Following significant increases in infection rates during the COVID-19 pandemic, hospitals have reduced health care-acquired infections (HAIs) post-pandemic, according to a new report from The Leapfrog Group. Nearly 30% of hospitals earned an “A,” 24% earned a “B,” 39% earned a “C,” 7% earned a “D” and less than 1% earned an “F” in the patient safety nonprofit’s fall 2023 Hospital Safety Grades. The report assigned a letter grade to nearly 3,000 general hospitals on how well they prevent medical errors, accidents, and infections.
Utah is the state with the highest percentage of “A” hospitals in the country this fall. Rounding out the top 10 states for “A” hospitals are: Virginia, North Carolina, Pennsylvania, South Carolina, Connecticut, Montana, Tennessee, Florida and Texas. States with the least favorable performance are Vermont, Wyoming, Delaware, North Dakota, and Washington, DC, where no hospitals earned an “A.”
“Now that we have pre- and post-pandemic data for patient safety measures, we are encouraged by the improvement in infections and applaud hospitals for reversing the disturbing infection spike we saw during the pandemic,” said Leah Binder, president and CEO of The Leapfrog Group. “However, there’s still more work to be done. It’s deeply concerning that patient reports about their health care experience continues to decline.”
The new grades are the first to reflect hospital performance post-pandemic. Nationally, hospitals significantly reduced three HAIs — Methicillin-resistant Staphylococcus aureus (MRSA), central line-associated bloodstream infections (CLABSI) and catheter-associated urinary tract infections (CAUTI) — after CLABSI, MRSA, and CAUTI reached a five-year high during the pandemic. In the fall 2022 Safety Grade cycle, hospitals experienced a 35% increase in the average standard infection ratios (SIRs) of CLABSI and MRSA from pre-pandemic levels as well as a 20% increase in CAUTI.
The latest data shows that over 85% of hospitals have improved performance on at least one of the three dangerous infections the Hospital Safety Grade accounts for. That includes:
- 19% of hospitals have improved in all three infection measures,
- 66% of hospitals have improved at least one infection measure, and
- 16% of hospitals have continued to worsen or made no improvement.
Measuring Patient Experience
The Leapfrog Hospital Safety Grade also includes five patient experience measures that evidence suggests are closely associated with patient safety issues. The scores for the measures are calculated using patient responses to a national and standardized patient survey following a hospital visit. Patients are asked to rate their experience of nurse communication, doctor communication, staff responsiveness, communication about medicine, and discharge information. Nationally, patient experience scores worsened for the second year in a row, and all states experienced a significant decline in reported patient experience from the fall 2021 to the fall 2023 Safety Grade.
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Patient experience reports show the most significant declines in the categories of “communication about medicines” and “responsiveness of hospital staff,” both of which correlate with preventable medical errors according to recent studies, Binder reported.
“In talking with hospital leaders, we believe staffing shortages are one key reason for the continued decline,” said Binder. “Many hospitals are innovating to help make patient experience better, which is critical because these results are disheartening and unsustainable.”
The Leapfrog Hospital Safety Grade is the only hospital ratings program based exclusively on hospital prevention of medical errors and harms to patients. Fully transparent and free to the public, the grades are updated biannually in the fall and in the spring.