Leapfrog shows important gains in patient safety, but execution gaps persist

What’s trending

The Leapfrog Group’s Spring 2026 Hospital Safety Grades report shows measurable improvement in patient safety nationwide across most tracked measures. Despite these gains, scores are still recovering from pandemic-era lows. Progress also remains uneven, with more than 30% of hospitals still scoring a “C” or lower grade.

Overall, hospitals improved in 17 of the 22 safety measures, with the most notable progress tied to healthcare-associated infections (HAIs), medication safety technologies, and patient experience metrics. These include:

HAIs: Rates have returned to pre-pandemic levels, with sharp improvements ranging from 30% to 50% across key indicators, such as central line-associated bloodstream and Clostridium difficile infections.
Medication safety technologies: Adoption of computerized physician order entry (CPOE) and bar code medication administration (BCMA)—both strongly associated with reductions in prescribing and administration errors—has increased significantly.
Patient experience metrics: Five Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) measures saw a modest one-point average improvement from their low in 2023.

The latest release notably omits 450 hospitals that did not participate in the 2024 and 2025 surveys. This comes following a federal ruling to remove safety grades for five hospitals that did not choose to submit data voluntarily. In response, Leapfrog extended the same approach to hundreds of other non-participating hospitals to ensure consistency in its methodology. The facilities are now listed as “grade not assigned.” Leapfrog is appealing the decision.

A forthcoming methodology change in Spring 2027 may further reshape how Leapfrog measures and compares performance. The introduction of a new Failure-to-Rescue measure, along with updated HAI baselines, could impact hospital grades by changing how Leapfrog benchmarks infection performance and factors various safety measures into the overall score.

Why it matters

The improvement reflected in Leapfrog’s latest results is meaningful, but concern remains around uneven quality and safety levels in many organizations and regions. More than 700 hospitals received “C” or “D” grades, and four states had no hospitals receiving an “A” grade at all.

That unevenness matters as transparency in safety performance is continuing to reshape how hospitals are evaluated by patients, employers, and payers. Consumers are increasingly acting on publicly reported data to inform care decisions, while employers and health plans are embedding safety performance directly into network design and benefit structures. In some markets, participation in programs like Leapfrog already influences inclusion in preferred tiers, with direct implications for patient volume, revenue stability, and market positioning.

Recent gains must also be viewed in the context of a still-fragile operating environment. The pandemic demonstrated how quickly quality performance can erode under sustained pressure. While infection rates have normalized, variability persists—often driven more by inconsistent execution than gaps in clinical knowledge. Interventions such as infection prevention bundles and medication safety technologies are effective, but only when reliably implemented.

Leading organizations are differentiating themselves by aligning strategy and execution—connecting board priorities to front-line operations. This includes investing in standardized clinical and operational processes, strengthening measurement infrastructure, and building clear accountability for outcomes.

Just as important is the development of a durable safety culture that persists through disruption and reduces variation across sites of care. Organizations that embed reliability into daily operations, rather than episodic improvement efforts, are better positioned to sustain gains.

The uneven performance across hospitals highlights a major opportunity to make quality and safety a true strategic priority, with direct implications for patient outcomes and overall health. For executives, the implication is clear: the path forward is about building systems capable of consistently delivering high performance. Sustained success will depend on organizations’ ability to perform effectively in complex environments, integrating quality, safety, experience, and operations into a unified model.