New hospital safety report cards released. See how Triangle hospitals stack up.

Korie Dean
·8 min read

Two Triangle hospitals rank among the top in the nation for safety and quality of care, and several others scored high marks, according to watchdog reports released this fall.

The Leapfrog Group, a national watchdog nonprofit focused on health care safety and quality, named its 2021 Top Hospital Award winners Tuesday, and had previously released its fall Hospital Safety Grade list last month.

The group’s Top Hospital Award winners are determined using data from the Leapfrog Hospital Survey, which is voluntary for hospitals to submit. The survey and corresponding awards are used to identify the nation’s top hospitals based on excellence in upholding quality standards across areas of patient care.

More than 2,200 hospitals were considered for the Top Hospital Awards this year, and 149 winners were selected.

UNC Rex Healthcare in Raleigh was selected as one of 72 Top Teaching Hospitals for 2021, while WakeMed Cary Hospital was named as one of 46 Top General Hospitals.

The Leapfrog Group’s Hospital Safety Grade list assigns a letter grade to general hospitals in the U.S. based on how well they prevent medical errors, accidents, injuries and infections that kill or harm patients. Hospital Safety Grades are focused solely on safety, and are assigned using publicly available data, regardless of whether a hospital participates in the Leapfrog Hospital Survey.

Whether you’re deciding where to have surgery, or you’re just curious about the grades Triangle hospitals received, here’s a look at how they stacked up in this fall’s Hospital Safety Grade list, along with more information on UNC Rex and WakeMed Cary’s Top Hospital Awards.

Note: The Leapfrog Group says you should never refuse care in an emergency because of a hospital’s safety grade, but you can use the group’s resources as a guide for planned events and a research tool for potential emergencies.

How are Top Hospital Awards decided?

Leapfrog’s Top Hospital Awards are chosen from the hospitals that complete the Leapfrog Hospital Survey. The group has been conducting the survey since 2001.

▪ The survey is an annual, free and voluntary patient safety and quality survey open to all hospitals in the U.S.

▪ Hospitals report all data for the survey directly to Leapfrog.

▪ The survey focuses on hospital structures, processes of care and outcomes, including nationally standardized and endorsed measures of the safety and quality of inpatient care such as maternity care, high-risk surgical procedures, ICU physician staffing and more.

▪ More than 2,300 hospitals generally participate in the survey.

▪ Top Hospital Award winners are chosen in four categories: Top General Hospital, Top Rural Hospital, Top Teaching Hospital and Top Children’s Hospital.

▪ To be eligible for the Top Hospital Awards, hospitals must also have earned an A on the most recently reported Leapfrog Hospital Safety Grade.

UNC Rex Healthcare, which received a Top Teaching Hospital Award, has received an A rating every year that Leapfrog has offered its Hospital Safety Grade program. It is the only hospital in North Carolina, and one of only 23 nationwide, to receive an A rating every year.

WakeMed Cary Hospital, which received a Top General Hospital Award, received its first A rating this fall, up from a C rating earlier in 2021 and in 2020, 2019 and 2018.

To see if your local hospital participated in the voluntary Leapfrog Hospital Survey this year, visit ratings.leapfroggroup.org and search for the hospital by name or location.

How are Hospital Safety Grades calculated?

Leapfrog’s Hospital Safety Grades are assigned biannually — once in the spring and once in the fall. The Hospital Safety Grade program was established in 2012.

▪ Grades are assigned using letters, with A being the best possible grade and F being the worst.

▪ The overall grades are a composite score of more than 30 evidence-based measures of the basics of patient safety only, including handwashing, entering prescriptions through a computer and the availability of highly trained nurses.

▪ The grades are assigned using data from a variety of public sources, including from the Centers for Medicare and Medicaid Services. If a hospital participates in Leapfrog’s Hospital Survey, which is voluntary, data from the survey will also be used to determine the hospital’s grade.

▪ Grades are generally assigned to nearly 3,000 hospitals. Any general, acute-care hospital in the U.S. for which there is enough publicly available data is included in the grading list.

▪ Individual scores that contribute to a hospital’s overall letter grade fall into five categories:

  • Infections, including how often patients at the hospital contract MRSA, urinary tract infections, blood infections and more.

  • Problems with surgery, including how often dangerous items are left in a patient’s body after surgery and how often surgical wounds split open.

  • Safety problems, including patient falls and dangerous bed sores.

  • Practices to prevent errors, including whether hospital staff practice proper handwashing.

  • Doctors, nurses and hospital staff, including whether the hospital has effective leadership and enough qualified nurses.

For the fall 2021 Hospital Safety Grade list, released last month, North Carolina was among the five states with the highest percentage of hospitals with A ratings.

▪ To see every Hospital Safety Grade in North Carolina, visit hospitalsafetygrade.org and search by state for NC.

Triangle hospital ratings for fall 2021

The following Triangle-area hospitals received an A grade in Leapfrog’s fall 2021 Hospital Safety Grade program:

▪ WakeMed Raleigh Campus. This is the first time WakeMed Raleigh has received an A grade since fall 2018.

▪ Duke Raleigh Hospital. Duke Raleigh has received straight A grades since at least spring 2018.

▪ UNC Rex Healthcare in Raleigh. UNC Rex is the only hospital in North Carolina to receive straight A grades since Leapfrog began the Hospital Safety Grade program in 2012.

▪ WakeMed Cary Hospital. This is WakeMed Cary’s first A grade since at least fall 2018. The hospital previously received C grades in 2020, 2019 and 2018.

▪ WakeMed North Hospital in Raleigh. This is WakeMed North’s first rating by Leapfrog.

▪ Johnston Health Clayton. This is the hospital’s first A grade since spring 2019.

▪ Duke University Hospital in Durham. This hospital has received A grades since fall 2018.

▪ Duke Regional Hospital in Durham. Duke Regional has received straight A grades since at least spring 2018.

▪ UNC Hospitals in Chapel Hill received a C grade this fall, down from A grades dating back to at least spring 2018.

▪ Leapfrog’s analysis shows the hospital scored below average in five of the six measures in the infections category.

Leapfrog recommends patients decide on where to receive care based on a hospital’s current safety grade, but says past grades can “tell you a lot about that hospital’s track record in keeping its patients safe from errors, injuries, accidents and infections.”

How should you use the hospital safety scores?

In a video explaining how to use the hospital safety grades, Leapfrog recommends using the Hospital Safety Grades to inform your decision when choosing a hospital, or to simply learn more about hospitals in your area.

▪ Using Leapfrog’s search tool on the homepage at hospitalsafetygrade.org, you can search for hospitals by hospital name, city and state, just state or by ZIP code.

▪ When you get to your results page, Leapfrog recommends looking for hospitals with the highest grade.

  • If there is more than one hospital with a good grade, look at other things that are important to you when seeking care, such as location of the hospital and its proximity to you.

  • If a hospital doesn’t have a good grade, Leapfrog recommends searching for another location, or talking with your doctor to discuss what you can do to stay safe in the hospital.

The overall letter grade for a hospital gives you the “big picture,” Leapfrog says. But you can also see the individual scores that make up the hospital’s grade.

▪ If there are certain issues or risks you’re concerned about, make sure to check the hospital’s score on that measure. Leapfrog recommends always checking a hospital’s scores on handwashing, blood infections and patient falls.

▪ Each score the hospital receives is also listed with the best and worst score on that measure by any hospital, as well as the average score for hospitals on that measure.

More information on how to use the Hospital Safety Grades can be found at hospitalsafetygrade.org/your-hospitals-safety-grade/how-to-use-the-grade.

What can you do to stay safe in the hospital?

Regardless of a hospital’s safety grade, Leapfrog recommends the following tips to stay safe if you need to receive care at a hospital:

▪ Bring someone with you when you arrive and when you’re discharged. If possible, also try to have someone visit every day of your stay. The extra person can make sure that even when you’re groggy or tired, there’s someone there to be alert, ask questions and advocate for your care. Hospitals might have patient advocates on staff who can also provide these resources.

▪ Be alert and say something. During your stay, you or your companion should take notes to keep track of what’s happening, including if hospital staff and your care team are washing their hands.

▪ Know your medications. Leapfrog recommends keeping track of which medications you’re taking during your stay and why you’re taking them. Don’t be afraid to ask your care team for this information. You can also ask that your care team cross-checks your name with your medications before giving them to you in order to prevent possible mix-ups.