The Leapfrog Group is now to hospitals as a teacher is to students—at least in the age-old educator’s duty of grading exams from A for outstanding to F for failing. The Washington, D.C.-based healthcare-quality watchdog launched its hospital report-card system, the “Hospital Safety Score,” June 6 to show healthcare consumers how their local hospitals measure up on various criteria for safety.
Grading some 2,652 of the U.S.’s 5,754 facilities, Leapfrog made its calculations with guidance from a nine-member panel of experts, Leapfrog explained in a news release. The panel included Ashish Jha, MD, MPH, of Harvard School of Public Health in Boston; Peter J. Pronovost, MD, PhD, of Johns Hopkins University School of Medicine in Baltimore; and Arnold Milstein, MD, MPH, of Stanford University in Stanford, Calif.
The group organized its point-by-point appraisals of 26 safety “identifiers” in six categories—structural measures, safe practices, surgical-care improvement projects, hospital-acquired conditions, hospital-acquired infections and patient safety practices.
Leapfrog said that, to develop the scoring system, the panel gathered data publicly reported at the national level, including measures reported by the federal government via the Centers for Medicare & Medicaid Services (CMS) and Leapfrog’s own hospital surveys.
The 26 identifiers look at incidence of, for example, central line-associated bloodstream infections, severe pressure ulcers and preventable complications brought on during surgery. The scorecard also takes into account procedures and protocols deployed to prevent problems, such as hand-hygiene policies, computerized physician order entry systems and safety-first organizational leadership and culture.
Of the hospitals issued an overall safety score, 729 earned an “A,” 679 earned a “B” and 1,243 were graded “C” or lower.
Surprises sprung up at both ends of the grading spectrum—some rural community facilities went to the head of the class while some academic medical centers found themselves in the principal’s office—and, not surprisingly, some of the low scorers are questioning the validity of Leapfrog’s new scoring system.
After being given a “C,” Mount Sinai Hospital in New York City—one of the country’s oldest and most highly regarded teaching hospitals—sent a statement to the Wall Street Journal ’s health blogger calling the Leapfrog scorecard “an incomplete and imperfect snapshot,” and asserting that much of the analysis is based on “outdated information from disparate sources. Leapfrog’s analysis is simply not indicative of the quality of care patients receive at Mount Sinai.”
Similar objections are not hard to find in healthcare blogs and online news outlets.
Meanwhile, Leapfrog appears ready to defend its work.
“The Leapfrog Group’s goal is to give patients the vital information they need and deserve before even entering a hospital,” said Leah Binder, the group’s president and CEO. “We hope people will use this score to talk with their doctor, make informed decisions about where to seek care and take the right precautions during a hospital stay.”
Leapfrog also said its membership of employers and other purchasers of health benefits, along with healthcare-related business coalitions across the country, will now work “to engage communities, employers, health plans, and hospitals in using the Hospital Safety Score to improve safety.”
The group plans to reissue the report card using updated data in November, then release annual editions beginning in 2013.