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    Mass. hospitals receive top marks

    Using the model of letter grades posted in New York to steer ­diners away from the dirtiest restaurants, a prominent health quality group is grading US hospitals on safety, giving ­Massachusetts medical centers the highest overall scores in the nation.

    The Leapfrog Group planned to post the assessments online Wednesday morning, at The grades are meant to measure how well hospitals prevent errors that kill tens of thousands of patients each year and are designed as a deliberately simple tool for patients choosing where to get care, said Leah Binder, Leapfrog’s chief executive.

    “It’s a fair assessment that I would use as a mother and a daughter,” she said.


    Sixty-two Massachusetts hospitals were included, with 15 receiving a B or C. No Massachusetts hospital received a grade lower than a C, Binder said. Boston’s signature teaching hospitals all received A’s.

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    The grades are based on up to 26 measures, including nurse staffing levels, processes for preventing infection and medication errors, and the rates of patient injuries, bloodstream infections, or surgical errors.

    Binder’s group was created in 2000 by large employers and health insurance purchasers in response to an Institute of Medicine report that found as many as 98,000 patients die in US hospitals each year from medical errors.

    Binder said little progress has been made since then. The rate of harm to patients in 10 North Carolina hospitals, for example, did not significantly change between 2002 and 2007, according to a New England Journal of Medicine study. And the US Department of Health and Human Services reported in 2010 that about 13.5 percent of Medicare patients were harmed during hospital stays, with avoidable errors contributing to about 15,000 patient deaths in a one-month study period.

    “We’re frustrated,” Binder said.


    Much of the patient safety movement has focused on collecting reliable data to measure the problem, said Dr. Ashish Jha, associate professor of health policy at Harvard School of Public Health. But, Jha said, “we have failed to engage consumers on this issue.”

    Jha served as a project adviser to Leapfrog, along with other leaders in patient safety. Jha said the letter grade provides an easy way to compare hospitals and pressure hospital leaders to act, although he acknowledged the system is not perfect.

    Some of the measures are based on voluntary performance surveys hospital officials complete. But most are pulled from safety data used by the Centers for Medicare & Medicaid Services that come from billing records.

    One safety specialist remained skeptical of the format. The letter grade system “is likely to be an oversimplification,” said Bill Marella, director of patient safety reporting programs at the ECRI Institute, a Pennsylvania nonprofit that focuses on patient care.

    Patients often choose a hospital based on a doctor’s referral or a recommendation from family or friends, Marella said. The rankings may influence hospital officials concerned about their reputation, but the simple format may not give them enough information to know where to improve.


    Merrimack Valley Hospital in Haverhill was among Massachusetts hospitals given a C. The Steward Health Care System hospital, along with two other Steward medical centers that received B’s — Nashoba Valley and Quincy — were docked points because they lacked 24-hour physician staffing in intensive care units and computerized systems for doctors to order tests or treatments, said Dr. Justine Carr, Steward’s chief medical officer.

    Carr said the hospitals are installing the computer systems now and will connect their ICUs to intensive care specialists working remotely through video monitoring technology.

    Dr. Robert Klugman, chief quality officer at UMass Memorial Medical Center, which received C’s at two locations, has taken issue over the years with how Leapfrog calculates quality. Klugman said that the hospital system is working on installing a computer entry system and that he is confident in the hospital system’s quality of care.

    Chelsea Conaboy can be reached at Follow her on Twitter @cconaboy.