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Original Article
Safety in Numbers: The Development of Leapfrog's
Composite Patient Safety Score for U.S. Hospitals
J. Matthew Austin, PhD, Guy D'Andrea, MBA, John D. Birkmeyer, MD, Lucian L. Leape, MD,
Arnold Milstein, MD, Peter J. Pronovost, MD, PhD, Patrick S. Romano, MD,
Sara J. Singer, MBA, PhD, Timothy J. Vogbus, PhD, and Robert M. Wachter, MD

Despite the hundreds of thousands of patients who suffer preventable harm each year in US hospitals, patients, health care providers, and health care purchasers lack a standardized method to evaluate patient safety in US hospitals. This lack of standardized evaluation is especially concerning given recent evidence that many US hospitals have made small incremental improvements in safety or continue to harm patients in large numbers. While the number of publicly-reported patient safety measures has grown over the last decade, there is little evidence that patients and providers are using these data to inform their choice of hospital. One possible explanation for the lack of use is that safety data have typically been reported on a measure-by measure basis, requiring patients and providers to synthesize many disparate data points in their decision making process.

Composite measures, which combine multiple performance measures using a pre-determined weighting methodology to produce a single score, provide a more general picture of the safety performance of a hospital, making it more understandable and usable for nonmedical personnel. However, while composite measures are easier for patients to understand, they can mask a hospital's excellent or poor performance on individual measures. Additionally, the pre-determined weights assigned to each measure may not reflect the preferences of individual patients. Nevertheless, the potential to motivate patient and provider response, and thereby improve patient utility, makes it worthwhile to develop a composite measure of hospital patient safety.

This article has been posted by TMIT with permission from the Journal of Patient Safety.

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