Patient Data Access News

Simplifying Patient Safety Grades for Patient Decision-Making

The Leapfrog Group's patient safety grades help hospitals guide patient decision-making for treatment options.

Patient safety grades can aid patient decision-making for treatment options.

Source: Thinkstock

By Sara Heath

- Hospital safety grade and patient experience reports are emerging as effective tools to aid patient decision-making about where to receive care. These tools need to be simple, succinct, and usable for the layman because they are patient-facing.

Healthcare is complicated, and industry leaders are working to make it simpler. At CMS, experts developed the star rating guide, which aggregates various factors of the patient experience into a single, five-star rating.

On social media, patients are utilizing websites like Yelp and Healthgrades to give their peers personal testimony about a hospital experience. These tools are especially helpful because they emphasize the points that are specifically important to healthcare consumers.

In a 2017 study published in the Journal of General Internal Medicine, about half of patient respondents said they consult online reviews, while 77 percent of patients in a Software Advice survey said they do the same.

At the Leapfrog Group – a healthcare company best-known for its patient safety grades – experts wanted to combine industry expertise and genuine consumer strategies.

READ MORE: CMS Hospital Star Ratings Release Met with Provider Dismay

The Leapfrog Group developed its patient safety grades approximately six years ago, leveraging expert-informed patient safety metrics and translating them to a consumer-facing scale. According to Leapfrog Group’s Director of Communications and Development Erica Mobley, the team modeled the scale after a burgeoning industry at the time: restaurant sanitation ratings.

 “What we wanted to do was find a very easy and very direct way to go straight to consumers with the really important information about patient safety,” Mobley said in an interview with “We wanted to make something that would be simple for consumers to understand and easy for them to use.”

 “They gave restaurants a letter grade of A, B, C, D, or F on how clean they were,” Mobley continued. “The early results showed that people found that really valuable and a lot of people used that information to choose a restaurant.”

While Mobley conceded to the differences between the two service providers, she maintained that the model was useful in offering patient-centered information.

“Obviously hospitals are not restaurants and there are other factors that need to be considered, but we thought this was a really good model,” she said. “We went forward and created a composite grade for safety that we would present in a letter grade format.”

READ MORE: Online Physician Reviews Stressful for Docs, Useful for Patients

Leapfrog adopted the same grade scale, finding that it’s successful because patients are familiar with it. Individuals know from their experiences in school that they want to see an A grade, are okay with a B grade, but become concerned when the grade is a C or below. Leapfrog keeps things simple by forgoing pluses or minuses.

As noted above, Leapfrog is not the only healthcare group offering a simplified hospital grade. CMS has developed its star rating program to represent the patient experience in a five-star score.

However, CMS hasn’t had much luck resonating with patients or providers. Providers say the star ratings are reductive and don’t take into account the compounding factors dictating the entire patient experience.

Leapfrog avoids that problem by being hyper-focused on patient safety. Patient safety – and the adverse health effects present when safety is left wanting – is a pressing issue in the healthcare industry.

Between 10 and 12 percent of patients experience some sort of harm in the hospital, according to data from the Agency for Healthcare Research and Quality. Separate research from Johns Hopkins Medicine has determined that adverse patient safety events are the third leading cause of death in the US.

READ MORE: How Hospitals Can Raise Patient Satisfaction, CAHPS Scores

“We try to take a very narrow focus on that with it being a safety grade,” Mobley said, noting the importance of patient safety over other patient experience characteristics. “Those are all important factors to consider, but we wanted to remain laser focused on safety, meaning the harm and mistakes that can happen to patients in the hospital.”

Offering patient-facing hospital safety grades has resonated with patients, Mobley added. Simplified scores such as that Leapfrog Group uses are especially helpful for patients.

“A lot of times we hear from people saying that they wish they had this information available before they chose a hospital,” Mobley reported. “If they have a negative experience with a hospital, and then they see it was a hospital that got a C or a D, wishing that they had known that information beforehand.”

Although it is nice to hear in retrospect that safety data has explained a negative hospital experience, Mobley said she hopes patients can have access to hospital safety information before they schedule a procedure.

“Our data is the most valuable when you have time to think about where you’d like to go for a certain procedure like having a baby or a hip replacement – something that isn’t an emergency so you have time to think about it,” she explained.

For example, Mobley recently assisted a patient choosing between two hospitals with different Leapfrog safety grades. The patient’s physician practiced at two hospitals – one with a high grade but long travel distance, and the other with a low grade but closer to home.

Mobley explained the grading methodology and the areas in which the C-grade hospital fell short. Upon discussing this information, the patient chose to stay at the A-grade hospital despite its farther distance.

While experts at Leapfrog are available to help in those situations, this example is the exception, not the rule. Hospitals need to make this information better available to help patients in the above-mentioned situations, Mobley asserted. Advertising high quality and a positive patient experience is more meaningful to patients than advertising all of the bells and whistles, she stated.

“It’s really good to see advertising on a safety grade or any of their other quality metrics that hospitals do well on. It’s encouraging to see hospitals try to advertise themselves based on that information rather than a new MRI machine or short ER wait times,” Mobley explained. “Those things are important, but maybe not as much as good hospital safety.”

And when a hospital receives a low patient safety grade – or another negative quality rating – Mobley recommends they face it head-on and use it as a learning and hospital marketing opportunity. Hospitals that own up to their mistakes and outline an action plan show a commitment to improvement and their patients that is valuable, she argued.

“What I think is really commendable that we’ve seen in a number of cases is hospitals that do poorly coming forward and publicly acknowledging that,” Mobley pointed out.

“Hospitals should come forward and say that they recognize their problems and are working on improving infection rates, for example. They can outline a plan for employee education campaigns for checklists, and use it to tell a story of how to improve and why it’s important. The community can feel assured by this.”

The backbone of these efforts should be connecting with patients in a way that they can understand. Hospitals should confront negative scores and tell a story, and high-performing facilities should lean on the simplicity of the patient-facing grades.

Healthcare organizations can empower their patients with the information necessary for making individual treatment decisions by taking a patient-centered approach to displaying patient safety and experience grades.


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