Latest Leapfrog report card hits urban hospitals hard
The majority of urban hospitals don’t perform well on patient safety measures, according to the Leapfrog Group’s latest report card.
Of the 11 hospitals in New York City included in the spring 2018 Hospital Safety Grade report, only one—NYC Health & Hospitals/Metropolitan—received an
“A” grade, while the rest received a “C” or “D.” Additionally, just three of Los Angeles’ 12 hospitals in the report earned an “A” while six of them got a “C” or lower. One-third of Chicago’s 18 hospitals received an “A” grade, while 11 were rated “C” or lower.
Even though hospitals in large cities treat patients with an array of social risk factors, the location of a hospital is no excuse for poor performance on safety, said Leah Binder, CEO of the Leapfrog Group. “Patient safety doesn’t depend on the patient population.”
While groups like Leapfrog continue to advocate for greater transparency in quality and safety metrics, there are discrepancies when comparing ratings. Some of the hospitals that received low grades from Leapfrog have been recognized for strong quality performance by other organizations. For example, Cedars-Sinai Medical Center in Los Angeles and Mount Sinai Hospital in New York City both received “C” grades from Leapfrog even though they were recently recognized by U.S. News & World Report as “Best Hospitals.”
Such inconsistencies point to a frequent criticism of rankings and lists among industry experts.
With so many different quality rankings, it’s difficult for patients to decide which they should rely on.
Hospitals have also questioned the validity of Leapfrog’s methodology. Cedars-Sinai said in a statement that it doesn’t participate in Leapfrog’s hospital survey because it doesn’t support the method. The hospital claimed it was penalized with a low grade as a result.
“A more reliable and accurate measure of Cedars-Sinai’s quality can be found through reputable sources such as the CMS’ Hospital Compare,” a spokeswoman said.
Similar to its fall report, Leapfrog’s latest analysis shows wide variation in patient safety performance across hospitals. Leapfrog graded 2,479 hospitals this spring, of which 750 earned A’s, 683 scored B’s, 879 received C’s, 145 got D’s, and 22 were given F’s.
Hospitals nationwide can tackle persistent patient safety issues by considering them more in value-based purchasing programs, Binder said.
“A lot of the value movement has been aimed at quality outcomes and pricing, and they have overlooked the third leg of the stool, which is safety,” she said.
Leapfrog is working with the CMS to integrate patient safety measures into value-based purchasing programs so hospitals will have additional incentives to focus on patient safety.
Leapfrog calculates the grades using 27 measures, including hand hygiene, falls and pressure ulcers. The data are derived from the CMS, Leapfrog’s own hospital survey, and secondary data sources such as the American Hospital Association.
Leapfrog also announced last week that it’s accepting public comments on two proposed changes to its methodology. The not-for-profit organization has suggested lowering the number of points that hospitals will earn for the computerized physician order-entry measure if the data are derived from the AHA, which it considers a secondary source that offers less detail than if the information is from the Leapfrog hospital survey.
Leapfrog has also proposed adding a bar-code medication administration measure. Most hospitals have a process in place where a clinician scans the bar code on a medication and the patient’s identification badge to ensure the patient is getting the correct medicine. While this should be done at a patient’s bedside, that doesn’t always happen, Binder said.
The Leapfrog survey would ask hospitals if they have a process to ensure bar code medication administration is done in front of the patient.
Binder said medication administration errors are the most frequent patient safety mistakes in hospitals, but they are difficult to track and monitor.
The proposed changes—if approved—would be implemented in the next Hospital Safety Grade report in fall 2018.