Patients treated at hospitals that earned “D” or “F” grades when it comes to patient safety face a 92% higher risk of death from avoidable medical errors than at hospitals with an “A” grade, according to a new report from The Leapfrog Group.

In Leapfrog’s Annual Hospital Safety Grades, about 32% of the 2,600 hospitals evaluated received an “A” grade for safety, 26% earned a “B” grade and 36% earned a “C” grade.

The hospital safety group awarded a “D” or an “F” grade to about 7% of the hospitals it examined.

“It was pretty shocking to us and should be pretty sobering to hospitals that are not getting an ‘A.’ It’s really time to take this seriously. You know you can do better,” said Leah Binder, president and CEO of The Leapfrog Group.

In the report, released with the Johns Hopkins Armstrong Institute for Patient Safety and Quality, officials estimated 160,000 people died from avoidable medical efforts in 2018. That’s an improvement from 205,000 avoidable deaths in 2016.

The researchers also found “A” hospitals were getting safer. For instance, they said, if all hospitals had an avoidable death rate equivalent to “A” hospitals in 2018, 50,000 lives would have been saved compared to 33,000 lives that would’ve been saved by “A” level performance in 2016.

“We see now that hospital leadership has already made a difference and I’m hopeful this will be an incentive to recommit to the importance of the patient,” Binder said.

Some industry groups have criticized Leapfrog’s grading and methodology as overly simplistic and potentially misleading. Critics of Leapfrog’s rating system have also called into question its reliance on self-reported safety data.

Hospitals that self-reported compliance with Leapfrog’s Safe Practices did not necessarily have lower hospital-acquired infection rates or lower federal readmission penalties, a 2017 University of Michigan study found.

Binder said the data are “as good as you’re going to get on patient safety,” because the information is very much tied to actual death rates and actual events we know happened. The Hospital Safety Grade uses performance measures from the Leapfrog Hospital Survey, the Centers for Medicare & Medicaid Services and secondary data sources.

Leapfrog also released a state-by-state ranking with the highest percentage of “A” hospitals located in Oregon, Virginia and Maine. There are no “A” hospitals in Wyoming, Arkansas, Washington, D.C., or North Dakota.

“Hospitals that get an ‘A’ put a priority on patient safety. It sounds simple. But it’s very difficult,” Binder said. “There are a lot of competing priorities in hospitals and unless everyone from the top leader to the support staff recognizes patient safety as the number of priority, there will not be change. It’s not something you can treat as a middling priority. It’s a relentless pursuit of what’s best for the patient.”