Twenty-five hospitals across the country — 4 of them in Chicago, Illinois — have received a failing grade on patient safety from a quality-improvement organization called The Leapfrog Group.

The organization bases its grades on publicly available hospital safety data that measure how well a hospital averts preventable infections, injuries, and medical and medication errors.

Leapfrog, a coalition of public and private purchasers of health insurance benefits that includes behemoths such as General Motors and FedEx, issued its first safety grades in June 2012 to 2652 hospitals. At that time, Leapfrog did not publicly report Fs and Ds for the hospitals that earned them. Instead, the group put them in a "grade pending" category. Yesterday, Leapfrog published an update to the June 2012 grades identifying the D and F hospitals, which in its words represent "the most hazardous environments for patients in need of care."

Perhaps the biggest name among the 25 hospitals flunked by Leapfrog is the University of California Ronald Reagan UCLA Medical Center in Los Angeles. In response to the Leapfrog grade, the academic medical center issued a statement saying that UCLA's mission of delivering "the safest, highest quality, cutting-edge care" is reflected in numerous rankings and reports. It faulted hospital report-card methodologies used by various quality-improvement groups as being inconsistent.

"The same hospital can rank high on one report card and low on another report card," the hospital stated.

Only one city, Chicago, was home to multiple hospitals with an F grade for safety. Those in the Windy City were Jackson Park Hospital and Medical Center, Loretto Hospital, Norwegian American Hospital, and Roseland Community Hospital.

Table. Hospitals Receiving an F for Safety in Fall 2012 Scores of Leapfrog Group (Alphabetically by State)

Wiregrass Medical Center Geneva, Alabama Hazel Hawkins Memorial Hospital Hollister, California Palo Verde Hospital Blythe, California University of California Ronald Reagan UCLA Medical Center Los Angeles, California Western Medical Center Anaheim Anaheim, California Phoebe Putney Memorial Hospital Albany, Georgia Madison Memorial Hospital Rexburg, Idaho Jackson Park Hospital and Medical Center Chicago, Illinois Jersey Community Hospital Jerseyville, Illinois Loretto Hospital Chicago, Illinois Norwegian American Hospital Chicago, Illinois Roseland Community Hospital Chicago, Illinois Daviess Community Hospital Washington, Indiana Richardson Medical Center Rayville, Louisiana Texas County Memorial Hospital Houston, Missouri Holy Rosary Medical Center Ontario, Oregon Clarendon Memorial Hospital Manning, South Carolina Wallace Thomson Hospital Union, South Carolina Christus Spohn Hospital Beeville Beeville, Texas Gulf Coast Medical Center Wharton, Texas Renaissance Hospital Houston, Texas Renaissance Hospital Dallas Dallas, Texas Renaissance Hospital Terrell Terrell, Texas Buchanan General Hospital Grundy, Virginia Valley General Hospital Monroe, Washington

Massachusetts Has Highest Percentage of Grade-A Hospitals

On a positive note, the percentage of hospitals receiving an A for patient safety increased from 27% to 30% since June. In a coup for New England, Massachusetts led the nation with the highest percentage (83%) of hospitals earning As, with Maine (80%) close behind in second place, and Vermont tied with North Dakota and Delaware (50%) in third place.

New Mexico brought up the rear, with only 7% of its hospitals — one, to be exact — awarded an A.

No single class of hospital dominated the A list, Leapfrog noted. Top honors went to those in rural areas such as Blessing Hospital in Quincy, Illinois; hospitals serving impoverished, highly vulnerable populations such as Detroit (Michigan) Receiving Hospital; and prestigious academic medical centers such as the Mayo Clinic in Rochester, Minnesota, and Brigham and Women's Hospital in Boston, Massachusetts.

Leapfrog said that hospital safety grades are calculated under the guidance of a 9-member panel of patient safety experts. They include Lucian Leape, MD, an adjunct professor at the Harvard School of Public Health, and Peter Pronovost, MD, PhD, director of the Armstrong Institute for Patient Safety and Quality at Johns Hopkins Medicine in Baltimore, Maryland.

To come up with a grade, the panel analyzed 26 measures of publicly available hospital safety data, some from the federal government, some collected by Leapfrog itself, and weighted each measure on the basis of evidence, opportunity for improvement, and impact. Half of the final grade reflected measures that involve the process and structure of care. An example of a process measure is how often a hospital gives an antibiotic to a surgery patient within an hour before the first incision. A structural-measure example is whether a hospital uses a computerized physician order entry (CPOE) system to reduce prescribing errors.

The other half of the safety grade was based on outcome measures, such as the frequency of retractors and other foreign objects left in surgery patients and the rate of central-line associated bloodstream infections.

More information on The Leapfrog Group's safety scores is available on the group's Web site.