Hospital Safety Grade

Identifying Attributes

Care Settings
Hospital Care
Country
United States of America
Publishing Organisation
The Leapfrog Group
Type of Quality Indicator
Outcome
IOM Quality Dimension
Safety
Domain
Complications and Adverse Events

Defining Attributes

Definition

A composite score of up to 22 national patient safety measures representing a hospital's overall performance in keeping patients safe from preventable harm and medical errors.

Numerator

Hospitals receive a letter grade of A through F based on their overall safety performance. See technical specs for weighting and compositing algorithm.

Denominator

This is a categorical variable using a "report card" style letter grading system.

Exclusions

Critical access hospitals (CAH) • Rural emergency hospitals (REH) • Long-term care and rehabilitation facilities • Mental health facilities • Federal hospitals (e.g., Veterans Affairs, Indian Health Services, etc.) • Some specialty hospitals, such as surgery centres and cancer hospitals • Free-standing paediatric hospitals • Hospitals in U.S. territories • Hospitals that are missing scores for more than six (6) process/structural measures, or more than five (5) outcome measures, or missing PSI 90

Use of Risk Adjustment
Yes
Risk Adjustments

Z-scores

Stratifications

By hospital and state.

Collection and Reporting Attributes

Type of Data Collection
Administrative data, Surveys
Data Collection Methods

Centers for Medicare & Medicaid Services (CMS); Leapfrog Hospital Survey

Frequency of Data Collection
6 monthly
Frequency of Data Collection in Days
182
Reporting Methods

Publicly reported at: www.hospitalsafetygrade.org/

Reporting Frequency
6 monthly
Reporting Frequency in Days
182
Indicator Has Recommended Targets
No

Source and Reference Attributes

Link to Measurement Tools
Quality Indicator Confirmed to be Part of a Program Used to Monitor Quality and Safety of Care Among Older People at a Population-Level between 2012-2022
Yes
Assessed by the Australian Consortium for Aged Care Collaborators as Generally Containing Good Properties (Importance and Scientific Acceptability)
No
Australian Consortium for Aged Care Endorsed
No
Can the Quality Indicator be Readily Implemented at a Population Level in Australia Given its Current Data Landscape?
Implementation of this quality indicator was not assessed.
Identified by PHARMA-Care Project
No
Upload Date
31 March 2026