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Leapfrog's New Safety Report Card Alarms Hospitals

Cheryl Clark, for HealthLeaders Media, November 28, 2012

Some 25 hospitals, including 520-bed Ronald Reagan UCLA Medical Center in Los Angeles, received a failing grade of F, while another 121 hospitals, including the Cleveland Clinic, got a barely passing D in the release today of the controversial Leapfrog Group Hospital Safety Score, an effort to inform patients and payers which hospitals are most likely to cause avoidable harm.

Leapfrog Hospital Safety Scores

>>>VIEW SLIDESHOW


The grades reflect the risk that a patient will suffer a preventable medical error, an injury, an accident, or an infection while hospitalized. The D and F grades, given today for the first time, "represent the most hazardous environments for patients in need of care," Leah Binder, Leapfrog Group's CEO, explained in a news conference Tuesday.

In an interview with HealthLeaders Media, Binder said that in talking with low-scoring hospitals, "Most realize they have a problem with patient safety, but they don't realize how serious that problem is until they see how their data compares nationally."

These scores should guide patient choices, she says. And if low scores impact hospitals' bottom lines, so be it.

"If it were me or someone in my family, frankly, I would hesitate before going to a hospital that scores poorly (below an A) on a hospital safety score, especially if there's an alternative hospital that got a higher score that meets my needs," she says.

Executives of several hospitals that received F scores were incensed said they were caught off guard. One declared that Leapfrog was attempting to "extort" hospitals to join Leapfrog's voluntary reporting system, while others said the methodology is flawed or unknown to anyone except Leapfrog.

"UCLA is clearly not an 'F' hospital in quality and safety," says Tom Rosenthal, MD, the hospital's chief medical officer. "And if UCLA is not an 'F' hospital, it seems to me there must be flaws in the Leapfrog methodology."

A nonprofit quality improvement group formed by employers 12 years ago, Leapfrog launched its first hospital safety report card in June. That gave 2,651 hospitals an A, B, C, or a "grade pending," which Leapfrog officials said was a surrogate for a D or F grade, to give the hospital six months for more recent data to show improvement. In today's update, all "grade pending" scores now are listed as a D or an F.

The grades are based on how each hospital scores on 26 separate measures of safety divided among three categories of harm or risk of harm:

  • Preventable adverse outcomes of hospital care such as postoperative respiratory failure, pressure ulcer development, puncture or laceration, foreign object retention, bloodstream infections, or falls and trauma.
  • Process measures such as appropriate use of antibiotics or prophylaxis for patients at risk of blood clots.
  • Structural measures, such as whether the hospital uses computerized physician order entry systems or staffs an around-the-clock intensivist in its intensive care units.
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9 comments on "Leapfrog's New Safety Report Card Alarms Hospitals"


Roberta Hughes (12/1/2012 at 9:17 AM)
Interesting article, thank you for sharing. Whether LeapFrog rating system is flawed or not, it raises the awareness of patient safety and will influence where patients choose to receive care. As a healthcare image consultant, I "see" many safety and security issues. The appearance of healthcare professionals also impact patient safety. While on-site consulting with a client about their healthcare image and uniform program (or lack there of), a bomb threat occurred and 150,000 patient financial records were stolen. Hospital's relaxed uniform dress policies make it difficult to discern between patient and care provider, and between physician, nurse, or medical assistant, creating significant safety issues. While conducting an on-site image assessment, to the dismay of the hospital, we witnessed visitors enter restricted hospital areas. The appearance of the hospital and hospital staff play also play a key role in patient safety.

rn (11/30/2012 at 5:34 AM)
I communicated with LeapFrog and was impressed. I like the integrity of the people at LeapFrog. I think LeapFrog's compassionate ethics and skill comes across in the explanations and information given by Ms. Binder. The background of the people on staff at LeapFrog is superior and will give patients confidence in LeapFrog's opinions. Think about all the required patient safety defenses that UCLA doctors and administrators breach to receive an F from LeapFrog. UCLA's "F" is not about uninsured people draining the resources of a taxpayer funder hospital. An F from LeapFrog should frighten everyone into action – encouraging people to speak up and not let your family be a victim. Health care consumers' personal funds and taxpayer money should not result in preventable suffering. A score of F takes a "team effort" and bad leadership to become that bad and stay that bad. UCLA's organized pattern of patient abuse is beyond random chance and qualitatively different from negligence. LeapFrog's info. shows that the danger to patients is the quid pro quo amongst hospitals, health plans and California government that is supposed to be monitoring hospitals – especially taxpayer funded hospitals. Their tit-for-tat seems to include negligently retaining employees willing to harm patients. Other readers here may be interested in these MD's experience about UCLA. I think it will help people to understand how UCLA received an F Joseph A. Stirt, MD http://www.bookofjoe.com/2006/04/behindthemedspe_6.html www.anesthesiologyexpert.com/ Peter T Banos MD http://tryingforsense.blogspot.com/

concerned consumer (11/29/2012 at 7:04 PM)
I applaud what Leapfrog is trying to do, but what John Q. Public does not realize is that you cannot compare hospitals in the way Leapfrog is attempting. Their methodology does not take into account how sick or injured a patient is and they don't account for patients who don't follow doctors orders or who have language, cultural or socio-economic challenges. What Leapfrog doesn't tell the public is that they are a watchdog group funded by employers who want to use the scores to extort hospitals and insurance companies. As someone who lost their father because of an HCA-owned hospital's inappropriate care (that does not meet the legal definition of negligence), what I want to see is more transparency from regulatory bodies like CMS, the states and The Joint Commission. Any rating system from publicly-reported data is going to be skewed because the data is out-of-date by the time its published. Regulatory bodies are the ones who need to score hospitals and health systems, not an Angie's List type of organization like Leapfrog.