Quality Improvement

Healthcare News of Note: The Leapfrog Hospital Safety Grade shows hospitals ‘significantly’ reduced 3 hospital-acquired infections post-pandemic

November 16, 2023 4:27 pm
  • Hospitals significantly reduced rates of Methicillin-resistant Staphylococcus aureus, central line-associated bloodstream infections and catheter-associated urinary tract infections.
  • Doctors’ Management Services has agreed to pay $100,000 to the Office of Civil Rights (OCR) and implement a corrective action plan as part of the terms of an OCR settlement agreement announced Oct. 31.
  • Americans have less confidence in vaccines for addressing a variety of illnesses than just a year or two ago, and more people accept misinformation about vaccines and COVID-19.

Over the past few weeks, I have found these recent industry news stories that should be of interest to healthcare finance professionals.  

1.  Healthcare-acquired infection scores improve for hospitals, but patient experience scores continue to decline, says new Leapfrog report

Although hospitals are doing better when it comes to reducing healthcare-acquired infections (HAIs) “after significant increases in infection rates during the COVID-19 pandemic,” patient experience scores continue to decline, says The Leapfrog Group’s fall 2023 Hospital Safety Grades report.

“The new grades* are the first to reflect hospital performance post-pandemic,” wrote the report authors. “Nationally, hospitals significantly reduced three HAIs — Methicillin-resistant Staphylococcus aureus (MRSA), central line-associated bloodstream infections (CLABSI) and catheter-associated urinary tract infections (CAUTI) — after CLABSI, MRSA and CAUTI reached a 5-year high during the pandemic.”

Reductions seen

The latest data shows that over 85% of hospitals have improved performance on at least one of the three dangerous infections accounted for in the latest Hospital Safety Grades report:

  • 19% of hospitals have improved in all three infection measures
  • 66% of hospitals have improved one or two of the measures
  • 16% of hospitals have continued to worsen or made no improvement

Worse patient experience scores likely were due to staffing shortages

“Nationally, patient experience scores worsened for the second year in a row, and all states experienced a significant decline in reported patient experience from the fall 2021 to the fall 2023 Safety Grade,” wrote the report authors.

See the full report for which five states saw the “most significant declines” in each patient experience category, including nurse communication, doctor communication, staff responsiveness, communication about medicine and discharge information.

“In talking with hospital leaders, we believe staffing shortages are one key reason for the continued decline,” said Leah Binder, president and CEO of The Leapfrog Group. “Many hospitals are innovating to help make patient experience better, which is critical because these results are disheartening and unsustainable.”   

Highlights across all states

According to the latest report, here are the overall safety-grade findings for 3,000 general hospitals on how well they prevent medical errors, accidents and infections:

  • Nearly 30% of hospitals earned an “A,” 24% a “B,” 39% a “C,” 7% a “D” and less than 1% earned an “F.”
  •  The five states with the highest percentages of “A” hospitals are Utah at 51.9%, Virginia at 50.7%, North Carolina at 47.7%, Pennsylvania at 44.1% and South Carolina at 43.1%.
  • The five states where no hospitals earned an “A” are Vermont, Wyoming, Delaware, Washington, D.C., and North Dakota.

*The Leapfrog Hospital Safety Grade is an “A,” “B,” “C,” “D” or “F” assigned to general hospitals in the U.S., “focused exclusively on how safe they are for their patients,” according to an FAQ. “The grade uses over 30 measures including rates of preventable errors, injuries, and infections, and whether hospitals have systems in place to prevent them.”

2. OCR announces a settlement of $100,000 for a data breach that affected more than 206,000 people in 2017

In an Oct. 31 news release about a settlement under the Health Insurance Portability and Accountability Act (HIPAA) with Massachusetts-based Doctors’ Management Services, the Office of Civil Rights (OCR) also lists best practices that healthcare providers, health plans and others covered by HIPAA can follow to help mitigate or prevent cyberthreats.

Settlement details

“Under the terms of the settlement agreement, OCR will monitor Doctors’ Management Services for three years to ensure compliance with HIPAA,” stated the news release. “In addition, Doctors’ Management Services has agreed to pay $100,000 to OCR and to implement a corrective action plan, which identifies steps that [the company] will take to resolve potential violations of the HIPAA Privacy and Security Rules and protect the security of electronic protected health information.”

The breach was brought to OCR via a report filed with HHS on April 22, 2019, by Doctors’ Management Services, stating “approximately 206,695 individuals were affected when their network server was infected with GandCrab ransomware. The initial unauthorized access to the network occurred on April 1, 2017; however, the company did not detect the intrusion until December 24, 2018, after ransomware was used to encrypt their files. In April 2019, OCR began its investigation.”

OCR Director Melanie Fontes Rainer was quoted in the release: “In this ever-evolving space, it is critical that our health care system take steps to identify and address cybersecurity vulnerabilities … These practices should happen regularly across an enterprise to prevent future attacks.”

Best practices for those covered by HIPAA to follow

Best practices recommended by OCR to mitigate or prevent cyberthreats include:

  • Ensure audit controls are in place to record and examine information system activity.
  • Implement regular review of information system activity.
  • Utilize multifactor authentication to ensure only authorized users are accessing electronic protected health information.
  • Incorporate lessons learned from incidents into the overall security management process.
  • Provide training specific to organization and job responsibilities, and regularly reinforce workforce members’ critical role in protecting privacy and security.

HFMA insight

HFMA offers original content regarding cybersecurity in the healthcare sector, including:

  • My April 10 blogHealthcare News of Note: The healthcare sector was targeted by nearly 24% of cyber-attack activity in 2022.”
  • The Dec. 5, 2022, column “Cybersecurity in healthcare has emerged as a national priority,” by Gail R. Wilensky, PhD.
  • The Nov. 7, 2022, article “Healthcare’s cybersecurity stakes reach alarming levels,” by Eric C. Reese, PhD.

3. New health survey: Americans express less confidence in vaccines for a variety of illnesses and more people believe COVID-19 misinformation

Americans have less confidence that vaccines can address a variety of illnesses than just a year or two ago, “and more people accept misinformation about vaccines and Covid-19,” according to a Nov. 1 post based on findings from a recent health survey* by the Annenberg Public Policy Center (APPC) of the University of Pennsylvania.

Key findings

Results from the APPC’s October 2023 health survey, compared with results from an April 2021 survey, include:

  • Fewer Americans (71%) “think vaccines approved for use in the United States are safe,” down six percentage points.
  • 16% of adults “don’t think vaccines approved in the U.S. are safe,” up from 9%.
  • Fewer Americans (63%) think it is safer to get the COVID-19 vaccine than COVID-19 disease, a decline from 75%.
  • More people (16%) believe that “increased vaccines are why so many kids have autism these days,” up from 10%.

Kathleen Hall Jamieson, director of the APPC and director of the survey, said in the post: “There are warning signs in these data that we ignore at our peril. Growing numbers now distrust health-protecting, life-saving vaccines.”

Additional insight

The survey also asked respondents when they expected to be able to return to their normal, pre-COVID life, and about mask wearing in public, and found:

  • 67% say they have returned to their normal, pre-COVID lives, while 20% say they never will.
  • 75% say they never or rarely wear a mask or face covering.

*APPC’s latest health survey was conducted Oct. 5-12, with a panel of over 1,500 U.S. adults.

HFMA insight

HFMA has provided coverage on vaccine hesitancy over the past few years, including the Feb. 13 Voices in Healthcare Finance podcast episodeVaccination: Good for the community, the industry and your bottom line,” where Jacob Braude, a principal at ZS, discussed his firm’s latest research on vaccine hesitancy. Erika Grotto, senior editor, is the host.

HFMA bonus content

  • Read the November issue of hfm magazine, including the commentary “Solving the nursing crisis: 3 lessons learned from the COVID-19 experience,” by Jeff Richards, MMSc, MBA; the Eye on Washington column “4 reasons results of the 2024 election won’t matter for healthcare,” by Andrew Donahue, FHFMA, CPA; and the Chapter News piece “First Illinois Chapter kicks off 75th anniversary celebration,” by Crystal Milazzo.
  • Listen to the Nov. 6 Voices in Healthcare Finance podcast episode “November policy roundup with Nick Hut and Shawn Stack,” hosted by Senior Editor Erika Grotto.
  • Read the Nov. 13 article “Senate bill would give hospitals a big break from looming Medicaid disproportionate share hospital cuts (updated),” by Nick Hut, senior editor.


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