Leapfrog Group, American Diabetes Association team up to recognize hospitals

The Leapfrog Group has earned recognition for its hospital safety grades.

Hospitals earning high marks tout them in marketing and advertising, while those getting poor marks on safety understand they have some work to do in terms of protecting patients and restoring public confidence.

Now, the Leapfrog Group, a nonprofit watchdog founded by employers, is adding a new dimension to its work. The organization is teaming with the American Diabetes Association to recognize hospitals providing exceptional care for patients with diabetes. The groups announced the partnership last month.

Leah Binder, president and CEO of the Leapfrog Group, says the new program will spotlight leaders in caring for patients with diabetes. She tells Chief Healthcare Executive® that they plan to announce the first hospitals to earn the designation next spring.

“Our goal is to give these hospitals deserved attention for making that extra effort to care for their patients who are living with diabetes,” Binder says.

• Read more: The Leapfrog Group’s spring hospital safety grades find ‘dramatic’ rise in infections

Unlike the safety grades, the Leapfrog Group and ADA won’t be giving low marks to hospitals that don’t fare as well in caring for patients with diabetes. Those that don’t earn the recognition will be welcome to apply for consideration in the future, she says.

“The idea is really to be a positive recognition, and that’s it,” Binder says. “And hopefully that will be helpful in galvanizing change across all hospitals. Because any hospital can do this. And I know all hospitals want to do this. Hopefully this will give them a little impetus to put some priority to it.” (See part of our conversation with Leah Binder in this video. The story continues below.)

‘A major issue’

Robert Gabbay, chief scientific and medical officer for the ADA, said in a statement that those with diabetes are at risk for serious complications during hospital visits.

“There is an immense need to ensure hospitals provide safe, patient-centered care for all people who live with diabetes,” Gabbay says.

About 30% of all Americans hospitalized are diagnosed with diabetes, according to a 2021 analysis by the Agency for Healthcare Research and Quality.

With so many hospitalized patients with diabetes, Binder says, “This is a major issue.”

“This isn't a minor issue, this isn’t a sideline,” Binder says. “It's just something that's been overlooked, that we really have to address pretty aggressively.”

Not too long ago, Binder says she viewed diabetes in terms of chronic care management by physician groups.

“However, it is also an issue for hospitalized patients for traditional inpatient care,” she says. “And that is something I frankly never thought about until I talked to the folks at ADA, who really educated me about what they hear, which is constant complaints from their members about issues that they have while they are in the hospital.”

Some hospitalized patients don’t receive insulin or other treatments at scheduled times, which she says can be a huge problem for those with diabetes.

“The timing of medications is really critical,” Binder says. “People who live with diabetes really do have to make sure they're getting their insulin in particular, but other medications at the right time. And sometimes it's difficult for hospitals to manage medications in general.”

Studies have found low blood sugar in hospitalized patients is associated with higher mortality risk. A 2017 study also found inconsistent timing in hospitals providing insulin doses.

Other patients say hospitals aren’t recognizing their dietary restrictions, Binder says.

In addition, Binder says some patients say there can be a lack of communication when shifts change and clinicians aren’t promplty told that a patient has diabetes.

Diabetic patients don’t always get the proper guidance when they are discharged, she says.

“Sometimes they're not given the right education, because there may be new restrictions based on whatever condition that had them in the hospital to begin with,” Binder says. “There may be new restrictions, and they may not understand how those interact with their diabetes and what they need to do.

“So that's why it's really important that hospitals have certified diabetes educators on staff to help these patients,” she adds. “That's another complaint we hear a lot of times. People are confused. They don't know what they should be doing about their diabetes when they are discharged.”

• Read more: ‘Unprecedented decline’: The patient experience plunged in the pandemic

‘A special level of risk’

The diabetes association has produced standards of care for hospitals treating patients with diabetes. But Binder says in discussions with the association, the adherence to those recommendations isn’t as high as the ADA has hoped.

“That's really when this whole project got started,” Binder says.

The Leapfrog Group will examine how hospitals fare in meeting the ADA’s standards of care, and will also incorporate its own data from the hospital safety grades. A panel of experts will review applications from hospitals, and the groups will announce the first recipients in the spring, she says.

“Hopefully that will get a lot of attention,” Binder says.

The Leapfrog Group will be looking beyond patients who are in the hospital because of complications related to diabetes. She says the evaluation will take into account patients with diabetes who are in the hospital for other reasons, such as childbirth or a knee replacement.

“If you're in the hospital for whatever reason, and you also have a diagnosis of diabetes, you are at a special level of risk, particularly for patient safety challenges that hospitals need to attend to,” Binder says.

“And that's why we're doing this, is really to highlight the hospitals that are paying that attention, and doing what's needed for people with diabetes.”

(Hospitals interested in applying for consideration in the program can find out more from The Leapfrog Group here.)