Leapfrog’s Hospital Safety Grades Find Patient Safety Improvements Nationwide

‐

By Jay Kumar

Hospitals are improving in the prevention of medical errors, accidents and healthcare-associated infections, according to the fall 2024 Hospital Safety Grade from The Leapfrog Group, an independent nonprofit focused on patient safety.

The Hospital Safety Grade evaluates nearly 3,000 hospitals and uses up to 30 performance measures to assign an “A, “B,” “C,” “D” or “F” to individual hospitals and uses a public, peer-reviewed methodology, calculated by top patient safety experts under the guidance of a National Expert Panel. It is transparent and free to the public. Leapfrog analysts use the data to observe national performance trends and state rankings.

For fall 2024, Utah ranks number one with the highest percentage of “A” hospitals for the third cycle in a row, followed by Virginia and Connecticut in second and third. The latest Grades also show hospitals are making progress in patient safety across several performance measures including notable improvements in healthcare-associated infections (HAI), hand hygiene and medication safety.

“Preventable deaths and harm in hospitals have been a major policy concern for decades. So, it is good news that Leapfrog’s latest Safety Grades reveal that hospitals across the country are making notable gains in patient safety, saving countless lives,” said Leah Binder, President and CEO of The Leapfrog Group, in a statement. “Next, we need hospitals to accelerate this progress—because no one should have to die from a preventable error in a hospital.”

Key improvements nationally

The latest grades saw improvements in three major categories.

HAI

With HAIs, hospitals have rebounded since the beginning of the COVID-19 pandemic, says Alex Campione, Program Analyst for the Leapfrog Group.

“In part, the decline is due to the drop in severe COVID cases, so we always saw a spike in those other hospital-associated infections whenever there was a surge in COVID or a new variant, but it doesn’t explain why,” she notes. “Now they’re better than pre-pandemic. The pandemic placed considerable strain on the U.S. healthcare system in general and COVID patients were sicker and they had more morbidities. But I think we really kind of took our eye off the ball when it came to basic guidelines that prevent infections. I think it’s clear that hospitals have recognized the issue and they responded appropriately.”

Since Leapfrog reported Hospital Safety Grades in fall 2022, when HAI rates were at their highest peak since 2016, average HAI scores have declined dramatically:

  • Central line-associated bloodstream infections (CLABSI) decreased by 38%
  • Catheter-associated urinary tract infections (CAUTI) decreased by 36%
  • Methicillin-resistant Staphylococcus aureus (MRSA) decreased by 34%

Hand hygiene

As Leapfrog detailed in its 2024 Hand Hygiene Report, since Leapfrog began public reporting a tough new standard for hand hygiene in 2020, the percentage of hospitals achieving the standard has soared from 11% to 78%.

“I think everyone knows hand hygiene is important, especially after COVID,” Campione says. “But I think our standard is more about creating and maintaining a strong and resilient culture of hand hygiene within the hospital, so that when you’re in those times of strain and you’re distracted by other things, hand hygiene still stays a priority. Our standard really lays out exactly what a hospital must do to ensure that its staff is trained and then also consistently encouraged to practice hand hygiene. Are you providing them with hand hygiene washing stations and make sure there’s hand sanitizer and as soon as they’re leaving the room? Things like that.”

Hand hygiene requires a real commitment, she adds. “With hand hygiene, hospitals can’t just simply check a box and move on,” Campione says. “It’s really something they must work at daily and we’re really happy with how the hospitals that complete our survey are performing. They’ve clearly made a commitment to improving hand hygiene and we hope this will continue until 100% of hospitals are achieving our standard.”

Medication safety

The Safety Grades also highlight the use of technology to prevent medication errors, which are the most common type of error that occur in hospitals.

Two of the measures in the Leapfrog Hospital Safety Grade show this progress:

Computerized Prescriber Order Entry (CPOE): Leapfrog tracks how well hospitals use CPOE systems to catch common errors in prescribing, such as prescribing the wrong dose or prescribing a medication with a dangerous interaction with other medications the patient takes. Studies have shown CPOE systems can reduce harm from prescriber errors by as much as 55%. In 2018, only 65.6% of hospitals met Leapfrog’s Standard, while this year, that number rose to 88.1%.

Bar Code Medication Administration (BCMA): Leapfrog scores hospitals on deployment of BCMA systems, which use barcodes at the bedside to ensure the right patient gets the right medication at the right time. In 2018, 47.3% of graded hospitals met the standard, while this year, 86.9% did.

“Hospitals that are achieving our standard have devoted resources towards that technology that prevents medication errors and we’re very pleased to see so many hospitals recognizing the seriousness of medical errors,” Campione says. The use of CPOE systems has increased over the last decade, she adds.

“BCMA was a little bit behind in hospitals implementing that across all of their units and we’ve seen now we’re at a very high percentage of hospitals that are using that technology, so it has been a consistent upward trend.”

Trends in Safety Grades by state 

Key findings on state performance on the fall 2024 Leapfrog Hospital Safety Grade include:

  • The states with the highest percentages of “A” hospitals are Utah, Virginia, Connecticut, North Carolina, New Jersey, California, Rhode Island, Idaho, Pennsylvania, Colorado and South Carolina.
  • Utah ranks #1 in percentage of “A” hospitals for the third Safety Grade cycle in a row. California ranks in the top 10 for the first time since fall 2014.
  • “Utah continues to be #1 in the state ranking since last spring,” says Campione. “We did see a little bit of a shakeup, especially the biggest surprise was California. They were ranked 19 last round and now they rank sixth. We’re seeing several strong systems in California that are leading that charge and providing patient-centric care and improving patient safety.”
  • There were no “A” hospitals in Iowa, North Dakota, South Dakota or Vermont.

“Despite improvements seen in this fall’s Safety Grade, significant variation in performance remains across U.S. hospitals,” Binder added. “That’s why it’s so important for people to consult grades when making decisions about seeking care. All hospitals are not the same.”

The Leapfrog Hospital Safety Grade is the only hospital ratings program focused exclusively on preventing medical errors and patient harm. It is fully transparent, free to the public and updated biannually in the fall and spring. Detailed hospital performance information, including patient experience and safety measures, as well as grades for individual hospitals searchable by states and localities is available at HospitalSafetyGrade.org.