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Does the Leapfrog Group's new safety scoring system measure up?

In an effort to make patient safety info easily available to the public, The Leapfrog Group has released a report card-style rating system, Hospital Safety Score. The safety scores give information on hospital infection rates, injuries, etc., based on 26 different measures from Leapfrog and CMS officials.

But of the 2,651 hospitals surveyed across the country, 1,111 earned a grade of C or, worse, “Grade Pending”. The C scores include many well-known and reputable hospitals, such as Cleveland Clinic Hospital, New York-Presbyterian, and Henry Ford Hospital in Detroit. UCLA Ronald Reagan scored a Grade Pending – the scorecard’s version of a D or F. (D and F scores will officially be used in about six months.) Hospitals that received A-grades include the Mayo Clinic in Minnesota, Cedars-Sinai in LA, Brigham & Women’s Hospital, NYU Langone Medical Center, and a smattering of smaller hospitals across the country. (Critical access hospitals were not considered.) Information was culled from Leapfrog Group surveys and data from CMS billing records and Hospital Compare.

"This is a patient safety score. It's not the same as whether you'll have a good experience in the hospital, and not even whether you'll get high quality care, such as the right tests or the right medications. This is about whether you will be harmed if you go to this hospital, and that's a very specific thing," said Ashish Jha, MD, of the Harvard School of Public Health Department of Health Policy and Management and a member of the Hospital Safety Score advisory panel.

“We designed this to capture the attention of the public,” said Leapfrog Group CEO Leah Binder. “No one has ever given one individual score to most of the general hospitals in the country, including those that didn’t perform well.”

Some in the medical community seem poised to give the scoring system itself a C. Cleveland Clinic’s chief quality officer pointed out that data used in the scoring is a year or two old and does not show any improvements made since then. It also stopped its reporting to the Leapfrog Group, citing more involved CMS reporting requirements. “You are automatically at a deficit if you did not participate in their survey,” said Dr. Shannon Phillips of Cleveland Clinic.

The American Hospital Association is also less than pleased, and AHA's vice president of quality and patient safety policy said, "The American Hospital Association has supported several good quality measures but many of the measures Leapfrog uses to grade hospitals are flawed and they do not accurately portray a picture of the safety efforts made by hospitals."

Some of the measures used include:

  • Entering physician orders into electronic records
  • Prompt removal of catheters
  • Incidence of pressure ulcers
  • Surgical object retention
  • Incidence of central line infections
  • Accidental puncture or laceration
  • Death following surgery
  • Best practices to prevent pneumonia, infections, etc.
The hope is that things will improve as time goes on and the grading system is tweaked. “As better data comes along and as time goes by, my hope is this grading will get refined,” Jha told Kaiser Health News.