The number is startling for how large it is. It pops off the page: 440,000 people die each year from preventable errors in hospitals.

As it does twice a year, hospital safety watchdog The Leapfrog Group shines its light on the good, the bad and the ugly with a letter grade – A through F.

What it shows with this fall ranking is sluggish improvement on the safety front, even as some hospitals continue to sustain A ratings year after year, others can't seem to make the grade.

See all hospitals that earned an 'A' in the latest Leapfrog rankings

See all hospitals that earned an 'F' in the latest Leapfrog rankings

Consider this: Of the 28 measures used to calculate the A through F grades, on average, hospital performance improved on eight measures. The bad news? Average performance declined on six of them.

There are some bright spots that shine through the gloom, however, and they are significant and worth noticing for what can be learned from them, says Jillian Laffrey, senior communications and membership coordinator at Leapfrog.

There are 133 "Straight A" hospitals – organizations that have scored and sustained an 'A' each over the two times they're graded year after year – since the launch of the safety score in 2012. They're a diverse group, big and small, serving a wide range of communities.

Straight A hospitals are a diverse group, and demonstrate that any hospital -- no matter their size or community -- has the potential to achieve consistently safe care, says Laffrey.

[Infographic: Fall 2015 Hospital Safety Score update.]

"That tells a really good story of their commitment to day-in, day-out commitment to patient safety, putting it as t top priority and doing everything that they can to making sure that they don't fall," she tells Healthcare IT News. "They are being responsive to their patients, protecting their patients and always looking to improve. It shows that patient safety isn't something that they check off – that's it really a daily commitment."

However, the 133 hospitals represent a small subset – just 5 percent of all hospitals Leapfrog graded.

Still, Leah Binder, president and CEO of Leapfrog sees them as an indicator that any hospital anywhere could achieve high safety scores.

"No matter how large or small, no matter what kind of community they serve, all hospitals have the potential to give their patients this high level of safe care," Binder said in a press statement.

[See also: Leapfrog grades hospitals A to F on patient safety.]

Among the "Straight A" hospitals are three hospitals in the Baptist Health South Florida system, Chicago's Rush University Medical Center and University of Chicago Medical Center, Baystate Medical Center and Beth Israel Deaconess Medical Center in Massachusetts.

Also encouraging, Binder added, are the hospitals showing significant improvement.

Beckley ARH Hospital, part of the Appalachian Regional Healthcare System in Beckley, W.V., made one of the most significant jumps ever. From receiving a D in Spring 2015, the organization is now scoring an A grade.

The hospital now has top scores in CPOE and all five measures of safe surgical practices It also made strides In its scores on falls and trauma, the five Patient Safety Indicator measures, and achieved a rate of zero for central line infections.

Binder urges hospitals to "double down on their commitment to safety."

Although some hospitals have recorded exemplary safety measures and  positive trends for certain hospital-acquired conditions, this most recent update, shows hospitals are performing worse on critical measures such as foreign objects left in after surgery.

[See also: Deaths by medical mistakes hit records.]

Overall, performance on safe practices and process measures varied greatly.

Key findings:

• Of the 2,530 hospitals issued a Hospital Safety Score, 773 earned an A, 724 earned a B, 866 earned a C, 133 earned a D and 34 earned an F.
• Also, 133 hospitals earned the "Straight A" designation, which calls attention to hospitals who have consistently received an A grade for safety since the Hospital Safety Score launched in 2012.
• For the fourth time in a row, Maine claimed the number-one spot for the state with the highest percentage of A hospitals, with nearly 69 percent of its hospitals receiving an A.
• Zero hospitals in the District of Columbia, Alaska, North Dakota, New Mexico, Vermont, or Wyoming received an A grade.
• Due to a considerable data update, 46 percent of hospitals changed at least one letter grade.

The Hospital Safety Score assigns A, B, C, D and F grades to more than 2,500 U.S. hospitals twice per year. It is calculated by top patient safety experts, peer-reviewed, fully transparent and free to the public.

More information about the Hospital Safety Score a list of state rankings here.

To learn how employers are footing the bill for hospital errors, visit Leapfrog's Cost Calculator here.

See the next page for a map of Leapfrog's letter grades.