Leapfrog Group: Hospitals have made 'significant' patient safety gains over the past decade

Over the course of the past decade, U.S. hospitals collectively improved patient safety measures such as medical errors and healthcare-associated infections, according to the Leapfrog Group, a hospital watchdog organization in its 10th year of tracking such events.

Alongside the release of its latest collection of hospital report cards, Leapfrog said it took a look back at its historical ratings and found “a consistent pattern of better performance” across 10 measures continuously reported by hospitals nationwide as far back as 2009.

“We salute hospitals for this milestone and encourage them to accelerate their hard work saving patient lives,” Lead Binder, president and CEO of Leapfrog, said in a press release.

Among the decade’s highlights were reductions in two so-called “never events,” patient fall and injury incidents, as well as incidents when objects are unintentionally left inside of a body after surgery. Both decreased by more than 25% on average from late 2010 to the end of 2019.

The group also saw reductions for three different types of healthcare-associated infections: methicillin-resistant staphylococcus aureus (22.4% average reduction), Clostridium difficile (7.6% average reduction) and central line-associated blood stream infections (43.8% average reduction).

Other recorded improvements spanned hospitals’ adoption of safer staffing strategies, culture and technologies.

Average scores related to staffing of specialized physicians for intensive care units grew by 280.7% from 2011 to 2022, while qualified nurse staffing grew by a more modest 13.5%.  Adoption of computerized physician order entry, which are tied to a reduction in medical errors, also increased by a mean 680.9% from 2011 to 2022.

Leapfrog noted in the release that these trends are on par with adverse event rate reductions observed by researchers. A study published this summer in JAMA, for instance, found reductions across various in-hospital adverse events across 190,286 discharge records from 2010 to 2019.

For Binder, the improvements are linked to increased transparency requirements and the accompanying scrutiny from watchdogs like Leapfrog.

“For a long time, the health care community tried to improve safety, but progress stalled,” she said. “The big difference over this decade is that for the first time, we publicly reported each hospital’s record on patient safety, and that galvanized the kind of change we all hoped for. It’s not enough change, but we are on the right track.”

Wednesday also saw the release of Leapfrog’s twice-annual Hospitals Safety Grade report. The latest reviews combined data from voluntary hospital surveys and Medicare-required quality reporting that, for certain categories, reached back as far as July 2018.

Among 2,861 hospitals, 844 (29%) received an “A” safety grade and 877 (28%) earned a “B” grade. There were 1,032 (36%) hospitals that received a “C,” 184 (6%) a “D” and just 15 (1%) an “F.”

Regionally, there were five states in which half or more hospitals received Leapfrog’s highest grade: New Hampshire (53.8%), Virginia (52.1%), Utah (51.9%), Colorado (50%) and Idaho (50%). North Dakota, Vermont and Washington, D.C., each had zero hospitals that received an “A” grade.

The full methodology of the grading system and a tool to look up grades for specific hospitals is available on Leapfrog’s website.

Last fall’s rankings, the first to include data collected during the COVID-19 pandemic, highlighted a “significant” jump in healthcare-associated infections as well as heavy variation across regions and individual facilities. The group has also warned of recent patient experience declines surrounding staff responsiveness, cleanliness and communication regarding medicines.