A recent report from the Leapfrog Group — a nonprofit organization that aims to improve healthcare quality by increasing hospital transparency — and Johns Hopkins found that poor hospital performance on 16 patient safety measures caused more than 161,000 deaths annually, a decrease from 2016.

The Spring 2019 Leapfrog Hospital Safety Grades updates the group’s estimate of deaths due to errors, accidents, injuries, and infections, breaking them down by the A through F scores Leapfrog assigns to hospitals.

An analysis of 2,600 hospitals reveal that when compared to A hospitals, there was a 92% greater risk of avoidable death at D and F hospitals.

There was an 88% greater risk of avoidable death at C hospitals and a 35% greater risk at B hospitals.

“Even A hospitals are not perfectly safe, but researchers found they are getting safer,” the Leapfrog report says.

“If all hospitals had an avoidable death rate equivalent to ‘A’ hospitals, 50,000 lives would have been saved, versus 33,000 lives that would have been saved by ‘A’ level performance in 2016.”

Leapfrog estimates that 160,000 lives are lost each year to avoidable medical errors. That is down from the group’s estimate of 205,000 avoidable deaths annually in 2016 (The report is available online at: https://bit.ly/2WNecia.)

The report suggests that healthcare organizations are still struggling to address patient safety and quality, says Stanley Pestotnik, MS, RPh, vice president of patient safety products at Health Catalyst, a healthcare data analytics company based in Salt Lake City. “A lot of organizations chase regulatory measures and get focused on the regulatory aspect of healthcare, what is required for reporting — and in doing that, they unintentionally separate safety from quality,” he says.

“As we move into this higher reliability organization paradigm, we need to be preoccupied with safety and other failures. If you take a myopic view of this from a regulatory standpoint, you lose this connectivity.”

Culture also plays a pivotal role and tends to be undervalued in some healthcare organizations, Pestotnik says.

“We also need to be able to measure more accurately events that are occurring, and not just those that have to be reported from a regulatory standpoint but all events that cause harm. As part of that, we have to understand the culture at the unit level because that is where the culture lives,” he says.

“Those organizations that have a good culture of safety usually do a good job of providing quality care and have limited safety events,” Pestotnik adds.

“I think that’s what Leapfrog is trying to do here, showing that the A hospitals are doing much better than the other grades with preventable deaths, and that validates the accomplishments that got them the A grade.”

Leapfrog also recently released its 2019 Maternity Care Report. Based on data voluntarily submitted by more than 2,000 U.S. hospitals, it shows how those hospitals adhere to best practices in cesarean sections, early elective delivery, and episiotomy rates. The group says only 20% of the reporting hospitals are fully in compliance with Leapfrog’s standards on those issues. (The report is available online at: https://bit.ly/2W18gB2.)

These are the main findings of the report:

• The average rate of early elective deliveries was 1.5% in 2018, the lowest rate since 2010 when the rate was first measured at 17%. The current 1.5% is well below Leapfrog’s target of 5%.

• Episiotomy rates were at 6.9% in 2018, down from 7.8% in 2017. Leapfrog’s target is 5% or less.

• The average rate of nulliparous, term, singleton, vertex cesarean births is not changing. It has been about 26 since 2015, deviating only by one-tenth of a percentage each year since. The 2018 rate is 26.1%, and Leapfrog’s target is 23.9%.


• Stanley Pestotnik, MS, RPh, Vice President, Patient Safety Products, Health Catalyst, Salt Lake City. Phone: (855) 309-6800.