Dive Brief:
- Hospital safety watchdog group Leapfrog awarded five hospitals their first A grades, all jumping from F, placing those facilities within the 30% of the group's graded hospitals to receive the top mark.
- Of the 2,500 hospitals Leapfrog evaluated, about a third received an A, 28% a B, 35% a C, 6% a D and 1% an F.
- Hawaii, Idaho, Rhode Island, Massachusetts and Virginia were ranked the top five states for hospital safety, while Maryland, New York, Alaska, Delaware and North Dakota were at the bottom of the list. Still, the Washington, D.C. area and Maryland, were noted for improvements, which included three new A hospitals: Howard County General Hospital, Northwest Hospital and The Johns Hopkins Hospital.
Dive Insight:
Once again, the most common grade awarded was a C, though more hospitals received As than Bs. Leapfrog's rubric is based on 27 performance measures of patient safety, collected and reported by both the nonprofit and CMS. Each measure has a designated score that is then tallied up and used to represent a hospital's patient safety performance. Leapfrog also announced it is updating its methodology for Fall 2018 to adjust measures that protect against medication errors.
The Washington D.C. metro area was called out for improvements. Maryland, for example, had three “A” hospitals: Howard County General Hospital, Northwest Hospital and The Johns Hopkins Hospital.
The nation's capital also saw its first “A” grade hospital since 2013, Sibley Memorial Hospital. D.C. normally ranks near the bottom of the list.
As with critics of Healthgrades and the CMS star rating system, not all providers are on board with the group's current methodology, as ratings can directly impact a health system’s bottom line and brand. Last year, Chicago-based nonprofit Saint Anthony Hospital sued Leapfrog for defamation after its safety grade dropped from A to C. The hospital said the downgrade to would “erase years of improvements at the hospital and irreparably degrade the public perception of the hospital.”
Similarly, a recent analysis from consulting firm Sullivan, Cotter and Associates and Modern Healthcare found the CMS star rating system favors specialty hospitals over major teaching hospitals, despite major teaching hospitals consistently reporting all measures required to meet CMS safety of care, mortality, re-admissions and patient experience categories.
Leapfrog is seeking public comment on its proposed changes to methodology for determining safety scores. One change would affect evaluation of computerized physician order entry. More weight would be given to testing a CPOE system to demonstrate it alerts prescribers to serious medication ordering errors. Leapfrog said a panel of medication safety experts and other researchers found that “while implementation of CPOE systems has expanded significantly among hospitals across the country, the ability of CPOE systems to alert physicians and other prescribers to serious, sometimes fatal medication ordering errors has not improved as dramatically.”
The other change is adding a measure on bar code medication administration, which Leapfrog notes can reduce medication errors. The organization released a report earlier this month showing that while the vast majority of hospitals use a BCMA system, fewer than 35% meet all four of Leapfrog’s standards for proper deployment.