Hospitals cut safety-related patient deaths by 22% since 2016: Leapfrog

May 15—A national safety-grading group concluded that a combination of factors enabled hospitals to reduce annual safety-related deaths by 45,000, or 22%, since 2016.

The spring 2019 safety grades released this week by the Leapfrog Group, a national nonprofit representing large employers and purchasers of healthcare coverage, found an estimated 160,000 deaths stemmed from avoidable medical errors. That was a big cut from 2016, when an estimated 205,000 such deaths occurred.

The reduction came even as total admissions increased from 35.4 million to 35.7 million since 2016, according to data from the American Hospital Association.

The progress was credited to hospital improvement on several measures, including staffing intensive care units with physicians trained in critical care medicine. Research has attributed a reduced risk of mortality to that practice, said Erica Mobley, director of operations for Leapfrog Group.

Most avoidable deaths stem from errors that lead to infections, especially MRSA and central line-associated bloodstream infections, Mobley said.

The mortality figures fall far short of some research estimates that as many as 400,000 annual deaths occur because of hospital safety errors. The Leapfrog survey only assesses impacts from specific safety initiatives and the extent to which they are used, Mobley said.

“Hopefully this does represent progress from that [research], but there’s still a long way to go,” Mobley said.

It’s unclear whether the recent reduction in lost lives was part of an ongoing trend because this year marked only the second time that Leapfrog has performed the calculation.

What the grades may mean to hospitals

Mobley increasingly has seen hospitals promoting their safety grades as part of the growing consumerism trend, including on billboards touting their grades.

 “The fact that they are promoting their safety rather than how long you have to wait in their ER is a promising sign that they are more committed to this,” Mobley said.

However, Leapfrog’s president and CEO, Leah Binder, was disappointed at the 2019 meeting of the Healthcare Information and Management Systems Society that no vendors appeared focused on patient safety.

What employers may do with the data

The letter-grade assessments of more than 2,600 hospitals aim to provide a qualifiable summation of their efforts to reduce errors, accidents, injuries and infections. In addition to spurring hospital action, the purpose of the grades is to better inform purchasers and consumers. Grading results among hospitals include:

• 32% earning an “A”
• 26% earning a “B”
• 36% earning a “C”
• 6% earning a “D”
• Less than 1% receiving an “F”

However, it’s unclear whether the grades are having the intended impact.

“Are we seeing increased interest and are we hearing more people talking about it? Yes,” Mobley said. “Are we seeing employers actually [using it]? Not really.”

Health plans are interested in the results, and some are discussing incorporating the data into their efforts to create “high-performance networks.”

“There’s a lot of intentions to do so, but we unfortunately just don’t see it yet,” Mobley said. “We are all frustrated with the slowness with which these initiatives are put into place.”

The disconnect likely stems from the lack of high-performing hospitals in some markets, she said. Instead of using the safety grades to exclude hospitals from provider networks, employers appear to be focused on developing relationships with centers of excellence, where they send their high-cost elective surgical cases.

States with the highest numbers of safe hospitals

The five states with the highest percentages of “A” hospitals are:

• Oregon (58%)
• Virginia (53%)
• Maine (50%)
• Massachusetts (48%)
• Utah (48%)

The survey found 41 hospitals that have achieved an “A” in every update since the launch of the safety grades in spring 2012. Those perennial high-performers include nationally recognizable leaders in healthcare innovation and delivery but also smaller hospitals.

“We’ve seen, throughout the history of the safety grade, hospitals of all shapes and sizes and varieties able to earn an ‘A’ — from the large, well-funded academic medical centers to small hospitals in rural communities that really face a lot of challenges and don’t have the funding,” Mobley said.

The range of high-performers likely is possible because many of the steps advocated by Leapfrog as effective ways to improve safety are not expensive. For example:

• Hand hygiene policy
• Leadership training focused on safety
• Processes to avoid so-called “never events”