OVERVIEW OF THE FALL 2016 HOSPITAL SAFETY SCORE
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1 OVERVIEW OF THE FALL 2016 HOSPITAL SAFETY SCORE September 21, 2016 Missy Danforth Vice President, Hospital Ratings, The Leapfrog Group
2 Presentation Overview 2 Program Name and Branding Updates General Info & Eligibility Measure Highlights Reporting Periods Methodology Details of the Courtesy Safety Grade Review Period Important Dates Proposed Changes to 2017 Leapfrog Hospital Safety Grade Questions
3 3 NAME AND BRANDING UPDATES
4 New Branding 4 As of Fall 2016, the Hospital Safety Score will be re-branded as the Leapfrog Hospital Safety Grade Intent is to reduce confusion for consumers and purchasers, and emphasize that this is one of many of The Leapfrog Group s programs/offerings (live when new branding launches with release of letter grades at the end of October)
5 5 ABOUT THE SAFETY GRADE
6 6 What is the Leapfrog Hospital Safety Grade? The Leapfrog Hospital Safety Grade is an A, B, C, D, or F letter grade reflecting how safe hospitals are for patients. The Leapfrog Hospital Safety Grade launched in June 2012 and was formerly known as the Hospital Safety Score. The grade is issued two times per year: April and October. This fall will be the tenth release. More information is available at
7 7 What Hospitals Will Receive a Leapfrog Hospital Safety Grade? General, acute-care hospitals for which there is adequate public data The following hospitals are excluded: Specialty hospitals (i.e., surgical centers, cancer hospitals, women s hospitals, etc.) Critical Access Hospitals Free-standing Pediatric facilities Non-IPPS participating hospitals (hospitals from the state of MD) Hospitals Missing Too Much Data: More than 9 process measures; or, More than 5 outcome measures
8 8 SCORING OVERVIEW
9 Measure Selection Criteria 9 Measures are publicly-reported from national data sources, reflecting individual hospital results Leapfrog Hospital Survey Centers for Medicare & Medicaid Services data sets American Hospital Association s Annual Survey and HIT Supplement Measures are endorsed or in use by a national measurement entity Measures are linked to patient safety ( freedom from harm ) Directly quantifying patient safety events Assessing processes that lead to better outcomes Identified by experts as important to patient safety
10 Process and Structural Measures 10 Measure Name Primary Data Source Secondary Data Source Process and Structural Measures (15) Computerized Physician Order Entry (CPOE) 2016 Leapfrog Hospital Survey 2015 HIT Supplement ii ICU Physician Staffing (IPS) 2016 Leapfrog Hospital Survey 2014 AHA Annual Survey i Safe Practice 1: Leadership Structures and Systems 2016 Leapfrog Hospital Survey N/A Safe Practice 2: Culture Measurement, Feedback & Intervention 2016 Leapfrog Hospital Survey N/A Safe Practice 3: Teamwork Training and Skill Building 2016 Leapfrog Hospital Survey N/A Safe Practice 4: Identification and Mitigation of Risks and Hazards 2016 Leapfrog Hospital Survey N/A Safe Practice 9: Nursing Workforce 2016 Leapfrog Hospital Survey N/A Safe Practice 17: Medication Reconciliation 2016 Leapfrog Hospital Survey N/A Safe Practice 19: Hand Hygiene 2016 Leapfrog Hospital Survey N/A Safe Practice 23: Care of the Ventilated Patient 2016 Leapfrog Hospital Survey N/A H-COMP-1: Nurse Communication CMS N/A H-COMP-2:Doctor Communication CMS N/A H-COMP-3: Staff Responsiveness CMS N/A H-COMP-5: Communication about Medicines CMS N/A H-COMP-6: Discharge Information CMS N/A i AHA Annual Survey, Health Forum, LLC, a subsidiary of the American Hospital Association ii AHA Annual Survey 2014 Health Forum, LLC
11 Outcome Measures 11 Measure Name Primary Data Source Secondary Data Source Outcome Measures (15) Foreign Object Retained CMS N/A Air Embolism CMS N/A Falls and Trauma CMS N/A CLABSI 2016 Leapfrog Hospital Survey CMS CAUTI 2016 Leapfrog Hospital Survey CMS SSI: Colon 2016 Leapfrog Hospital Survey CMS MRSA 2016 Leapfrog Hospital Survey CMS C. Diff Leapfrog Hospital Survey CMS PSI 3: Pressure Ulcer CMS N/A PSI 4: Death Among Surgical Inpatients CMS N/A PSI 6: Iatrogenic Pneumothorax CMS N/A PSI 11: Postoperative Respiratory Failure CMS N/A PSI 12: Postoperative PE/DVT CMS N/A PSI 14: Postoperative Wound Dehiscence CMS N/A PSI 15: Accidental Puncture or Laceration CMS N/A Change in Fall 2016
12 Measure Highlights of the 30 measures have fully updated data since Spring 2016 (both primary and secondary data sources) Leapfrog Hospital Survey Results for CPOE, ICU Physician Staffing, NQF Safe Practices, CLABSI, CAUTI, SSI: Colon, MRSA, and C. diff All CMS measures (HCAHPS, HACs, HAIs, PSIs) AHA HIT Supplement for CPOE The AHA Annual Survey is the only data source that hasn t been updated it is used as a secondary data source for ICU Physician Staffing For Fall 2016, the 2016 Leapfrog Hospital Survey will become the primary data source for the following measures: SSI: Colon MRSA C. diff CLABSI & CAUTI Data CMS data will no longer be used for hospitals that receive Unable to Calculate Score for CLABSI/CAUTI on the Leapfrog Hospital Survey
13 Reporting Periods 13 Leapfrog Hospital Survey Measures The 2016 Leapfrog Hospital Survey includes two reporting periods: Hospitals that submit a survey before September 1, 2016 are asked to report on the 12-months ending December 31, Hospitals that submit a survey on or after September 1, 2016 are asked to report on the 12-months ending June 30, Because the data snapshot date is August 31 st, the reporting period for the Leapfrog Hospital Survey will be listed as 01/01/ /31/2015 for all Leapfrog Hospital Survey measures. CMS Measures A list of reporting periods for CMS measures is available online at
14 Weighting Process 14 Two measure domains, each weighted 50%: Process/structural measures Outcome measures Three criteria for weighting individual measures: Strength of evidence (rating of 1 or 2) Opportunity (rating of 1, 2, 3), based on coefficient of variation Impact (rating of 1, 2, 3) based on: number of patients possibly affected by the event (0, 1, 2, 3) severity of harm to individual patients (1, 2, 3) Weight Score = [Evidence + (Opportunity x Impact)
15 Z-Score Methodology 15 Standardizes data from individual measures with different scales Counts how many standard deviations a hospital s score on the measure is away from the mean Mean is set to 0 Negative z-score: worse than the mean Positive z-score: better than the mean How to Calculate Z-Score from Raw Measure Score: Process/structural measures: (Raw Measure Score Mean)/Standard Deviation Outcome Measures: (Mean Raw Measure Score)/Standard Deviation
16 Overall Numerical Score 16 Summation of z-score for each measure multiplied by the weight for each measure If measure has missing data, then the weight for that measure is re-apportioned to other measures within the same domain 3.0 is added to each hospital s final numerical score to avoid possible confusion with interpreting negative patient safety scores CPOE z-score CPOE weight + IPS z-score x IPS weight + CLABSI z-score CLABSI weight.... etc.
17 17 DETAILS OF THE COURTESY SAFETY GRADE REVIEW
18 Secure Website 18
19 19 Contact Information
20 20 Source Data
21 Where to Locate Source Data 21 Leapfrog Hospital Survey Table provided in Data Review Instructions Leapfrog Performance Category Displayed on Leapfrog s Public Reporting Website Measure Score for Hospital Safety Score Calculation Fully meets standard 4 filled-bars 100 Substantial progress 3 filled-bars 50 Some progress 2 filled-bars 15 Willing to report 1 filled-bar 5 Declined to respond See Uses of Secondary Data
22 Where to Locate Source Data - CMS 22 Enter MPN without the Dash in Search Box
23 Where to Locate Source Data AHA 23 AHA Data is used for hospitals that didn t submit a 2016 Leapfrog Hospital Survey by August 31, AHA Annual Survey Secondary data source for ICU Physician Staffing 2015 HIT Supplement to the 2014 AHA Annual Survey Secondary data source for CPOE Please contact the AHA Health Forum for more information
24 24 What if the Measure Score Doesn t Match the Public Report? Hospitals are asked to contact the help desk immediately once they have confirmed the data source, measure, and reporting period. Hospitals must provide a copy of the public report that shows the different score. If we find a recording error, we will update the score and re-issue a numerical score and safety grade.
25 25 Preview Numerical Score
26 Important Dates 26 August 31 st Data Snapshot Date For hospitals that have submitted a Leapfrog Hospital Survey by August 31, 2016 TBA will be sent to the hospital CEO and primary survey contact listed in the profile section of the online Leapfrog Hospital Survey. For Hospitals that have not submitted a Leapfrog Hospital Survey by August 31, 2016 TBA Letters sent to CEOs of hospitals receiving a Leapfrog Hospital Safety Grade. Both s and letters will include: Information about the Leapfrog Hospital Safety Grade Username/password to a secure website where hospitals can review the source data that Leapfrog used to calculate their numerical score Links to the Hospital Safety Grade help desk and other helpful documents September 14 th October 4 th Courtesy Safety Grade Review Period End of October Hospitals will be able to preview letter grades prior to the public release End of October Letter Grades will be published at For more information about important dates, visit:
27 27 Proposed Updates to the 2017 Leapfrog Hospital Safety Grade Spring 2017 ICU-only data will continue to be used for CLABSI and CAUTI in the Spring 2017 Hospital Safety Grade. The 2016 Leapfrog Hospital Survey will be the primary data source. CMS Hospital Compare data published in October will be the secondary data source (October will be the last time CMS publishes ICU-only data for CLABSI/CAUTI). Fall 2017 All unit data will be used for CLABSI and CAUTI in the Fall 2017 Hospital Safety Grade Leapfrog Hospital Survey will collect all unit data on CLABSI/CAUTI and this data will be used at the primary data source. CMS Hospital Compare will be used as a secondary data source for CLABSI/CAUTI all unit data.
28 More Information 28 Hospital Safety Score Help Desk: Hospital Safety Score Website: (live when new branding launches with release of letter grades at the end of October)
29 Notes 29 Please be sure to review Leapfrog s policy on updating data used in the Hospital Safety Grade. A copy is available on the Data Review Website. Information is also included in the Data Review Instructions and Methodology document. There is a typo on the Data Review Website, and in the Data Review Instructions and Methodology documents: The Reporting Period for the 5 infection measures from the Leapfrog Hospital Survey is: 01/01/ /31/2015 It is not 01/01/ /30/2015 We cannot update this on the website or in the documents until the data review period has closed.
30 30 QUESTIONS?
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