Making the Grade

From the thrill of an “A” to the agony of an “F”, most of us have experienced the stress of letter grades in our education.  Letter grades emerged in the late 19th century as educators sought standardized ways to assess student performance. Before letter grades, vague descriptors like “excellent” and “unsatisfactory” were the norm. Mount Holyoke College led the change to letter grades  in 1897 with an A to E system, later adding F in 1898. However, E disappeared from grading scales by 1930, fearing confusion with excellent.

Just like how education has changed over time, the way we evaluate healthcare providers has also evolved.

Florence Nightingale – Setting the Stage 
Florence Nightingale pioneered the practice of collecting data on medical interventions and outcomes in hospitals, despite being best known for her nursing leadership in 1854 during the Crimean War.

Over the next 120 plus years, hospitals collected performance data, though these remained inaccessible to the public. In the mid-1980s, public reports on hospital processes and outcomes began to emerge, initially through state-led initiatives like Maryland’s Quality Indicator Project and New York’s Cardiac Surgery Reporting System (CSRS). National reporting began in 1987 when the Health Care Financing Administration (now CMS) publicly reported hospital mortality rates.

Tadpole Tales: The Birth of the Leapfrog Group
In 1998, business and healthcare quality leaders identified a problem: there was no reliable way to gauge the quality of the healthcare that they were spending billions of dollars on for active and retired workers. They hatched a small idea, like a tadpole, which would soon grow into something much bigger – and so, the Leapfrog Group was born!

In 2001, Leapfrog launched its first Hospital Survey, asking hospitals to publicly report on three key “leaps.” Initially, 200 hospitals participated, with results published on Leapfrog’s website.

Since then, Leapfrog has expanded its metrics, introducing the Hospital Safety Grade. This system evaluates nearly 3,000 general acute-care hospitals twice a year, assigning letter grades (A, B, C, D, or F) based on safety and quality performance. Updated biannually, this report card helps patients make informed healthcare decisions by highlighting hospitals’ strengths and areas for improvement.

Perceptions versus Reality – Take A Test!
Perceptions can often diverge from reality, and this holds true for hospital safety and quality as well. Our views may be influenced by subjective experiences, incomplete information, and personal biases. So, let’s put it to the test! Do you have a particular hospital in mind that you perceive as high- or low-quality?

Click here to see how your perceptions match up with the data!

Happy reading,

Enjoy the weekend!

Best,
Suzanne
Suzanne Daniels, Ph.D.
AEPC President
P.O. Box 1416
Birmingham, MI 48012
Office: (248) 792-2187
Email: [email protected]