Frequently Asked Questions
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How is the Leapfrog Hospital Safety Grade different from the Leapfrog Hospital Survey?
Patient safety watchdog The Leapfrog Group, a national nonprofit, evaluates and reports on the safety and quality performance of U.S. hospitals. Leapfrog is deeply committed to increasing transparency among health care providers in order to reduce the estimated 440,000 annual deaths from hospital errors, accidents and injuries.
Leapfrog publishes findings from the Leapfrog Hospital Survey starting in July each year, and monthly through January. Twice per year, it issues the Leapfrog Hospital Safety Grade, using publicly available data from a variety of sources.
If you receive hospital communications from Leapfrog, you may have seen information on both of these programs, perhaps even around the same time.
The infographic at right and the guide below are meant to help you understand the differences between the two, the timeline for each, and who to contact if you have any questions.
Web address: www.hospitalsafetygrade.org
What it is: The Leapfrog Hospital Safety Grade is a composite score made up of 27 different, nationally-reported patient safety measures that indicate how well hospitals protect patients from preventable errors, injuries and infections. Grades are assigned to U.S. general hospitals twice annually, using a scoring algorithm to determine each hospital’s score as an A, B, C, D, or F letter grade.
How many hospitals? Approximately 2,500 general hospitals are assigned a grade twice per year.
What kind of hospitals are included/eligible? Any general, acute-care hospital in the U.S. for which there is enough publicly available data. Submission of a Leapfrog Hospital Survey is strongly encouraged but not required to receive a score, as long as the hospital has enough data available from other sources. Because of limitations and exclusions in publicly available data, the Leapfrog Hospital Safety Grade does not assess hospitals such as:
- critical access hospitals
- specialty hospitals such as children’s hospitals or cancer hospitals
- hospitals in Puerto Rico or Guam
What does it measure? The Leapfrog Hospital Safety Grade looks at publicly available measures of safety – inpatient injuries, infections, and medical and medication errors.
- Outcome Measures include, among other measures:
- infections, including: central line-associated bloodstream infections, catheter-associated urinary tract infections, surgical site infections for colon surgery, MRSA and C. diff.
- falls and trauma, very severe pressure ulcers
- preventable complications from surgery such as foreign objects retained in the body and accidental punctures or lacerations
- Process/Structural Measures include, among other measures:
- strong nursing leadership and engagement
- computerized physician order entry systems to prevent medication errors
- hand hygiene policies
- the right staffing for the ICU
- The Leapfrog Hospital Safety Grade does NOT measure:
- Issues commonly considered quality measures, such as death rates for certain procedures
- Measures of hospital quality, such as ratings by specialty or procedure
- Readmission rates
Where does the data come from? The Leapfrog Hospital Safety Grade primarily consists of measures collected and publicly reported by the Centers for Medicare & Medicaid Services (CMS), and also includes some measures from the Leapfrog Hospital Survey for hospitals that report to Leapfrog. If a hospital does not submit a Leapfrog Hospital Survey, Leapfrog uses data from the American Hospital Association’s annual survey and IT supplement instead. Hospitals are not penalized for not reporting to Leapfrog.
How is the data assessed? The scoring algorithm was developed by an Expert Panel of patient safety experts from across the country. The panel carefully considers the evidence base and opportunity for impact behind each of the 27 measures, and weight the importance of each of the measures based in part on the strength of that evidence. The Panel regularly reconvenes to reevaluate the merits of each measure. Leapfrog’s transparent methodology involves computing data for these 27 measures through a scoring algorithm and then assigning each hospital an A, B, C, D, or F letter grade.
Why were less hospitals graded in the Spring 2018 grading cycle? In Spring 2018, fewer facilities were eligible to receive a Safety Grade due to an increase in the number of facilities missing too much data. Each round, hospitals are not graded if they are missing more than six process/structural measures or more than five outcome measures. In Spring 2018, more hospitals were missing data for the Patient Safety Indicators (PSIs), which are only reported for sample sizes greater than or equal to 25. This lower sample size could be due to a variety of factors, including the following:
- The PSIs represent a shorter reporting period this round due to the transition to ICD-10 and therefore hospitals may be seeing smaller sample sizes than previously.
- Some PSIs, including PSI-12 and PSI-15, were re-specified by CMS.
Is it true that hospitals can “game” the Hospital Safety Grade, as recently reported in Medical Care? While it’s theoretically possible to “game” any ratings system, we find that hospitals attempting this with the Leapfrog Hospital Safety Grade are generally frustrated by the result for two reasons. First, the grade is composed of 27 measures, meaning that there are thousands of potential statistical outcomes that cannot be predicted with certainty. Second, the grade is calculated on a curve, so even by using data from one point in time, hospitals cannot know how they will compare until the full range of hospitals are scored.
How long has Leapfrog been doing this? Since 2012
How often are results made available? The Leapfrog Hospital Safety Grade is issued twice a year, in the fall and spring. Results are publicly available and presented in an easy-to-use format for consumers and other interested parties.
How do I communicate with patients who have questions about our grade? Health care consumers are increasingly becoming concerned with the quality and safety of care they receive at hospitals and are using this information to make a decision on where to seek care. To help patients interpret your Safety Grade, refer them to the detailed information on the 27 measures that make up your grade. The colored gas gauge images show areas where your hospital has demonstrated strong performance and where there is room for improvement. For areas in which your hospital scores poorly, assure your patients that you recognize this is an area of concern and illustrate what steps you are actively taking to improve the safety of care you provide. No hospital is perfectly safe, so even if your hospital has received an A Safety Grade, it is likely that there are still some areas where you score poorly. If your hospital has received a low grade and scores below average on many measures, explain to your patients how your hospital leadership has recognized these shortcomings and hopefully is instituting a facility-wide commitment to improving safety. Finally, you can also encourage patients who have additional questions to contact Leapfrog directly at email@example.com.
Where can I find more information? You can find more information and the full methodology at www.HospitalSafetyGrade.org.
Who can I contact for help with this? For the Leapfrog Hospital Safety Grade, please contact GradeHelp@LeapfrogGroup.org.
How can my hospital promote our "A" grade? Hospitals that are interested in promoting their "A" or "Straight A's" Safety Grade are encouraged to issue a press release about their achievement.
For hospitals interested in using their Safety Grade in paid advertising or other promotional and marketing materials, a licensure agreement is required. Please visit our licensure agent's website, www.leapfroglicensing.org.
Web address: www.leapfroghospitalsurvey.org
What it is: The Leapfrog Hospital Survey is a voluntary, annual patient safety and quality survey that is free to all hospitals in the U.S. It was created to encourage hospitals to publicly report their progress in meeting quality and safety objectives, and it focuses on hospital structures, processes of care and outcomes.
How many hospitals are included? Almost 1,900 hospitals voluntarily report to the Leapfrog Hospital Survey.
What kind of hospitals are eligible? All hospitals are eligible and encouraged to submit data.
What does it measure? The Survey includes a variety of nationally standardized and endorsed measures pertaining to the safety and quality of inpatient care, including maternity care, high-risk surgical procedures, Computerized Physician Order Entry (CPOE) system implementation, ICU physician staffing, and more.
Where does the data come from? Hospitals provide all data for the Leapfrog Hospital Survey directly.
How is the data assessed? All measures on the Leapfrog Hospital Survey are reviewed and approved by a voluntary panel of experts in that subject area. Where possible, measures are harmonized with other reporting entities such as the Joint Commission or the Centers for Medicare & Medicaid Services (CMS) to minimize the reporting burden on hospitals. The Leapfrog Hospital Survey does not have an overall composite score; each measure included on the survey is scored individually.
How long has Leapfrog been doing this? Since 2001
How often are results made available? Leapfrog publishes findings from the Leapfrog Hospital Survey starting in July each year, and monthly through February. From time to time, Leapfrog also releases topical reports on the results of the Survey, offering trends and insights on areas such as maternity care. All results are publicly available on the website.
How do I communicate with patients who have questions about our Survey results? Health care consumers are increasingly becoming concerned with the quality and safety of care they receive at hospitals and are using this information to make a decision on where to seek care. To help patients interpret your Leapfrog Hospital Survey results, refer them to your hospital’s detail page that can be accessed from www.LeapfrogGroup.org/Compare-Hospitals. This will allow patients to see where your hospital has demonstrated strong performance and where there is room for improvement. For areas in which your hospital scores poorly, assure your patients that you recognize this is an area of concern and illustrate what steps you are actively taking to improve the care you provide. Patients deserve full transparency from the hospitals in which they trust their lives and will likely be skeptical if they see your hospital has Declined to Respond to some or all of the Leapfrog Hospital Survey. We hope that you will respond to requests from patients to participate in the voluntary Survey, and escalate this request to your hospital leadership if appropriate. Finally, you can also encourage patients who have additional questions to contact Leapfrog directly at firstname.lastname@example.org.
Where can I find more information? You can find more information about the survey at www.LeapfrogGroup.org/Survey, which also contains the link to the online survey tool that your hospital would use to complete the annual survey. Leapfrog Hospital Survey Results are publicly reported at www.LeapfrogGroup.org/compare-hospitals.
Who can I contact for help with this? For the Leapfrog Hospital Survey, please contact HelpDesk@LeapfrogGroup.org.
|Month||Leapfrog Hospital Survey||Leapfrog Hospital Safety Grade|
|January||January 31: Data Snapshot Date for Spring Hospital Safety Grade.|
|February||Mid-month: Hospital CEOs receive notification indicating that their hospital will receive a Safety Grade this spring. It contains instructions for the Courtesy Review Period.|
|March||Hospital CEOs receive a letter requesting their participation in the Leapfrog Hospital Survey. This letter will contain the security code your hospital needs to access and complete the Survey.|
The Leapfrog Hospital Survey opens on April 1.
|Public release of Spring Leapfrog Hospital Safety Grades.|
June 30: First Leapfrog Hospital Survey submission deadline. Hospitals that do not submit a survey by June 30 will be publicly reported as “Declined to Respond” on the Survey results website. More information about Survey deadlines can be found here.
Leapfrog Hospital Survey Desk Review: Hospitals must review, verify, or correct any potential data entry or reporting errors identified by Leapfrog.
August 31: Hospitals MUST submit a Leapfrog Hospital Survey on or before August 31 in order for it to be used in the Fall Leapfrog Hospital Safety Grade calculations.
|August 31: Data Snapshot Date for Fall Hospitals Safety Grade.|
|September||Mid-month: Hospital CEOs receive notification indicating that their hospital will receive a Safety Grade this fall. It contains instructions for the Courtesy Review Period.|
|October||Public release of Fall Leapfrog Hospital Safety Grades.|
|December||The Leapfrog Hospital Survey closes on December 31. No new surveys or CPOE Evaluation Tools can be submitted after this date.|