To improve patient safety, hospital leaders must make it a top priority

When it comes to driving improvements in patient safety in a hospital, the entire organization needs to make it a priority, analysts say.

But there’s no getting around the fact that the top leadership of the hospital need to be highly engaged and invested in protecting patients.

Hospitals that are succeeding in patient safety generally have strong commitment from the C-suite, says Katie Stewart, director of health care ratings for The Leapfrog Group.

The Leapfrog Group released its Spring 2025 Hospital Safety Grades today, and hospitals receiving higher grades typically have leaders pushing to do better in patient safety.

“So when we look at ‘A’-graded hospitals in general, and certainly those that have consistently earned an A, these are hospitals that are putting patient safety first and putting their patients first every minute of every day,” Stewart says.

“It requires an absolute commitment from the C-suite level to see real change. So that C-suite is driving the culture of putting patients first," she adds. "And also these hospitals have systems in place to prevent errors, injuries and infections, all the things that we look at in the end, in the safety grade.”

(See part of our conversation in this video. The story continues below.)

Staff throughout the hospital need to be empowered to flag concerns about issues that could affect patient safety, and clinicians and healthcare workers throughout the health system all play an important part in protecting patients, Stewart says.

But she adds that it’s still up to leaders of hospitals to set the tone and ensure that staff are focused on safety and watching for any potential issues that could harm patients.

“We call that a culture of safety,” Stewart says. “But it does start really at the C-suite level, and it trickles down, and it's immensely important. And it's one of the measures included in the safety grade, and certainly impact several of the measures too, in terms of making sure that staff feel like they're able to speak up if they see a patient safety error or things that can compromise patient safety.

“Culture of safety is immensely important, but it does start often with that C-suite being committed to a culture of safety, committed to creating an environment where their staff feel comfortable speaking up,” she says.

• Read more: Hospitals making strides in Leapfrog Group's Spring 2025 Safety Grades

Hospitals that are looking to improve in patient safety need to closely examine their data to see where they can do better.

When The Leapfrog Group sees hospitals that have scored higher compared to previous safety grades, they often see leaders of those organizations pushing to improve.

“The number one thing that we like to highlight and see is that commitment from leadership,” Stewart says. “So it really shows in some of these hospitals where maybe they're underperforming. You can see how a commitment from leadership to change really impacts patient safety.”

“So again, it requires that commitment from leadership. It requires that you're looking at your performance and reporting it and being transparent to your community,” she adds.

• Read more: These 11 hospitals have earned an 'A' on every Leapfrog Group report card

Hospital executives also point to the role that leaders have in setting the tone for patient safety.

Jack Lynch, the president and CEO of Main Line Health, stressed the importance of patient safety at the Pennsylvania-based health system. Lynch also said the system focused intensely on improving health equity and closing disparities in care as a key in its effort to protect patients. Those efforts helped Main Line Health earn the American Hospital Association’s Quest for Quality Prize in 2023.

““I contended a number of years ago that you're kidding yourself if you're committed to quality and safety, and you're not committed to equity,” Lynch told Chief Healthcare Executive in a 2023 interview. “Because what that says to me is, ‘I'm committed to safety and quality for people that look like me.’

“And when an institution says, ‘We're committed to equity, and the elimination of disparities of care,’ that says, ‘We're not just concerned about the people who look like me. We're concerned about every single person in our community,’” he said.

Tejal Gandhi, the chief safety and transformation officer at Press Ganey, said hospital leaders need to see the link between staff engagement and patient safety.

In a discussion at the Hospital + Healthcare Association of Pennsylvania Leadership Summit in April 2024, Gandhi said a culture of safety is tied directly to the performance of overall engagement.

“There are tight correlations between your performance on safety culture, your performance on inclusion and belonging, and the performance on overall engagement,” Gandhi said.

“If you feel like you belong, and your background is valued and matters, you're going to be more likely to speak up around a safety concern and more likely to be engaged in your organization,” she said.