals from the patient safety organization Leapfrog Group suggests hospitals that get high marks on limiting preventable errors tend to be part of a larger health system.
In its twice-a-year hospital safety grade report of U.S. hospitals released Nov. 13, Leapfrog Group said 94% of hospitals that achieved an "A" grade were part of a health system with two or more hospitals. It could be a sign that high-performing health systems enforce safety plans across all their hospitals to limit errors, accidents, infections and other preventable harms, said Leah Binder, CEO of Leapfrog Group.
Health systems have grown larger in the past decade through consolidation and acquisitions of smaller hospitals and medical practices, Binder said. While such consolidation has raised concerns about billing practices and physician independence, a silver lining might be these larger systems have resources and attention to improve quality of care.
"Some systems are doing an excellent job with safety," Binder said. "They have a plan. They have a strategy at the system level for how they are going to drive better and safer outcomes for their patients."
How did states fare in Leapfrog's report?
Leapfrog ranks states based on the percentage of hospitals that earned an A in the the organization's report card. About 61% of hospitals scored an A in Utah, which had the highest percentage of top-ranked hospitals. Virginia, New Jersey, Connecticut and North Carolina rounded out the top five states with the greatest share of A hospitals.
Four states − Iowa, North Dakota, Vermont and Wyoming − had no hospitals with an A grade.
How did hospital chains fare?
Hospital chains accounted for 90% of the total hospitals graded and 94% of A grades awarded by Leapfrog.
The nation's largest hospital chain, HCA Healthcare, earned an A grade for 51 of 163 hospitals, including 18 facilities that received the top grade for at least two consecutive years.
A dozen smaller chains with two to seven hospitals received A grades for all their graded hospitals, including Houston Methodist, Loma Linda University and Stanford Medicine.
Focus on safety
Leapfrog is one of several sources for patients to check safety scores of their local hospitals. U.S. News & World Report reports ratings and other information on hospitals and doctors. The Centers for Medicare & Medicaid Services offers searchable databases with detailed quality scores for hospitals. Other consumer sites such as Healthgrades and Yelp collect feedback from patients.
Leapfrog reports a letter grade on nearly 3,000 U.S. hospitals based on 22 measures of data from Medicare and Medicaid, adverse events information and Leapfrog's survey of hospitals. Leapfrog said its methodology was developed by patient safety experts at Johns Hopkins Armstrong Institute and reviewed by a national panel of experts. The organization reports information on every hospital it assesses at www.hospitalsafetygrade.org.
Patient safety websites have proliferated after the Institute of Medicine's influential 1999 report called "To Err is Human" found medical errors caused up to 98,000 deaths per year.
In 2022, government oversight investigators reported 1 in 4 older Americans on Medicare had some type of temporary or lasting harm during hospital stays.
Hospital safety has generally improved in recent years with the increased focus on patient safety, said Dr. Michael Ramsay, chief executive officer of the Patient Safety Movement Foundation, a nonprofit based in Irvine, California.
Medicare reduces payments for hospitals that perform poorly on measures such as hospital-acquired infections or patients being readmitted to a hospital within 30 days for the same condition.
Ramsay said a Medicare proposal to analyze hospital data within weeks after patients are discharged for surgeries or other procedures will drive timely improvements. Hospitals and doctors will no longer be able to argue that regulators are using out-of-date data.
"Once you get real numbers in real time, people change," Ramsay said. "They change dramatically because there's no avoiding it."
Why some F-grade hospitals are pushing back
In all, 18 hospitals that were part of a chain received an F grade, including five hospitals owned by Tenet Healthcare. Those hospitals included three Detroit-area hospitals, Saint Francis Hospital in Memphis, Tennessee, and Delray Medical Center in Delray Beach, Florida.
Delray Medical Center is one of five Tenet-owned Florida hospitals that filed a federal court lawsuit in April claiming Leapfrog's hospital grades are a "brazen pay-to-play scheme" that "distorts the truth, misleads patients and inflicts serious harm" on hospitals. The other plaintiffs include Good Samaritan Medical Center, Palm Beach Gardens Community Hospital, St. Mary's Medical Center and West Boca Medical Center.
In a legal filing in September, Leapfrog denied the hospitals' claims and described the lawsuit as attempt to silence "Leapfrog’s free speech in connection with a public issue."
The Florida hospitals have asked a U.S. District Court judge in the Southern District of Florida to issue a judgment in favor of the hospitals and order Leapfrog to remove the hospitals grades from its website and other material.
In a statement, the hospitals told USA TODAY that Leapfrog's "dangerous and misleading safety grades inflict substantial and immeasurable harm on our community hospitals, our patients and the public."
Binder denied the Florida hospitals claim that they must participate in Leapfrog's survey to get a good grade.
"Leapfrog does not operate a pay-for-play structure," Binder said. "The Leapfrog hospital survey is free for hospitals to complete, and all of Leapfrog’s ratings and data are free for the public to access."