"Across the board, we're at or near national and Georgia averages, and in some cases above."
"It appears that Leapfrog takes great pride in using the facilities that do report on their other [Leapfrog] measures, which they chose. I don't disagree with the importance of intensivists and electronic medical records and things like that, but if you don't, it impacts on your scores adversely."
Binder refutes much of the criticism, saying that after some objections were raised in June, the methodology committee changed the weights so that hospitals that report to the American Hospital Association for CPOE and intensivists receive the same amount of credit, 65 points, as they would if they reported those functions to Leapfrog. In the June scoring, a non-Leapfrog-reporting hospital received only 15 points for each of those measures.
But she's aware that hospitals receiving low grades will still say that the methodology is invalid. "We have no problem, and are expecting that they will be critical of our methods," she says.
"But I would strongly suggest that they not lose focus on what's important, which is reassuring the public they serve that they care about patient safety.
"And they should take a lesson from other industries outside hospitals that are very accustomed to very high levels of transparency. The auto industry has lots and lots of publications that compare different autos from different automakers with negative or positive ratings. But I rarely hear automakers complaining that a particular rating is bad or uses a bad methodology. They wouldn't waste their breath, because that's not going to get them more sales. What they do is they get better."
Some executives for smaller, rural hospitals felt they were disproportionately affected by the methodology. For example, James Barrett, CEO of 38-bed Richardson Memorial Center in Rayville, LA, says that not only did Leapfrog fail to contact him, but smaller, more rural hospitals are disproportionately represented among the low-scoring hospitals.
For example, he lamented, "a lot of the things they surveyed for we don't have. It's not a fair process." Because of that, one bad score on a measure that they are scored on can skew the entire grade downward, he says.
Binder deflected criticism that the methodology is flawed, saying that it was developed by a team of the nation's leading healthcare quality experts, such as Ashish Jha, MD, Sara Singer, and Lucian Leape, MD, all of Harvard University; John Birkmeyer, MD, of the University of Michigan; Arnold Milstein, MD, of Stanford University; and Peter Pronovost, MD, of Johns Hopkins University.
Binder also says that Leapfrog's safety score now has its own free mobile app that patients who travel may download so they know with a few clicks the safest nearby hospitals to get care if they're away from home.