Hospitals Give Leapfrog Safety Scores a Failing Grade

Cheryl Clark, for HealthLeaders Media , June 7, 2012

Asked if the Leapfrog Group methodology is fair, Martin Ciccocioppo, vice president of the Hospital and Healthsystem Association of Pennsylvania, answers bluntly, "No. This is a way of looking at a plethora of data and trying to dumb it down to a few data points. I don't want to seem pejorative, but this is not the way to drive a decision at which facility one should seek care."

"They haven't done very damn well at all with it, to be honest," says David Perrott, MD, senior vice president and chief medical officer for the California Hospital Association.

Not only is the scorecard flawed in major ways, he says, "They promised they were going to contact CEOS and the CEOs weren't contacted.  They promised the hospitals were going to be able to reply, but the hospitals weren't given the information. So let me tell you, we didn't receive a lot of this information until the last 24 hours or so...That's the frustration we're having."

California has 260 hospitals eligible for inclusion in the Leapfrog Group report card, more than any other state, and saw 10% receive a grade of D or F, also more hospitals than in any other state.

Perrott, a surgeon from Salinas, explains that among the 26 safety scores in the algorithm are at least six that the federal government plans to eliminate from Medicare's Hospital Compare database by FY 2015, so hospitals will no longer be reporting them starting in October, 2014. I was unable to confirm that Wednesday.

Also, Leapfrog is unfairly including measures such as accidental puncture or laceration during surgery, he says. That's an invalid measure because how hospitals report it depends on the phrases surgeons use when they dictate it into the medical record. If the surgeon mentions the laceration occurred in a patient who already had a lot of scarring from prior surgeries, that would not count. But not all surgeons do it that way, he says.

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10 comments on "Hospitals Give Leapfrog Safety Scores a Failing Grade"

cheryl clark (6/13/2012 at 9:40 AM)
Difference between an adverse event and an event that causes harm. It's my understanding that an adverse event is something that happens that would could have adverse consequences to a patient, but may not have. For example, let's say that a patient gets the wrong medication. That's an adverse event, it wasn't supposed to happen. It was a mistake in care. But it didn't cause the patient harm. (They got aspirin instead of a prescription medication, for example.) the mistake was quickly caught, the patient got the right meds. It's serious, though, because the mistake might not have been caught or the error may have involved a wrongly administered medication that has a higher risk of harmful side-effects. So there is a subtle difference between adverse events and harm. Clearly Jim Lott is correct, that 1/3 of the patients in hospitals are not worse off after their care than before it.

R Daniel King (6/12/2012 at 10:14 AM)
Dear James Lott: The definition of "adverse" contains "detrimental" which means "something that impairs, injures, or causes loss." I believe any patient subjected to an "adverse" event would say they were "harmed."

James Lott (6/11/2012 at 4:37 PM)
Dear R.D. King and Nurse Day: To say that 1 in 3 hospitalized patients experience an "adverse event" is not the same as "...1 in 3 patients suffers HARM from their hospital care." (emphasis added to Ms. Day's quote)




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