How Safe is Your Hospital?

Frequently Asked Questions About The Leapfrog Hospital Safety Grade

Who is The Leapfrog Group?

Founded in 2000 by large employers and other purchasers, The Leapfrog Group is a national nonprofit organization driving a movement for giant leaps forward in the quality and safety of American health care. For 20 years, we have collected, analyzed, and published health care ratings to give the public critical information to make decisions about their health care. Leapfrog works with expert panels of top national researchers in concert with the Johns Hopkins Armstrong Institute for Patient Safety and Quality to assure validity and reliability.

What is The Leapfrog Hospital Safety Grade?

The Leapfrog Hospital Safety Grade is an “A,” “B,” “C,” “D,” or “F” assigned to general hospitals in the U.S., rating how safe they are for their patients. The grade uses over 30 measures including rates of preventable errors, injuries, and infections, and whether hospitals have systems in place to prevent them. Grades are updated twice annually, in the fall and spring. The Safety Grades are based on a peer-reviewed methodology, calculated by top patient safety experts under the guidance of a National Expert Panel, and are 100% transparent and free to the public.

What is the difference between the Leapfrog Hospital Survey and the Leapfrog Hospital Safety Grade?

The Leapfrog Hospital Survey is an annual voluntary survey in which Leapfrog asks hospitals to report quality and safety data and then publicly reports that information by hospital. The Leapfrog Hospital Safety Grade is a letter grade Leapfrog bi-annually assigns to general hospitals in the United States, whether they voluntarily report data to Leapfrog or not. If a hospital does not report to the Leapfrog Hospital Survey, other sources of data are used to calculate a Grade. The majority of data used to calculate the Safety Grade comes from the Centers for Medicare and Medicaid Services (CMS).

Does a hospital get a better Safety Grade if it reports to the Leapfrog Hospital Survey?

The more information Leapfrog has about a hospital’s safety, the more opportunity hospitals have to tell their story. Participation in the Leapfrog Hospital Survey gives hospitals the opportunity to report additional information about their safety measures. If a hospital performs well on certain measures on the Leapfrog Hospital Survey, they have the opportunity to earn more points in their Hospital Safety Grade for those certain measures than they would if they did not report to the Leapfrog Hospital Survey. This is because the data hospitals report to Leapfrog is more comprehensive than data available from other publicly available sources. On the other hand, hospitals that perform poorly on Leapfrog Hospital Survey measures that are included in the Safety Grade will also feel the impact of that performance on their grade.

Why don’t I see my hospital?

Unfortunately, not all hospitals have enough data publicly available to be eligible for a grade. As per Expert Panel guidance, The Leapfrog Group has requirements for the minimum amount of data we accept for grading. Many rural or small hospitals  are unable to report substantial data to the federal government because of low patient volumes or fewer services. For instance, hospitals without an intensive care unit (ICU) cannot report on ICU-specific measures. Absence of a grade does not mean a hospital is unsafe; it means Leapfrog does not have enough data to assign a grade.

How is the data assessed?

The Expert Panel regularly convenes to reassess and recommend a weighting formula for each measure in the Hospital Safety Grade. The assessment is made on three main criteria: strength of the evidence, opportunity for improvement nationally, and impact on patient well-being. The scoring methodology is published in detail, and hospitals are given tools to analyze how their own grade was derived.

Does the fall 2021 Hospital Safety Grade reflect a COVID time period?

Data in the fall 2021 Safety Grades are mainly from a pre-COVID time period though some data from 2020 and 2021 is used. All five infection measures included in the Safety Grade contain one quarter of 2020 data (7/1/20 – 9/30-20) in addition to three quarters of 2019 data. Hospitals that submitted the 2021 Leapfrog Hospital Survey reported on the three most recent months for three measures: computerized physician order entry (CPOE), ICU physician staffing, and bar code medication administration (BCMA). Hospitals that did not report to the 2021 Leapfrog Hospital Survey have historical or like facility data imputed into their overall grade for the fall.

If sick, should patients avoid a “C,” “D,” or “F” hospital? What should people do if the only hospital in their community is a “C,” “D,” or “F?”

Patients should never refuse care or avoid a hospital in an emergency because of the Leapfrog Hospital Safety Grade. But when they have a choice, the Hospital Safety Grade offers important information and people should be discerning, because not all hospitals are the same. Leapfrog offers guidance and resources on our website for patients and family members to protect themselves during a hospital stay, which are important no matter the hospital’s grade. As patients seek care, we encourage patients to be their own advocate, and involve a family member or loved one, including via phone or video conferencing, when possible, who may also be able to advocate on their behalf.