Patient Experience Tanks as Patient Safety, Hospital Infections Grow

Patient safety events, like hospital-acquired infections, are still too common after hitting a five-year spike during the pandemic, and patient experience scores are taking as a result, according to The Leapfrog Group’s spring 2023 Hospital Safety Grades.

Overall, the report showed that rates of Methicillin-resistant Staphylococcus aureus (MRSA), central line-associated bloodstream infections (CLABSI), and catheter-associated urinary tract infections (CAUTI) are markedly higher now than they were prior to COVID-19’s outbreak.

The Leapfrog Group measured hospital-acquired infection (HAI) rates using the standardized infection ratio, which compares the actual number of HAIs at a facility compared to the predicted number.

This spring 2023 report, which reflects information from late 2021 and 2022, shows HAI standardized ratios that dwarf those from the 2021 report, which reflects data from right before the pandemic.

CLABSI ratios increased the most, with The Leapfrog Group reporting a 60 percent increase from pre-pandemic to 2021 and 2022. For MRSA, that increase was 37 percent, and for CAUTI, that ratio increased by 19 percent.

These findings should be alarming for hospitals, despite the external pressures they face due to the pandemic, according to Leah Binder, the president and CEO of The Leapfrog Group.

“The dramatic spike in HAIs reported in this Safety Grade cycle should stop hospitals in their tracks—infections like these can be life or death for some patients,” Binder said in a statement. “We recognize the tremendous strain the pandemic put on hospitals and their workforce, but alarming findings like these indicate hospitals must recommit to patient safety and build more resilience.”

Some states fared better than others, with some avoiding the significant increase in HAIs detailed in the report. Overall, 32 states had a significant increase in CLABSI, with the biggest spike happening in West Virginia. West Virginia also had the highest increase in MRSA and was joined by 17 other states that also faced a big increase.

Eleven states had a big jump in CAUTI, with the biggest increase happening in New Mexico, the report showed.

There was some good news; while MRSA, CLABSI, and CAUTI all increased from the 2021 spring report to the 2023 report, other HAIs saw improvement. Notably, the researchers detected a 15 percent improvement in Clostridioides difficile (C. Diff) standardized ratios and no change in surgical site infections.

Still, such stark increases in certain HAIs warrant evaluation, Binder indicated, and could signal some pitfalls that happened in hospitals when staff had to respond to an unprecedented public health crisis.

“Not only are HAIs among the leading causes of death in the U.S., they also increase length of hospitalization stays and add to costs,” Binder explained. “Our pre-pandemic data showed improved HAI measures, but the spring 2023 Safety Grade data spotlights how hospital responses to the pandemic led to a decline in patient safety and HAI management.”

What’s more, the 2023 spring report showed a decline in the patient experience factors related to patient safety. Comparing the 2023 report to 2021’s, the researchers said factors like communication about medicine and staff responsiveness both saw declines from pre-pandemic times to 2022.

Particularly, the scores for communication about medicine declined by 4.28 percent, and scores for staff responsiveness declined by 3.46 percent, The Leapfrog Group said.

As usual, The Leapfrog Group Patient Safety Grades also rated participating hospitals on its letter-grade scale. Around one in three (29 percent) hospitals received an A grade, while a quarter (26 percent) received a B, 39 percent received a C, 6 percent received a D, and less than 1 percent received an F.

New Jersey, Idaho, Utah, Pennsylvania, Connecticut, North Carolina, South Carolina, Colorado, Virginia, and Massachusetts had the highest proportion of A-graded hospitals. Conversely, Delaware, the District of Columbia, and North Dakota each had no A-rated hospitals.