What's New in 2025

Hospital Boarding in the Emergency Department

Boarding patients in the ED after the decision to admit them to an inpatient bed is a long-standing yet increasingly common, quality and safety issue. Studies suggest boarding patients in the ED is associated with delayed and missed care, medication errors, higher morbidity, in-hospital mortality, extended hospital length of stay, and poor
patient satisfaction. According to the Association of Academic Chairs of Emergency Medicine, inpatients boarding in the ED rose nearly 130% from 2012 to 2019, and further increased after COVID-19. We recognize that this problem is complex and often difficult for hospitals to address. But for patients and payors, the risk of inpatients boarding in the ED would be a critical factor in evaluating the safety of a hospital. 

Leapfrog has added questions to assess the percentage of ED patients that are admitted to the hospital that had a boarding time in the ED of more than 4 hours (where lower percentages are desirable), the median length of stay in the ED for patients admitted to the hospital (where lower values are desirable) the 90th percentile length of stay in the ED for patients admitted to the hospital (where lower values are desirable). These questions will not be scored or publicly reported in 2025.

Diagnostic Safety and Quality 

Safe, high-quality hospital care begins with patients receiving the right diagnosis, communicated accurately and in a timely manner. In practice, this process too often fails. Communication breaks down, diagnoses are inaccurate or informed by incorrect information, and patients suffer. Experts estimate that nearly every American will be harmed by at least one diagnostic error in their lifetime. Over the past two decades, our knowledge of how to improve diagnosis in different health care settings has grown substantially, driven in large part by a deeper understanding of how diagnostic errors arise and the realization that many can be prevented. 

Leapfrog has added questions to assess what actions hospitals are taking to reduce harm to patients from diagnostic errors, including delayed, wrong, or missed diagnoses, and diagnoses not communicated to the patient. These questions will not be scored or publicly reported in 2025.