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As Patient Safety Improves, Patient Experience Scores Go Down

The Leapfrog Group fall 2023 Hospital Safety Grades reflect a post-pandemic improvement in patient safety measures, particularly healthcare-acquired infections.

America’s hospitals are starting to rebound after a pandemic-imposed downturn in patient safety performance, particularly in terms of hospital-acquired infections, according to the latest fall 2023 Hospital Safety Grades from The Leapfrog Group.

But as patient safety improved, the patient safety watchdog group said patient experience scores went down for the second year in a row.

“Now that we have pre- and post-pandemic data for patient safety measures, we are encouraged by the improvement in infections and applaud hospitals for reversing the disturbing infection spike we saw during the pandemic,” Leah Binder, president and CEO of The Leapfrog Group, said in a press release. “However, there’s still more work to be done. It’s deeply concerning that patient reports about their health care experience continues to decline.”

The semi-annual report awards letter grades to participating hospitals based on a number of patient safety and quality measures, all with the intent of helping healthcare consumers make informed decisions about healthcare access. For the fall 2023 report, the first which The Leapfrog Group compiled using entirely post-pandemic data, the organization assessed more than 3,000 hospitals.

Three in 10 hospitals received an A grade, while 24 percent received a B, 39 percent got a C, 7 percent earned a D, and less than 1 percent received an F. Utah had the most A-rated hospitals in the country, joined by Virginia, North Carolina, Pennsylvania, South Carolina, Connecticut, Montana, Tennessee, Florida, and Texas as top-performers. Vermont, Wyoming, Delaware, Washington DC, and North Dakota had no A-rated hospitals.

This latest report underscores key gains the nation’s hospitals have made in improving patient safety after a five-year high during the pandemic. Particularly, hospitals seriously reduced the rates of Methicillin-resistant Staphylococcus aureus (MRSA), central line-associated bloodstream infections (CLABSI), and catheter-associated urinary tract infections (CAUTI), which are common dangerous HAIs.

In the fall 2022 Safety Grade cycle, hospitals saw a 35 percent increase in the average standard infection ratios (SIRs) of CLABSI and MRSA from pre-pandemic times, plus a 20 percent increase in CAUTI.

In the 2023 Safety Grades, 85 percent of hospitals showed improvement in at least one of the three HAIs assessed in the report; 19 percent made improvement in all three. Only 16 percent continued to worsen or remain stagnant.

But although hospitals have made strides in patient safety, the patient experience continues to falter, the report continued. As part of the Safety Grades, The Leapfrog Group looks at patient reports about nurse communication, doctor communication, staff responsiveness, communication about medicine, and discharge information. Each of these patient experience domains has a link to patient safety.

Overall, scores in these patient experience domains fell for the second year in a row. Declines were steepest in the communication about medicines and responsiveness of staff categories.

The nation’s issue with hospital staff retention and staffing shortages is likely the driving force behind these patient experience missteps, Binder stated.

“In talking with hospital leaders, we believe staffing shortages are one key reason for the continued decline,” she explained. “Many hospitals are innovating to help make patient experience better, which is critical because these results are disheartening and unsustainable.”  

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