Leapfrog safety ratings highlight top performers' COVID-19 prevention measures

Report card
The biannual report handed out "A" grades to a third of the 2,735 hospitals up for review. The watchdog group also invited its highest achievers to share the organizational practices they leaned on during the pandemic. (Getty/michaelquirk)

The Leapfrog Group’s latest report card of patient safety grades awarded 906 hospitals the top rating and more than 1,000 hospitals a “C” grade or worse.

The independent watchdog group graded a total of 2,735 hospitals for the spring 2021 iteration of its twice-yearly report.

Overall, Leapfrog awarded 33% of hospitals an “A” grade, 24% (659 hospitals) a “B” grade, 35% (968 hospitals) a “C” grade, 7% (192 hospitals) a “D” grade and fewer than 1% (10 hospitals) an “F” grade.

The spread of these ratings was virtually identical to the results released last fall, with the group noting that it had maintained the same scoring and letter grade scoring cut-offs for its latest report.  

The narrative focus this time around, however, was on the COVID-19 prevention practices adopted by 27 U.S. hospitals to which Leapfrog has awarded consecutive “A” grades since launching its reports in 2012.

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Leaders from each of these organizations described examples of their quality and COVID-19 preparation measures to the organization in a collection of testimonials highlighted by Leapfrog.

“Mayo used all available resources and talent throughout the organization to develop new tools, such as predictive analytics to help make critical decisions regarding responses and actions quickly,” Katherine Noe, M.D., and Judy Henderson, both of Mayo Clinic Hospital in Phoenix, said in one of these statements.

“In addition, Mayo's Healthcare Incident Command System–a team activated in preparation for or in direct response to any event that may disrupt hospital or clinic operations–was quickly formed to use these tools and respond. Since information and decisions were changing rapidly, communication was a key component of the process. Many forms of communication such as leadership memos, newsletter articles, scripting for front line staff, etc. were used to rapidly spread best practices and continue existing good practices,” they said.

Leapfrog President and CEO Leah Binder said in a statement that the performance measures Leapfrog uses to generate these grades can be seen as a proxy for safety during COVID-19 treatments—strong infection control procedures, for example, can reduce the harm of new infections among patients and staff.

“Hospitals with a consistent pattern of protecting patients from errors, accidents and injuries, like these straight ‘A’ hospitals, seem to have been more prepared when the pandemic hit,” she said. “For many, safety and quality are embedded in their daily work at all levels of the organization, which prepared them in turn to respond to the rapidly evolving pandemic. As a part of this culture, straight ‘A’ hospitals have consistently shown a commitment to their workforce, empowering them to ask questions and share safety concerns.”

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Leapfrog’s reports also include rankings of the states with top-performing hospitals. Here, Massachusetts, Idaho, Maine and Virginia were the only states with more than 50% of their hospitals scoring “A” grades.

On the other end of the spectrum, North Dakota and South Dakota posted zero “A” hospitals. Top performers were also rare in Iowa and West Virginia, as less than 10% of their hospitals received “A” grades.

Leapfrog releases its Hospital Safety Grade rankings as a free resource for the public to review the safety processes of their local hospitals. The reports are independently assessed and peer-reviewed, with the methodology of the scoring made available online, according to the organization.

The watchdog group has, however, drawn the ire of those it has measured over the years. In 2019, NCH Healthcare in Naples, Florida, challenged its “D” rating with a lawsuit that alleged deceptive and unfair trade practices as well as defamation.

This came shortly after a NEJM Catalyst article in which academic and private sector authors flipped the tables and awarded grades to various hospital ratings systems. The group gave Leapfrog a “C-“ grade that Binder said at the time contained “serious errors.”