Leapfrog Group Spring 2024 Hospital Safety Grades: Infections drop, but there’s room to improve

After a surge of infections during the COVID-19 pandemic, hospitals appear to be making more progress in protecting patients.

The Leapfrog Group, the patient safety organization, released its Spring 2024 Hospital Safety Grades Wednesday, and the report finds hospitals and health systems have seen a significant drop in infections.

Hospitals showed signs of improvement in The Leapfrog Group’s fall 2023 safety grades, and they are building on that progress.

• Read more: In a first, Leapfrog Group's hospital safety grades rank the top metro areas

Leah Binder, president and CEO of The Leapfrog Group, tells Chief Healthcare Executive® that she still sees room for improvement. But Binder credits hospitals with taking important steps to protect patients and reduce the risk of complications while they’re recovering.

“We see very significant and really steep change in improvement in infections and improvement in patient experience, which has been correlated with patient safety outcomes,” Binder says. “It’s all very, very good news.”

(See part of our conversation with Leah Binder in this video. The story continues below.)

Coming out of ‘dark times’

The Leapfrog Group, a nonprofit group founded by large employers, examined nearly 3,000 hospitals in compiling its safety grades. Just like school report cards, the grades range from “A” to “F.” This year, the hospital also included rankings of the top metro areas for patient safety.

Looking broadly, the rankings found a substantial decline of three types of infections among hospitalized patients.

• Central line-associated bloodstream infections fell by 34%;
• Catheter-associated urinary tract infections dropped by 30%;
• Methicillin-resistant Staphylococcus aureus (MRSA) declined by 30%.

Hospitals experienced a worrisome uptick in hospital-based infections during the COVID-19 pandemic. Federal officials, while acknowledging that hospitals faced an unprecedented crisis, said they were troubled by the rapid erosion of gains in patient safety.

In The Leapfrog Group’s spring 2023 Hospital Safety Grades, Binder pointed to the “dramatic” rise in hospital-based infections as an indication that hospitals must make a deeper commitment to patient safety. That report examined hospital performance in late 2021 and 2022.

A year later, hospitals have made important strides in reducing infections, Binder says.

But Binder says safety metrics haven’t reached new highs. She says hospitals have essentially recovered to pre-pandemic levels in terms of infections and patient safety.

“We're going backwards to prior to the pandemic,” Binder says. “We haven't gotten better than we were in 2019, prior to the pandemic. But during the pandemic, we saw really drastic and truly alarming increases in infections and problems with patient experience. So we're now back, or mostly back, to where we were.”

“And so now we have to continue that improvement journey, and we've got to accelerate it, so we get to where I think all of us want to be in this country in terms of patient safety,” Binder says. “So the good news is, we're coming out of very dark times in patient safety. The bad news is we're still not better than we were in the past. Let's get better.”

The Leapfrog Group also measures the patient experience, and hospitals are also showing signs of progress in that area. However, Binder notes that the patient experience has been slower to recover than patient safety indicators. With the patient experience, hospitals are measured in areas such as communication from nurses and doctors, responsiveness, explanation of medication, and discharge information.

Binder says she is relieved to see progress in the patient experience. In The Leapfrog Group’s fall 2023 report, hospitals were still sliding in measures of patient experience.

“I will say that that's another area where we've seen a reversal of the problems that we saw during the pandemic, but it took a longer time,” Binder says.

“In fact, patient experience was getting worse after the pandemic,” she says. “So there was a lot of concern about that.”

Hospitals have eased some restrictions they had put in place during the pandemic, and Binder says that is making a difference. While doctors would sometimes check in on patients via phone, even if they were in the hospital, physicians are going into rooms to talk with patients face-to-face, she says.

While lauding hospitals for faring better on patient experience reports, Binder says there is more work to be done.

“We definitely need improvement, that's for sure,” Binder says.

• Read more: These hospitals have earned recognition for treating patients with diabetes

Grading the hospitals

The most common grade for hospitals in the Spring 2024 analysis was a “C.” The Leapfrog Group says 37% of the hospitals evaluated received a “C.”

On the high end of the scale, 29% of the hospitals earned an “A” grade. Roughly a quarter of hospitals (26%) received a “B.”

Some hospitals didn’t fare as well. In The Leapfrog Group’s spring report, 211 hospitals (7%) received a “D.”

And yes, some hospitals did get an “F.” Ten hospitals received a failing grade.

When hospitals get an “A”, many are touting their high marks to their community and including those top grades in their marketing campaigns.

“I think that has been one of the great successes of the hospital safety grade program, that hospitals have put out a press release and made sure that their community, including the internal community, including the workforce, the board, everybody, knows that they've achieved this really important milestone,” Binder says.