New Leapfrog Hospital Safety Grade Reveals Significant Increase in Healthcare-Associated Infections and Worsening Patient Experience During COVID-19 Pandemic

WASHINGTON, May 3, 2023—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, released today. 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%; and
• Average CAUTI standard infection ratio increased by 19%.

“The dramatic spike in HAIs reported in this Safety Grade cycle should stop hospitals in their tracks—infections like these can be life or death for some patients,” said Leah Binder, president and CEO of The Leapfrog Group. “We recognize the tremendous strain the pandemic put on hospitals and their workforce, but alarming findings like these indicate hospitals must recommit to patient safety and build more resilience.”

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.

“Not only are HAIs among the leading causes of death in the U.S., they also increase length of hospitalization stays and add to costs,” Binder said. “Our pre-pandemic data showed improved HAI measures, but the spring 2023 Safety Grade data spotlights how hospital responses to the pandemic led to a decline in patient safety and HAI management.”

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.

The Leapfrog Hospital Safety Grade is the only hospital ratings program based exclusively on hospital prevention of medical errors and harms to patients. The grading system assigns a letter grade to nearly 3,000 U.S. general hospitals. It is fully transparent and free to the public, and grades are updated biannually in the fall and in the spring.

For more information about the Hospital Safety Grade, including details on individual hospital grades and state rankings, please visit HospitalSafetyGrade.org.

About The Leapfrog Group

Founded in 2000 by large employers and other purchasers, The Leapfrog Group is a national nonprofit organization driving a movement for giant leaps for patient safety. The flagship Leapfrog Hospital Survey and new Leapfrog Ambulatory Surgery Center (ASC) Survey collect and transparently report hospital and ASC performance, empowering purchasers to find the highest-value care and giving consumers the lifesaving information they need to make informed decisions. The Leapfrog Hospital Safety Grade, Leapfrog’s other main initiative, assigns letter grades to hospitals based on their record of patient safety, helping consumers protect themselves and their families from errors, injuries, accidents, and infections. For more, follow us on Twitter and Facebook, and sign up for our newsletter.