The annual survey of hospital safety and quality by the non-profit Leapfrog Group and Castlight Health finds improvement and increased participation by hospitals, but also reflects a “surprisingly high variance” in high-risk procedure survival rates and hospital-acquired injury and infection rates.

According to the survey, the predicted mortality rate for esophagectomies varies five-fold across hospitals and six-fold for abdominal aortic aneurysm repair. In addition, among the 1,302 hospitals that reported data for this year’s survey — the largest in the survey’s history — an “alarmingly high” and 131 reported hospital-acquired injury rates of over one in 1,000.

The survey’s findings came out at the same week as the U.S. Senate Subcommittee on Primary Health and Aging held hearings on patient safety. There, Ashish Jha, M.D., of the Harvard School of Public Health, testified that patient’s are no safer today than they were 15 years ago. "In certain areas, things are better, in certain areas things are probably worse, but we are not substantially better off compared to where we were,” he told the committee members.

The Leapfrog survey was not all bad news, however. Among other key findings, it uncovered that the measuring of early elective deliveries as a quality indicator is having a big impact.  The average rate of early elective deliveries was cut by more than half from 11.2 percent in 2012 to just 4.6 percent in 2013 among reporting hospitals.

Hand-hygiene policies are also improving as these become measures of quality, especially in urban hospitals. Rural hospitals still have some catching up to do, the survey found.

In addition, more hospitals are adopting computerized physician order entry (CPOE) to reduce medication errors and there is better compliance with the Leapfrog groups standards for ICU physician staffing. Also, around 80 percent of the hospitals that reported data have adopted Leapfrog’s five principles when a Never Event occurs in their facility. These are:

1. Apologize to the patient and/or family.
2. Report the event to an outside agency.
3. Perform root-cause analysis.
4. Waive costs directly related to the event.
5. Make the policy available to patients and payors.