Methodology and experts
Calculated under the guidance of The Leapfrog Group’s nine-member Blue Ribbon Expert Panel, the Hospital Safety Score uses 26 measures of publicly available hospital safety data to produce a single score representing a hospital’s overall capacity to keep patients safe from infections, injuries, and medical and medication errors.

The panel includes: John Birkmeyer (University of Michigan), Ashish Jha (Harvard University), Lucian Leape (Harvard University), Arnold Milstein (Stanford University), Peter Pronovost (Johns Hopkins University), Patrick Romano (University of California, Davis), Sara Singer (Harvard University), Tim Vogus (Vanderbilt University), and Robert Wachter (University of California, San Francisco). 

"Developing the Hospital Safety Score was an intensive nine-month process led by a group of patient safety experts from across the country, and we believe it resulted in a fair metric to assess a hospital’s performance on patient safety," said Jha. "There is an overwhelming amount of information out there that could be useful when we are admitted to the hospital, but very few of us know what it is or where to find it. Everyone deserves the same information to protect their families. We’ve been glad to guide The Leapfrog Group in developing the Hospital Safety Score to give the public a way to guide their own decisions."

The blue ribbon expert panel designed the methodology for hospitals with the most data publicly available at the national level: general short-stay hospitals. As a result, excluded from this first round of the Hospital Safety Score are critical access hospitals, specialty hospitals such as children’s hospitals and cancer hospitals, government hospitals such as VA and military hospitals, and long-term care facilities.

To develop the Hospital Safety Score, the blue ribbon panel gathered data publicly reported at the national level, including measures reported by the federal government via the Centers for Medicare and Medicaid Services (CMS) and the annual Leapfrog Hospital Survey.

The final 26 measures calculated in the Hospital Safety Score cover falls and trauma, central line-associated bloodstream infections, very severe pressure ulcers, and preventable complications from surgery such as foreign objects retained in the body, postoperative hazards, and accidental punctures or lacerations. The Hospital Safety Score also credits hospitals on measures of the procedures and protocols known to prevent infections, errors and accidents, such as strong nursing leadership and engagement, hand hygiene policies, computerized physician order entry systems, adherence to medical and medication protocols that prevent complications, safety-first organizational leadership and culture, and the right level of staffing for the ICU.

Not all hospitals make the full list of 26 measures publicly available, in which case the Hospital Safety Score was calculated only for the available measures. The blue ribbon expert panel required at least 14 measures for a hospital in order to calculate a Hospital Safety Score. Those without 14 measures were not scored. Unscored hospitals include all hospitals from the State of Maryland, and certain territories including Guam and Puerto Rico, which the federal government excluded from required public reporting at the national level.

“Residents of Maryland, Guam and Puerto Rico should be very concerned that they do not have information on safety that other U.S. residents have,” said Binder, a Maryland resident. “We will be working to improve hospital transparency, and people should contact their elected officials and local hospitals to insist on better public disclosure.”