These are some of the safest (and deadliest) hospitals in America

By Naveed Saleh, MD, MS, for MDLinx
Published June 10, 2019

Key Takeaways

Recently, the Leapfrog Group—a national nonprofit organization that represents the country's largest and most influential employers and purchasers of health care—released its Spring 2019 Hospital Safety Grades. Do you wonder how safe the hospitals are in your state, and whether they made the Leapfrog list? If so, read on.

This independent, nonprofit grading system doles out marks to general, acute-care hospitals across the United States, with grades ranging from "A" to "F." Of more than 2,600 hospitals assessed, 32% earned "A" grades, 26% got "B" grades, 36% "C" grades, 6% "D" grades, and less than 1% received "F" grades.

The Hospital Safety Grade covers 28 quality measures, which are all used by national measurement and reporting programs. These measures include 13 "process and structural messages" (eg, hand hygiene, nursing workforce, nurse communication, and physician communication) and 15 "outcome measures" (eg, foreign object retained, air embolism, falls and trauma, and in-patient methicillin-resistant Staphylococcus aureus infection), with the two domains contributing equally to the overall score.

Leapfrog Safety Grades are informed by safety data collected from the Leapfrog Group, the Agency for Healthcare Research and Quality, the CDC, the American Hospital Association, and the Centers for Medicare & Medicaid Services.

Let's take a look at some of the highlights from Leapfrog's semiannual report.

Best States

The 10 states with the highest percentage of hospitals receiving "A" safety grades included:
  1. Oregon (58.06%)
  2. Virginia (53.03%)
  3. Maine (50.00%)
  4. Massachusetts (48.28%)
  5. Utah (48.00%)
  6. New Jersey (45.59%)
  7. Rhode Island (42.86%)
  8. Ohio (42.20%)
  9. Texas (41.43%)
  10. Colorado (41.03%)

Worst states

The 10 states with the lowest percentage of hospitals receiving "A" safety grades included:
  1. South Dakota (10.00%)
  2. Iowa (9.10%)
  3. New York (7.53%)
  4. Nebraska (7.14%)
  5. Arkansas (6.90%)
  6. West Virginia (4.35%)
  7. Wyoming (0.00%)
  8. North Dakota (0.00%)
  9. Delaware (0.00%)
  10. Alaska (0.00%)
Also, 0.00% of hospitals assessed in Washington, DC, received "A" safety grades.

Avoidable fatalities

This year, the Leapfrog Group worked with the Johns Hopkins Armstrong Institute for Patient Safety and Quality to update estimates of avoidable deaths due to errors, accidents, injuries, and infections at "A", "B", "C", "D," and "F" hospitals.

When compared with "A"-rated hospitals, patients at hospitals that received "D" and "F" grades were found to have a 92% greater risk of avoidable death, patients at "C"-graded hospitals were found to face an 88% greater risk, and patients at hospitals with "B" ratings, a 35% greater risk.

According to Leapfrog, about 160,000 patients die each year due to avoidable medical errors that are accounted for in the Safety Grade. Although disconcerting, this statistic is an improvement from 2016, when there were 205,000 avoidable deaths.

Although "A" hospitals are susceptible to unnecessary deaths, too, they are improving. Indeed, "tens of thousands of lives have been saved because of progress on patient safety," remarked Leah Binder, president and CEO, the Leapfrog Group.

"The bad news is that there's still a lot of needless death and harm in American hospitals. Hospitals don't all have the same track record, so it really matters which hospital people choose, which is the purpose of our Hospital Safety Grade," she added.

Of note, if all hospitals assessed had an avoidable death rate equal to "A"-grade hospitals, 50,000 lives would have been saved compared with 33,000 lives saved in 2016.

Examples of top hospitals

Leapfrog doesn't rank individual hospitals by safety in the form of some master list. Instead, it publishes a short list of top hospitals in the states they are found. These top hospitals are categorized as either teaching, general, rural, or children's.

Let's briefly take a look at one top hospital from each of the top four states with the highest percentage of hospitals that received "A" safety grades in Leapfrog's spring report. (No top hospitals were specifically highlighted for Utah in Leapfrog's short list.)

1. Oregon

Spring 2019 percentage of hospitals receiving "A" safety grades: 58.06%

Fall 2018 percentage of hospitals receiving "A" safety grades: 54.55%

Spring 2019 state ranking: 1

Fall 2018 state ranking: 2

Kaiser Sunnyside Medical Center. Leapfrog ranked Kaiser Sunnyside Medical Center as the top teaching hospital in Oregon in 2018. This 236-bed hospital provides short-term acute care and is located in Clackamas, which is a suburb of Portland. This facility is known, in part, for the Kaiser Permanente Northwest Center for Heart and Vascular Care, which is a regional center for emergency care for heart attacks and strokes, cardiac surgery, diagnostic testing, arrhythmia treatments, and stents and angioplasty. Of note, Kaiser Sunnyside Medical Center ranked fifth for best hospitals in Oregon by U.S. News & World Reports in their list of 2018-2019 Best Regional Hospitals.

2. Virginia

Spring 2019 percentage of hospitals receiving "A" safety grades: 53.03%

Fall 2018 percentage of hospitals receiving "A" safety grades: 51.52%

Spring 2019 state ranking: 2

Fall 2018 state ranking: 3

Inova Alexandria Hospital. Located in Alexandria, VA, Inova Alexandria Hospital is a 318-bed community hospital, which was established way back in 1872. This top general hospital provides care to all demographics, from babies to the elderly, and is known for its cancer services, cardiovascular and interventional radiology, women's services, surgical services, and radiology services.

3. Maine

Spring 2019 percentage of hospitals receiving "A" safety grades: 50.00%

Fall 2018 percentage of hospitals receiving "A" safety grades: 40.00%

Spring 2019 state ranking: 3

Fall 2018 state ranking: 10

LincolnHealth. With two campuses in the coastal communities of Boothbay Harbor and Damariscotta, LincolnHealth was ranked in 2018 as one of the top three rural hospitals in Maine. In Damariscotta, the LincolnHealth–Miles Campus includes a 25-bed community hospital, a multispecialty practice, a skilled rehabilitation and long-term care facility, an assisted living facility, a retirement community, and a residence for those with dementia. The St. Andrews Campus in Boothbay Harbor offers outpatient services, including wound and urgent care, as well as residential care options akin to those at Miles Campus.

4. Massachusetts

Spring 2019 percentage of hospitals receiving "A" safety grades: 48.28%

Fall 2018 percentage of hospitals receiving "A" safety grades: 44.07%

Spring 2019 state ranking: 4

Fall 2018 state ranking: 4

Saint Anne's Hospital. Founded in Fall River by the Dominican Sisters of the Presentation in 1906, Saint Anne's Hospital is ranked a top general hospital in Massachusetts. It's a full-service, acute-care Catholic hospital, and boasts 211 beds and satellites in Attleboro, Swansea, Dartmouth, New Bedford, and Stoughton. The hospital provides nationally recognized inpatient and outpatient clinical services to those from Massachusetts and Rhode Island communities. Specialty services include the Center for Orthopedic Excellence, the Center for Pain Management in Swansea, inpatient geriatric psychiatry services in Fall River and Stoughton, and Saint Anne's Hospital Regional Cancer Center in Fall River and Dartmouth.

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