Leapfrog Data Show Safety Declines in Pandemic Era
EXECUTIVE SUMMARY
Recent patient experience data suggest the pandemic caused declines in some patient safety-related measures. Poor communication is a common theme.
- Hospitals should assess how their own experiences compare to the reported declines.
- Staff responsiveness declined during the pandemic.
- Patient experience reports are closely aligned with patient safety.
The latest Leapfrog Hospital Safety Grade report from The Leapfrog Group offers insight into the effect of COVID‐19 on patient safety, with several measures showing a significant decline.
The data are consistent with other recent research suggesting the pandemic caused the healthcare industry to lose ground on many patient safety metrics after years of improvement. The lowered performance may be lingering as hospitals and health systems move on from the public health emergency.
The report, “Patient Experience During the Pandemic: Adult Inpatient Care,” indicated the patient experience has declined between the beginning and middle of the pandemic.1
“Leapfrog’s assessment of the HCAHPS [Hospital Consumer Assessment of Healthcare Providers and Systems] survey results between a pre-COVD and mid-COVID time frame uncovers and further confirms patient safety lapses associated with the pandemic time frame,” the report authors wrote. “Areas of patient experience that were already in dire need of improvement before the pandemic began, like transitioning care once out of the hospital, communicating about medications, and hospital staff responsiveness, worsened the most during the pandemic. But regardless of the influence of the pandemic, significant challenges persist across all domains of patient experience, indicative of serious safety and quality problems that must be addressed.”
The findings raise serious patient safety concerns, says Missy Danforth, vice president of healthcare ratings with The Leapfrog Group in Washington, DC.
“One of the things we know about these patient experience measures is that there is a very strong link between those measures and actual patient outcomes,” Danforth explains. “If patients are saying they are having difficulty in communicating with their doctors and nurses, understanding their medications, and what do to after discharge, we know those things are related to readmission and falls in the hospital.”
Compare Your Own Experience
Risk managers can use the latest data to assess how the pandemic may have affected their own institutions in certain ways, focusing on units or areas of care that might have suffered setbacks in the same ways indicated in the survey data.
“Even anecdotally, apart from the data in the survey, a lot of us are hearing from family and friends who were in the hospital recently that their experiences were difficult due to a number of factors,” Danforth says.
Most of the concerns involved communication. The Leapfrog Group’s analysis found lower scores across the board on communication with doctors and nurses. The survey asked whether patients agree with certain statements about their experiences, and the current trend of responses is not good.
“We’re seeing people saying they don’t strongly agree that communication with doctors and nurses, communication about medicines, was effective,” she says. “When you have fewer people saying that communication was good across all of these different areas, that is likely to point to actual problems and potential harm to patients.”
Danforth notes that hospitals are paying more attention to these measures because CMS uses them as part of its value-based purchasing program, with many facilities even employing patient experience officers or similar positions. Risk managers can work with that person to address issues raised in the latest data report or take on the task themselves.
“For one hospital, the concern might be staffing shortages, for example. It is up to the hospitals to analyze their own data and look at specific areas or units of the hospital to search for interventions that are specific to the problems they are having,” Danforth says. “We get the sense that hospitals are paying more attention to these issues because CMS is using the data, but we’re still waiting to see if hospitals are taking corrective actions to address their particular problems.”
Parents Might Not Report Mistakes
Another report from The Leapfrog Group indicated parents and guardians were reluctant to report mistakes about their child’s care at a hospital during the pandemic.
The Pediatric Care2 report is the final part of the group’s three-part series, Patient Experience During the Pandemic. It calls for more transparency and public reporting in pediatric patient experiences.
The analysis addresses pediatric patient experience in hospitals from the pre-pandemic 2019 Leapfrog Hospital Survey and mid-pandemic 2021 Leapfrog Hospital Survey. Hospitals in the Consumer Assessment of Healthcare Providers and Systems Child Hospital Survey collected the data.
The report indicated the pediatric patient experience was mostly stable during the pandemic, even finding that “parents or caregivers reported more favorable responses regarding how well doctors communicate with their child, improving by a statistically significant amount during the pandemic.” That is in contrast to the communication issues highlighted by adult patients in other research by The Leapfrog Group.
But The Leapfrog Group concluded the data also show serious issues with patient safety. “Parents or caregivers of pediatric patients may not feel equipped to report mistakes about their child’s care,” the authors noted. “They indicated the least favorable responses about whether hospital staff check the patient’s wristband to confirm their identity and if parents were told how to report mistakes about their child’s care.”
REFERENCES
- The Leapfrog Group. Patient Experience During the Pandemic: Adult Inpatient Care. May 10, 2022.
- The Leapfrog Group. Patients of hospitalized children may not feel equipped to report mistakes, according to latest Leapfrog Group patient experience report. May 26, 2022.
SOURCE
- Missy Danforth, Vice President of Healthcare Ratings, The Leapfrog Group, Washington, DC. Phone: (202) 292-6713.
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