Leapfrog Hospital Safety Ratings and Strategic Communication

Leapfrog Hospital Safety Grade report released in November 2019 rated New Jersey among the leading states in terms of the top ranking hospitals that provide optimal patient safety measures. Among the 69 hospitals that were rated in the state, 55 recorded a high score of either grade “A” or “B.” These excellent outcomes, however, draw the attention to the hospitals that ended up with very low scores of grade “D” within the same state. Presumably, all hospitals in New Jersey are guided by similar laws and probably receive relatively homogeneous nature of support both internally and externally. This review presents a robust comparison between the Atlanticare Regional Medical Center (ARMC) and the City Campus and Trinitas Regional Medical Center (TRMC), which are the top-scoring and the lowest-scoring hospitals respectively. The two hospitals are separated by the differences in their management of safety practices, organizational culture, and the results presented to the Leapfrog Group. The “A” grade hospitals can leverage their ratings by developing latest technology, encouraging a culture of free communication and reporting, creating opportunities for peer learning and skills exchange, and encouraging patient feedback as well as community surveys.


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Comparison between Atlanticare Regional Medical Center and City Campus and Trinitas Regional Medical Center

Both the ARMC and TRMC are based in the same state and have relatively similar facilities. This implies that they are indifferent from each other in terms of their levels of advancement; hence, the similar capacity and potential to provide the best safety standards in their advancement of healthcare services. For instance, the ARMC has 181 acute-care beds and 26 ICU beds, whereas the TRMC has 195 acute-care beds and 26 ICU beds. Consequently, one would expect the similar service levels in terms of patient safety and protection. However, their performance is quite different. Below are the possible reasons that separate the two health care centers.

The two hospitals were rated by the Leapfrog Hospital Safety Group based on five major attributes, namely infections, problems related to surgery, practices aimed at preventing errors, general safety practices, and nurses and doctors’ competency. In most of these categories, the Atlanticare Regional Medical Center scored above the average, mostly getting “A” grades, whereas the Trinitas Regional Medical Center mostly scored below the average. The most distinguishing attribute of all is the infection prevention mechanisms. According to the Leapfrog ratings of TRMC, the hospital scored “D” grades in two major components of infection, namely infection in the urinary tract and infection in the blood (The Leapfrog Group, 2019). Further, in reference to infection, the score obtained by the hospital in surgical site infection after thecolon surgery had was the “C” grade. Aside from infectious disease prevention, other areas in which the hospital scored below the average grades include rectal cancer surgery, pancreatic resection for cancer, lung resection for cancer, and high risk surgery practices such as bariatic surgery for weight loss. On the contrary, the ARMC only scored below the average in terms of infection in the blood and infection in the urinary tract. Therefore, the main difference is that the ARMC has fewer areas of weakness that affect patient safety compared to the TRMC.

The high scores versus low scores between the two health care centers was also majorly attributed to the organizational culture which influences daily practices. Generally, the basic rules for the daily practices established for doctors and nurses to follow differ significantly between two hospitals. For instance, it is stated that nurses and doctors should always wash their hands after attending one patient before they can proceed to provide services to another patient regardless of whether the patients are in the same condition or not. Additionally, the sick individuals infected with infectious pathogens are kept separately from the rest of the patients. On the contrary, persons nursing their ailments in the hospitals that recorded below average grades are highly predisposed to the contraction of infectious sicknesses especially those brought about by bacteria such as methicillin-resistant Staphylococcus aureus (MRSA).

Finally, the grade of the TRMC was adversely affected by the report provided to the Leapfrog Group based on the extent to which the hospital responds to the high risk surgery. However, the ARMC declined to provide the vital information regarding the high risk surgery component of the patient protection. The failure to respond can be interpreted in different ways. The first possible explanation is that the center did not have data prepared on the components requested during the time of survey. Similarly, it can be argued that the ARMC deliberately failed to provide the details because of the fear of low scores, and only provided the data on the aspects they deemed the hospital is competent in.

How “A” Hospitals can Leverage their Rankings through Strategic Communication

Strategic communication is considered as one of the strongest attributes that contribute to the high Leapfrog rankings since it affects various areas of hospital organization, which ultimately influences elements of the patient safety. The World Health Organization defines the strategic communication as a framework of the information exchange that focuses on passing vital messages to and from all the key audiences who participate in decision-making on matters that concern health. The stakeholders include healthcare providers, policy makers, and the communities (World Health Organization, 2017). As such, “A” hospitals can take the advantage of this approach to leverage their rankings by developing measures and mechanisms that allow the efficient and effective information exchange and flow. The following are suggested ways in which top-rated centers can benefit from the strategic communication.

Implementing enhanced in-hospital systems of communication is one approach through which the hospitals can leverage their rankings. To accomplish this, the relevant technology should be availed to support the efficient communication. For instance, instead of manual data recording and supervision, these tasks can be digitized so that the information exchange takes place through the use of universal hospital portals that allows the open access to patients’ data while restricting sensitive information to the accessibility of the relevant staff only. Surveillance cameras should also be installed in all the places to facilitate easier acquisition of information about all the patient care processes. However, nurses should be taken through a session of orientation on the need to work independently with minimal worries about the surveillance system in place. This way, healthcare specialists’ individual scores will rise and ultimately contribute to the optimum hospital performance.

Encouraging a culture of free communication and reporting of any information that may have a serious implication to the patient safety is another way in which strategic communication can improve the top hospitals Leapfrog ratings. In the most healthcare organizations, chances of workers concealing information are high. In particular, providers hide the information due to the fear of far-reaching implications. It is the management’s responsibility to demystify such tendencies and encourage the staff to embrace the increased communication regarding their work, except for the information that is deemed confidential.

Peer learning is another component of strategic communication that can be implemented in different ways in the hospital setting. For example, nurses can be rated based on their performance and achievements in various aspects of patient care within the same hospital in order to encourage a culture of competitiveness. Whenever they are graded, there should be subsequent session of appraisal and recognition whereby other members of the staff are encouraged to learn from others. At the local level, the managers of various hospitals within a cluster can as well implement their own local rating in order to share the information on the areas of strengths and weakness. Consequently, managers can collectively perfect on the strengths and improve on various areas of weakness in order to leverage on the Leapfrog ratings.

Finally, patient feedback should also be encouraged both at the hospital level and at the community level. The clients and their caregivers should be encouraged to air their concerns about their perceptions on the extent to which the hospital is responding to their safety needs. Additionally, there is the need to have community-wide surveys so as to establish the concerns of the members of the locality on what is being done right, and what should be done to achieve the optimal service delivery.


In summary, Leapfrog Hospital Safety ratings provide an insight on the essential issues that should be considered by hospitals in order to provide quality safety standards for the benefit of the patients as well as hospitals’ long-term competitiveness. This review considers the position of one highly ranked hospital (the Atlanticare Regional Medical Center- City Campus) in relation to its lowly ranked counterpart (the Trinitas Regional Medical Center). Both of them are based in New Jersey and have similar infrastructure and patient-care elements. However, the Leapfrog Group scored the ARMC and TRMC with “A” and “D” grades respectively. Possible explanations for this difference include a low score in major components of infection in the TRMC compared to its counterpart. Similarly, the organizational cultures of the two hospitals differ significantly and thus, account for the difference in the scores obtained. However, since the ARMC declined to provide other vital information regarding the high risk surgery, it may have accounted for the huge difference in the score. The top ranking hospitals have an opportunity to use strategic communication to leverage their performance by developing latest technology, encouraging a culture of free communication and reporting, peer learning and skills exchange, and encouraging patient feedback.

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