Hospitals see setbacks in patient safety, Leapfrog Group finds

Hospitals have experienced some disturbing declines in patient safety, according to a new report released Tuesday from The Leapfrog Group.

The watchdog organization released its spring 2022 Leapfrog Hospital Safety Grades, designating a letter grade for nearly 3,000 hospitals. The Leapfrog Group also released a report examining the patient experience in hospitals, which found some areas where hospital safety has slipped since the start of the COVID-19 pandemic.

“We were extremely surprised with these declines in patient experience ratings,” said Missy Danforth, vice president of health care ratings at the Leapfrog Group.

The Leapfrog Group report comes as federal officials have expressed growing concern about patient safety in hospitals during the pandemic, including an uptick in infections.

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Key concerns: communication and responsiveness

In an interview with Chief Healthcare Executive, Danforth pointed to two areas of particular concern: hospital staff responsiveness and communication about medication.

Staff responsiveness relates to how quickly patients received help after they pressed the call button. If staff don’t respond in a short time, patients are more at risk of falling and getting injured, Danforth said.

Patients gave less favorable comments on staff responsiveness during the pandemic, the Leapfrog Group said. Before the pandemic, 67.1% of patients gave high marks on responsiveness, but that number fell to 63.4% mid-pandemic.

Medication errors also pose significant risks to patient safety, so patients need to have a good understanding of how they are supposed to take their prescriptions. The Leapfrog Group said 61% of patients reported good communication about medications mid-pandemic, down from 64% before the arrival of COVID-19.

“Communication about medication is extremely important, especially as patients are discharged home,” she said.

Patients also gave less favorable responses to care transitions during the pandemic (50.2%), compared to before the pandemic (52.1%).

Seven of 10 patients (70.7%) said they were satisfied with the cleanliness of hospitals in the pandemic, down from 73.6% before the arrival of COVID-19.

"Regardless of the influence of the pandemic, significant challenges persist across all domains of patient experience, indicative of serious safety and quality problems that must be addressed," The Leapfrog Group report stated.

Understanding the challenge

Danforth said the Leapfrog Group recognizes the tremendous challenge hospitals and health systems have faced during the pandemic. “Frontline caregivers have been heroic over the past two years,” Danforth said.

Many of the issues regarding patient safety reflect systemic problems, she said. “Hospitals don’t have some things in place to deal with things like a pandemic,” Danforth said.

“We need to make patients aware of what’s happening in hospitals today so they’re prepared,” she said.

For issues such as communicating about medication, Danforth said patients should consider having a family member assist the patient in making sure they understand the prescription regimen.

The Leapfrog Group is also aiming to help spread better practices among healthcare organizations. Hospitals can follow checklists to reduce the risk of central line infections.

Even reminders of hand-washing hygiene are critical, and an area that can be overlooked, Danforth said. All staff touching patients need to be washing hands, and that has to be drilled in by health systems.

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Making safety a priority

In its hospital safety grades, The Leapfrog Group includes the culture of safety in its evaluations.

Hospital executives need to make safety a top priority throughout the organization, Danforth said.

She said a common characteristic among hospitals earning top grades is ‘leadership prioritizing safety and establishing a culture where people feel safe to speak up and report errors.”

Hospitals and health systems must do more to be ready for future pandemics, Danforth said.

“Hospitals have to be prepared for dealing with these kinds of stresses in the future in ways that don’t include these erosions in patient safety,” she said.

“We certainly understand the reality of the workforce issues but are hoping leaders can find innovative solutions to build resilience in their hospitals,” she added.

In an analysis published in the New England Journal of Medicine, leaders with the Centers for Disease Control and Prevention and the Centers for Medicare and Medicaid Services  pointed to a sharp rise in infections and other worrisome indicators. The federal officials urged health systems to focus on improving the safety for patients and employees. They also said the government would consider more oversight to spur providers to improve.

The U.S. Labor Department said in March it was launching a three-month period of increased inspections of hospitals and nursing homes treating COVID-19 patients.

Safety grades

Among the nearly 3,000 hospitals surveyed, one in three (33%) received an “A” grade.

About one in four (24%) received a “B,” while 36% were given a “C”, 7% received a “D” and less than 1% received an “F.”

Consumers can learn more about the list and get more detailed information on hospitals by going to HospitalSafetyGrade.org.

These five states had the highest percentage of hospitals receiving an “A”: North Carolina, Virginia, Utah, Colorado and Michigan.

There were no hospitals receiving an “A” in Washington, D.C., West Virginia, Wyoming and North Dakota.

The hospitals receiving an “A” reflected institutions of all sizes from around the country.

“They are a diverse group,” Danforth said.

While nearly half the hospitals received a "C" or worse, Danforth said over the years, hospitals that get a "C" tend to improve over time.