The Leapfrog Group is a nonprofit organization that serves as the premier advocate of hospital transparency in the United States [1]. Through the Leapfrog Hospital Survey, it collects, analyzes, and disseminates hospital information to inform the public about various safety ratings of acute care hospitals [1]. Each participating hospital’s safety grade is available to the public on the Leapfrog organization website [1]. Patients also have the ability to search for specific hospitals and compare safety ratings to guide provider selection [1].
The Leapfrog Hospital Survey was launched in 2001 [2]. In 2004, Leapfrog updated the survey to include self-reported Safe-Practices Scores (SPS) that were inspired by the 34 National Quality Forum-endorsed practices to reduce risk of patient harm in hospitals [2]. In 2012, SPS were combined with other process and outcome measures to produce a more consumer-friendly Hospital Safety Score (HSS), which is in use today [2].
A unique aspect of the Leapfrog Safety Grade is its focus on patient safety and not direct patient outcomes, such as 30-day mortality rates or patient satisfaction [1]. Current Leapfrog safety grades are determined through the average weight of 28 national performance measures derived from the Leapfrog Hospital Survey, the Agency for Healthcare Research and Quality, the Centers for Medicare and Medicaid Services, and the American Hospital Association’s Annual Survey and Health Information Technology Supplement [3]. The final calculated value, the HSS, is determined by converting the various performance measures into a z-score, which is then used to compare safety performances amongst hospitals [1]. A HSS rates hospitals on a scale ranging from 0 to 4 and provides a corresponding letter grade of “A” (best), “B”, “C”, “D”, or “F” (worst) [2]. A HSS is assigned twice a year to over 2,500 hospitals nationwide [3].
One of the major reasons that hospital ratings like the Leapfrog Safety Grade are important is the prevalence of medical error, with estimates of attributable annual deaths in the U.S. ranging from 100,000 to as high as 400,000 [4]. In 2016, Leapfrog asked the Armstrong Institute to conduct an analysis of the approximate number of avoidable deaths in hospitals with each letter grade (“A” through “F”) [3]. The purpose of this study was to understand the relative risk of going to an “A” rated hospital versus hospitals that receive lower letter grades [3]. The results of the Armstrong Institute study found that the number of avoidable deaths per 1,000 admissions ranged from 5.13 lives in “A” hospitals to 7.68 lives in “D” and “F” hospitals [3]. In comparison to “A” hospitals, the estimated relative risk of an avoidable death is 8.5% higher in “B” hospitals, 35.2% higher in “C” hospitals, and 49.8% higher in “D” and “F” hospitals [3]. The researchers concluded that if hospitals with a grade lower than “A” were able to achieve the safety performance of “A” hospitals, more than 33,000 patient lives could be saved annually [3].
Additionally, the HSS can have major financial consequences for hospitals [4]. The Center for Medicare and Medicaid Services links hospital reimbursement to such measures, providing incentives to hospitals to emphasize quality patient care [4].
References
- Armstrong, S. M. (2019). The Association Between Leapfrog’s Healthcare Organizational Grades and 30-Day Mortality Rates. Retrieved from https://scholarworks.waldenu.edu/dissertations/6512
- Smith, S., Reichert, H., Ameling, J., & Meddings, J. (2017). Dissecting Leapfrog. Medical Care, 55(6), 606-614. doi:10.1097/mlr.0000000000000716
- Austin, M., & Derk, J. (2016). Lives lost, lives saved: A comparative analysis of avoidable deaths at hospitals graded by The Leapfrog Group. Armstrong Institute for Patient Safety and Quality.
- Popovich, D., Vogus, T., Iacobucci, D., & Austin, J. (2020). Are hospital ratings systems transparent? An examination of Consumer Reports and the Leapfrog Hospital Safety Grade. Health Marketing Quarterly, 37(1), 41-57. doi:10.1080/07359683.2020.1713578
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