Adventist Health Sonora improved from an F to a B in the Leapfrog Group’s fall 2018 hospital safety grades, which are billed as the “nation’s leading scorecard on hospital safety.”

Michelle Fuentes, president of Adventist Health Sonora, issued a statement Friday afternoon that said the hospital’s department of quality and infection prevention spent several months leading teams to implement processes that meet the specific requirements of the Leapfrog Group’s twice yearly survey.
“I am extremely proud of our team’s work and commitment to providing the best possible care for our community,” she stated.

The hospital received the failing grade in April after actively participating in the survey for the first time.

Hospital administrators said at the time that the goal of participating was to improve the grade from a C, which it had received in the prior three years of safety grades released by the Leapfrog Group.

Based in Washington, D.C., the Leapfrog Group is a national, nonprofit organization dedicated to improving health care quality and safety.

The group bills its biannual hospital safety grades as “the nation’s only rating focused entirely on errors, accidents, injuries and infections that collectively are the third leading cause of death in the United States.”

Hospitals are assigned a single letter grade of A, B, C, D, or F based on overall performance at keeping patients safe from preventable harm and medical errors, which studies say kill more than 500 people everyday in the U.S.

Grades are determined using 28 measures from publicly available data, as well as information provided voluntarily to the group by hospitals. More than 2,600 hospitals across the country are assessed twice each year.

In the fall grades, Adventist Health Sonora rated among the best performing hospitals in the nation when it came to performance measures such as leaving dangerous objects in patients bodies, air or gas bubble in the blood, doctors ordering medications through a computer, effective leadership to prevent errors, tracking and reducing risks to patients, and handwashing.

The hospital previously scored low in the “handwashing” category when it received the failing grade, which administrators attributed to not having a specific line item for hand hygiene in annual evaluations of officials whose responsibilities include preventing infections.

Administrators in April noted how the hospital previously did well in most categories related to patient outcomes, but scored below average in process-related categories such as handwashing, tracking and reducing risks to patients, and effective leadership to prevent errors.

“I would say this more accurately represents the level of service being provided by the hospital,” said Julie Kline, patient care executive at the hospital. “What we did as an organization and as a work group was to go back into the numerous areas that Leapfrog measures and make certain we left no stone unturned in our reporting structure that’s required to participate in Leapfrog.”

Among the measures of patient outcomes where the hospital scored above average in the latest round of grades were preventing urinary tract infections, dangerous bed sores, collapsed lungs, serious breathing problems, dangerous blood clots, surgical wounds from splitting open, and accidental cuts and tears.

The hospital also improved its score for having “enough qualified nurses” from a 70.59 to a 94.12 out of 100, with the average performing hospital in U.S. scoring a 97.68 and worst scoring a 29.41 in that category.

Kline said in May that the reason for the low score at the time was because the hospital did not have a specific budget for training nurses, though there were more than 60 online mandatory courses to make sure they understand the hospital’s policies and procedures.

“We hadn’t carved out specifically how much money we spent on specific educational things,” she said on Monday. “I knew what my education budget was as a whole, but where it went to specific areas we didn’t have penciled out. We went through those exercises to make sure things were done correctly.”

“Seeing that score come up was huge,” she added about the qualified nurses. “It validated what i know — that we have such a phenomenal crew.”

The hospital has received numerous recognitions and awards over the years related to its quality of care and trained staffing.

Most recently, the hospital received awards in July from the Collaborative Alliance for Nursing Outcomes for “best performance in preventing hospital acquired pressure ulcers” and “best performance in preventing hospital acquired infections.”

Areas where the hospital was still below average according to the latest Leapfrog survey were for surgical site infections after colon surgery, Clostridium difficile infections, death from treatable serious complications, and having specific trained doctors care for ICU patients.

Most of the data used to come up with the ratings comes from 2015 to this year.

According to the Leapfrog Group, 32 percent of the 2,600-plus hospital graded this fall received an A, 24 percent a B, 37 percent a C, 6 percent a D, and just less than 1 percent an F.

The five states with the highest percentage of hospitals that received an A were located in New Jersey, Oregon, Virginia, Massachusetts, and Texas, while California was ranked 23rd with about 32 percent of hospitals receiving the top grade.

Kline said she thought the time spent reviewing their processes to make sure they better met the requirements of Leapfrog was not a wasted effort and helped validate much of what the hospital has been doing.

“It’s helped rearrange some of the priorities, none of it would I say is critical, but it has been a driver to change some processes,” she said. “I feel like if the public looks to them as a credible source of information about their hospital, then I need to participate so they can be assured that their hospital is doing well.”

Contact Alex MacLean at or (209) 588-4530.