"It certainly feels that way, and you can't draw any other conclusion when 35% of the [Leapfrog] equation is derived from self-reported measures."
When Leapfrog released its report card in June, he says, the hospital was listed with a "grade pending" to indicate a D or F, and he should have complained then. Had UCLA officials done that, he says, "Leapfrog probably would have fixed it, or they would have put an asterisk by our score."
Nancy Foster, vice president of quality and patient safety for the American Hospital Association, last June heatedly criticized the scoring system on a variety of points. But in an e-mail to address the updated report card, she says that Leapfrog "has made some important changes in its scoring methodology, in that they minimize scoring disparities between those that report to AHA."
However, she says the AHA is "still concerned that they [Leapfrog] continue to use data that is being retired from Hospital Compare because the measures do not provide an accurate picture of the quality efforts in many hospitals today."
She added that patients should use all tools at their disposal, including talking with their doctors, nurses, friends, and family, in making healthcare choices, and not rely solely on Leapfrog's safety scores.
Shannon Phillips, MD, quality and patient safety officer at the Cleveland Clinic, regretted that her hospital showed up with a D, which was even lower than the C it received in June.
"Many of these measures come from the public space (reflected in statistics posted on Hospital Compare) and we know our performance in them, and we know many of them have improved," Phillips says, due to the efforts of the hospital’s dedicated quality improvement team. "But [the data Leapfrog uses] is a rolling three-year average. It takes a long time for data they're looking at to reflect our current work."
She says that she has yet to delve into the methodology to see all the reasons the Cleveland Clinic did so poorly. But she notes that one element is that the Cleveland Clinic several years ago stopped voluntarily reporting to Leapfrog.
Doug Patten, MD, senior vice president of medical affairs for 101-year-old Phoebe Putney Memorial Hospital, a 445-bed facility in Albany, GA, says he "patently disagrees" with his hospital's F grade, saying that's not reflected in current federally reported data.
"Much of what Leapfrog is using is three or four years old," he says, "and is based on some proprietary methodology, capriciously assigning adverse grades to someone."