Leapfrog's New Safety Report Card Alarms Hospitals

Cheryl Clark, 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.


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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