2022 Hospital Safety Grades announced at Leapfrog Group’s annual meeting: excellence and the power of transparency

On Tuesday I attended one of the most inspiring events in the annual calendar of health events: the Leapfrog Group’s annual meeting and awards ceremony. I could talk all day about what an important organization this is, because they don’t just do great work, they’re getting results in the world.

They do a superb job of research, then they do a top-notch job of distilling it down into legitimate summary grades, while letting you click through to see the details. (If you haven’t followed my writing on them, please see my first post ten years ago, which explains what this is all about, with a deep dive into their data and methodology.)

The composite image above brings together four important items from the event. From top:

• If a hospital achieves excellence, they can now post billboards telling people.
• Bottom left is a map of my town, Nashua NH, from their Hospital Safety Grade site. We have two hospitals. One earned an A, the other a D! Don’t you think we all have a right to know that?? Tell people!
• Next to that is a graph of how Leapfrog’s data and methodology are powerful: their per-hospital data on early induced childbirth has produced a dramatic drop. (Some hospitals didn’t realize they were overusing this questionable practice until Leapfrog told them!)
• The speaker is Rob Andrews, who gave the closing address. Obama calls him one of the authors of the ACA. He is inspiring and politically adroit.
• The bottom right image is a slide detailing the bad actions at a hospital that covered up a death (and blamed it on an employee, not their own mediocre management).

All that (and everything below) is a lot of “juice,” yet I was all in a half-day: the plenary sessions in the afternoon. I missed the “deep dive” working sessions in the morning.

Below are some specific items worth noting.

Excellence can be achieved. Weak managers say it’s too hard.

Their Schroeder Award went to Stephen Jones, CEO of Inova Health System, where EVERY HOSPITAL has earned an A in EVERY YEAR since 2018, including through the pandemic. (That’s important because for instance, CMS data says hospital-acquired infections (HAIs) increased 40% during the pandemic … yet every single Inova hospital still got an A, meaning their HAIs didn’t shoot up. They are well managed.)

Leapfrog CEO Leah Binder mentioned that every time it’s proposed in D.C. that hospitals be required to do safety improvements, they typically respond by saying it’s “burdensome.” Yes folks, many hospitals say “it’s too haaaaard,” like a lazy teenager. (This is why it’s so useful to you to know which hospitals just do it instead of complaining. The grades reward them by publicizing their achievement.)

Three sad, true stories of why this matters

In her opening keynote, Binder shared three stories of preventable deaths that were covered up by management that was worried about damage to their reputation if the public knew found out what happened.

#1: Father Florian Gall, killed by “killer nurse” Charles Cullen. Note: although several hospitals fired Cullen, they concealed why, so he killed again and again. This is exactly parallel to how the Roman Catholic Church would transfer a pedophile priest, enabling him to keep perpetrating. She mentioned two Netflix movies on Cullen: https://www.salon.com/2022/11/15/charles-cullen-capturing-serial-killer-nurse/

Story 2 was about Judie Burrows, the mother of conference MC Steve Burrows, as told in his film Bleed Out. She went in for a hip replacement and came out brain damaged. She died ten years later.

Story 3 was about Charlene Murphey, who died in a catastrophic medication error. The hospital (Vanderbilt) solely blamed the nurse (she was convicted), when any student of quality improvement quickly learns that a disastrous error like this one can only happen in a system that doesn’t put in protections to prevent disasters.

As Leah said in the speech, “The nurse showed a breathtaking level of disregard for the patient’s safety.” But so did the administration, by doing nothing to remove the sloppy systems that let the fatal error fall through the cracks. Before or since. (The photo at top includes the intolerable actions by these administrators.)

Note, in each case there was a clear screw-up by at least one employee, but the point here (as above) is that good management solves the problem while weak management hides. Which type of management do you want running the hospital you go to, or the one you send your mother or child to?

You can argue all day long about whose fault such things might be, but Leapfrog jumps straight to the bottom line: who has fixed it?? Who’s getting the job done?

Billboards and Web ads

In addition to the note above about billboards for excellence, someone in the audience suggested, “We should also put up a billboard about our competitor’s BAD safety grade! Everyone thinks they’re hot stuff, and they’re not.” Why not do that?? Don’t you think people have a right to know … and don’t you think the good hospital deserves to be rewarded with people’s business??

It’s about inspiring improvement

The closing speaker was Rob Andrews, a former Congressman from New Jersey who’s been named by President Obama as one of the authors of the Affordable Care Act. Note that the full name of “ObamaCare” is the Patient Protection and Affordable Care Act. He’s a big fan of the Leapfrog Group, and a powerful speaker who focuses on the “why,” not just the what.

Concluding his speech he pointed to how to get people aligned with purpose as they do the work: “You’re not hauling rocks up a hill – you’re building a cathedral.” Amen.