Twenty years after a landmark Institute of Medicine report revealed nearly 100,000 deaths in the U.S. annually occurred from preventable medical errors, at least a third of hospitals are earning top grades for their safety efforts, according to a new report from The Leapfrog Group.
Thursday, the firm released its biannual patient safety grades for 2,600 general acute care hospitals in the U.S. Looking at rates of preventable errors, accidents, injuries and infections, it also awarded 25% of those hospitals a "B" grade and 34% a "C" grade. The remaining 9% received a "D" or an "F" grade this year, officials said.
However, as Leapfrog was releasing this latest set of grades, it was also responding to a new lawsuit from a hospital that received one of those lower grades.
Late last month, NCH Healthcare in Naples, Florida, filed a suit to challenge its "D" rating in an effort to keep the grade from being published. The suit alleges deceptive and unfair trade practices, as well as defamation, saying the health system did not participate in the 2019 survey and, thus, Leapfrog had to rely on secondary information for more than half of its measures to compare it against hospitals that did provide those measures.
“The Leapfrog Hospital Safety Grade Fall 2019 methodology is deceptive and unfair as applied to NCH because it relies on incomplete and misleading data,” NCH wrote in the suit.
For its part, Leapfrog said the Leapfrog Hospital Safety Grade is reviewed by a National Expert Panel and receives guidance from the Armstrong Institute and is peer reviewed, fully transparent and free to the public. They say more than 50,000 lives could be saved annually if hospitals that received lower scores were able to achieve an "A" grade. "It shares critical patient safety information to consumers, in an easily digestible way, so that they can make informed decisions about where they seek care," they said.
The two NCH hospitals graded previously received grades over the years ranging from "A" to "C." On the latest report, Leapfrog said the hospitals performed below average in safety issues such as preventing dangerous blood clots during surgery, taking steps to effectively communicate with patients about medications and following systems to curb patient falls. The hospital performed above average when it came to taking steps to prevent the most common infections as well as identifying and responding to serious complications after surgery, the report said.
Several areas Leapfrog did not rate, because it indicated the health system declined to disclose data.
In the suit, NCH also alleges defamation saying Leapfrog “knows” the grade is false. “Upon information and belief, if NCH completed the Leapfrog Hospital Survey, then NCH would have received a 'B,' or at a minimum, a ‘C’ as it had in past grading periods."
Leapfrog Group President and CEO Leah Binder defended Leapfrog's methodology and said the organization has been fully transparent with its work and allowed NCH to provide more information.
"Naples residents should be very concerned when their hospital system wastes money on a frivolous lawsuit disputing the free speech rights of an independent nonprofit organization. NCH resources would be better spent on initiatives to improve patient safety," Binder said in a statement defending the group's methodology. "NCH may wish to withhold their hospitals’ grades from the community they serve, but Leapfrog intends to fully defend its First Amendment rights to publish grades for NCH hospitals."
While Leapfrog's scores have been lauded in patient safety circles as a helpful accountability tool, they've also been highly contested by the hospital industry, including the American Hospital Association. Critics of Leapfrog's safety grades have questioned its use of self-reported hospital data in calculating scores.
Researchers at the University of Michigan dived into Leapfrog's data and found hospitals that reported high compliance with the group's Safe Practices did not necessarily have lower infection rates or lower federal penalties for readmissions. Leapfrog has said in response to the study that hospitals who try to game their grading system are "generally frustrated" by the effort.
The state-by-state grades found five states with the highest percentages of "A" hospitals include Maine (59%), Utah (56%), Virginia (56%), Oregon (48%) and North Carolina (47%). But three states had no "A" hospitals. Those were Wyoming, Alaska and North Dakota.
More than 35 hospitals nationwide have achieved an “A” in every grading update since the launch of the grades in 2012.