Hartford HealthCare Made Giant Strides in Patient Safety. Here's How.

The health system has posted impressive patient safety improvements, including a 67% reduction in serious safety events from June 2019 to June 2025.

In 2017, Hartford HealthCare set a goal to achieve an A grade for patient safety from Leapfrog at the health system's seven hospitals, and it achieved that goal in 2023 and 2024.

The health system started this patient improvement journey with a B grade at one hospital, C grade at five hospitals, and D grade at one hospital. Raising the Leapfrog patient safety grades to A at the seven hospitals earned Hartford HealthCare the 2025 Quest for Quality Prize from the American Hospital Association.

Hartford HealthCare focused on improving Leapfrog patient safety grades to set a bold goal and drive improvement, according to Stephanie Calcasola, RN, MSN, chief quality officer at the health system.

"Leapfrog is a nationally recognized patient safety organization that provides objective data on quality and patient safety, and achieving an A grade for patient safety from Leapfrog was a way to measure ourselves against a national rating system," Calcasola says. "Leapfrog also informs us on how well we can set a target and use data to measure our performance year over year."

Over the past decade, Hartford HealthCare has posted impressive patient safety improvements, including the following:

• Since 2015, the health system has reduced hospital-acquired infections by 76%
   
• In 2024 and 2025, the health system received no penalties under the Centers for Medicare & Medicaid Services Hospital-Acquired Condition Reduction Program
   
• From June 2019 to June 2025, the health system decreased serious safety events by 67%

Creating a workplace culture that emphasizes psychological safety for staff members has been essential to improving patient safety because it encourages reporting of concerns and harm events, according to Ajay Kumar, MD, MBA, executive vice president and chief clinical officer at Hartford HealthCare.

"We have leadership behaviors across the health system such as encouraging people to speak openly about any concerns," Kumar says. "We have that philosophy at every meeting forum, which promotes staff members coming forward with concerns."

Harm event reporting is crucial to improve patient safety, Kumar explains.

"We like to see all segments of our organization reporting harm events appropriately and increasing their reporting," Kumar says. "We don't consider increased reporting of harm events as a bad thing—we want staff members to feel comfortable reporting events when things are not going well. We celebrate the reporting of harm events."

Striving to become a high-reliability organization has supported patient safety improvement efforts at the health system, according to Calcasola.

"In 2017, we recognized the complexity of changing behaviors and spreading training tactics across all sites of care—not only our acute-care hospitals," Calcasola says. "So, we branded our high reliability efforts as Safety Starts with Me. Now, we have more than 45,000 colleagues across our organization who are trained in high reliability because we believe every individual can drive safer care."

The Safety Starts with Me initiative includes several key elements. Every new employee receives initial training on high reliability. Managers embed high reliability language and training in their daily huddles. Under the initiative, high reliability is a complementary skillset that reflects the health system's operating model, which includes a commitment to integrity and being courageous.

"Every training effort through the Safety Starts with Me program starts with mindfulness," Calcasola says. "To be a high-reliability organization, all colleagues need to have a sense of their impact. They need to have attention to detail, which includes understanding workflows and stopping the line if there is a deviation from standard procedures."

Another part of the Safety Starts with Me initiative is a focus on failure, Calcasola explains.

"When things go wrong, the organization and individual staff members study that failure, then improve the systems involved in a failure," Calcasola says.

Stephanie Calcasola, RN, MSN, is chief quality officer at Hartford HealthCare. Photo courtesy of Hartford HealthCare.

Using Data and Technology to Promote Patient Safety

Harnessing data is a cornerstone for patient safety improvement and understanding performance, according to Calcasola.

"We use data from our EHR," Calcasola says. "We have partnered with Vizient, which is a national leader in health system and hospital quality and patient safety data, and they have helped us benchmark our performance against national leaders in quality and safety."

Key data points that support patient safety improvement include mortality, hospital-acquired infections, staff member engagement, and patient experience, Calcasola explains.

"With these kinds of metrics, we can study our whole health system, which now has eight hospitals across the state of Connecticut," Calcasola says. "We use data analytics and dashboards to harness data."

Leveraging technology has played an important role in improving patient safety at Hartford HealthCare.

"We have done a systemwide assessment of biomedical technology to see where there are gaps," Kumar says. "We want to make sure our staff members have the right equipment and technology to provide safe care."

Having every hospital on the same EHR, which is Epic, supports patient safety at the health system.

"That means patient journeys and patient data such as laboratory results can be transferred from one hospital to another, and one setting to another," Kumar says.

Artificial intelligence tools are also promoting patient safety at Hartford HealthCare.

"We are using AI to make sure our diagnostic errors are reduced in radiology," Kumar says. "We are using AI to provide access to care for patients through the HHC 24/7 virtual primary care service. We are using AI to augment our clinicians' ability to deliver value for patients."

An AI tool is helping care teams to make safer patient transitions out of the health system's hospitals.

"Before a patient is discharged from a hospital, this AI tool gives a score to clinicians to make sure it is safe to discharge the patient," Kumar says. "This has helped us to safely reduce hospital length of stay by 0.7 days across the health system."

Ajay Kumar, MD, MBA, is executive vice president and chief clinical officer at Hartford HealthCare. Photo courtesy of Hartford HealthCare.

Advice for Boosting Patient Safety

Leadership and culture are essential components to improving patient safety at health systems and hospitals, according to Kumar.

"A strong leadership commitment to patient safety and quality is paramount," Kumar says. "You also need a culture where psychological safety and a structural approach and mission to improve patient safety and quality is well understood."

Achieving significant gains in patient safety should start with setting ambitious goals, Calcasola explains.

"You need to set a bold target," Calcasola says. "We leveraged raising our Leapfrog scores as a true north, and it helped to inspire us to understand our performance and get better every day. Setting a bold target in the pursuit of excellence is one way to improve patient safety."