The Leapfrog Group has released a summary of three key changes for its 2024 hospital survey, which opens on April 1.
The group — known for its hospital safety grades published each spring and fall — convenes experts to review the survey every year to ensure it "aligns with the latest science and public reporting needs of purchasers and consumers." Public comments are collected once proposed changes are issued. The patient safety organization's research team then reviews public comments and pilots an updated version of the survey before finalizing changes ahead of the April 1 launch.
Three key changes for the 2024 version:
1. The scoring algorithm for informed consent was updated. Specifically, a question has been added regarding whether hospitals solicit feedback from patients/legal guardians at least once a year to understand how informed consent processes can be improved. The question is required, though responses will not be scored or publicly reported in 2024. Leapfrog said it decided to wait an additional year before including it in scoring and reporting based on feedback in which commenters requested additional clarification on appropriate methods to solicit patient feedback.
2. Leapfrog is removing the elective deliveries measure (PC-01) from its survey due to CMS' decision to retire the measure from Inpatient Quality Reporting and The Joint Commission's decision to remove it from their accreditation requirements at the start of this year. The organization said it is "deeply disappointed with the decision" to cut the measure because data shows that some hospitals continue to experience high rates of early elective deliveries, and that it will add a question about whether hospitals have a policy in place to prevent elective deliveries.
3. Several changes were made to update questions and scoring for nurse staffing and skill mix, which can be found in full here. As part of the updates, Leapfrog has limited the types of inpatient units included in the total nursing care hours per patient day, RN hours per patient day and nursing skill measures to single acuity adult and pediatric medical, surgical and med-surg units.
Additionally, it will not move forward with a proposal to create a composite score for the nursing workforce. Instead, it will continue to score and report total nursing hours per patient day, RN hours per patient day and nursing skill mix separately. Leapfrog also addressed concerns from some hospital leaders who said emerging nursing models that lean more on licensed practical nurses and virtual nursing may not be recognized in these measures, saying it agrees that these are "promising models" and that it will continue to watch for literature supporting the benefits of such models.