New Leapfrog hospital safety grade reveals significant increase in HAIs and worsening patient experience during COVID-19 pandemic

May 9, 2023
CLABSI, MRSA and CAUTI rates spiked to a 5-year high.

The average risk of three healthcare-associated infections (HAIs)— including Methicillin-resistant Staphylococcus aureus (MRSA), central line-associated bloodstream infections (CLABSI) and catheter-associated urinary tract infections (CAUTI)—spiked to a 5-year high in hospitals during the COVID-19 pandemic and remain high, according to The Leapfrog Group’s spring 2023 Hospital Safety Grade data. 

The Safety Grades also show a continued decline in patient experience measures, which are reported by patients and correlated with patient outcomes. 

The Leapfrog Group compared this Safety Grade cycle’s infection data, which covered late 2021 and 2022, to the 2021 Safety Grades, covering the period immediately prior to the COVID-19 outbreak. The analysis found that: 

  • Average CLABSI standard infection ratio increased by 60% 
  • Average MRSA standard infection ratio increased by 37% 
  • Average CAUTI standard infection ratio increased by 19% 

Across the country, increases in infections varied by state: 

  • 32 out of the 50 states had a significant increase of CLABSI, with the biggest increase in West Virginia; 
  • 18 out of the 50 states had a significant increase of MSRA, with the biggest increase in West Virginia; and 
  • 11 out of the 50 states had a significant increase of CAUTI, with the biggest increase in New Mexico. 

The 2023 spring Safety Grades measure six different HAIs using the standardized infection ratio, a statistic that compares the actual number of HAIs at each hospital to the predicted number of infections. Although MRSA, CLABSI and CAUTI worsened, Clostridioides difficile (C. Diff) improved 15% from spring 2021 to spring 2023 and there was not a significant change for surgical site infections following surgery. 

Of the over 30 measures used to generate Hospital Safety Grades, The Leapfrog Group reports on five patient experience measures that have a direct impact on patient safety outcomes: nurse communication, doctor communication, staff responsiveness, communication about medicine and discharge information. Nationally, the average of all five measures declined when compared to pre-pandemic numbers. Compared to the 2021 spring Hospital Safety Grade report covering 2019, the new spring 2023 Hospital Safety Grade results, covering data from 2021 and 2022, found the most significant declines in communication about medicine (4.28% decline) and staff responsiveness (3.46% decline). 

Additional highlights from the spring 2023 Safety Grades include: 

  • Twenty-nine percent of hospitals received an “A,” 26% received a “B,” 39% received a “C,” 6% received a “D,” and less than 1% received an “F.” 
  • The top ten states with the highest percentages of “A” hospitals are: New Jersey, Idaho, Utah, Pennsylvania, Connecticut, North Carolina, South Carolina, Colorado, Virginia and Massachusetts. 
  • There were no “A” hospitals in Delaware, District of Columbia or North Dakota. 

Leapfrog Group release

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