Leapfrog Hospital Safety Grades: Meeting Hand Hygiene Requirements

October 19, 2023

Discover Leapfrog’s specific requirements for hand hygiene and how our RTLS technology can help you meet them. 

Twice a year, hospitals around the country receive a Leapfrog Hospital Safety Grade. The Leapfrog Group was founded in 2000 and is a leading voice for American consumers and purchasers, driving change in the quality and safety of healthcare.  The Leapfrog Hospital Safety Grade is determined by using up to 27 evidence-based measures of patient safety, including hand hygiene policies, preventable errors, falls and trauma, and more.

To calculate scores, The Leapfrog Group assesses data publicly reported by the Centers for Medicare & Medicaid Services (CMS) and data from the Leapfrog Hospital Survey. Hospitals then receive a letter grade ranging from A to F. 

Understanding Leapfrog’s Hand Hygiene Requirements

While all of the grade’s measures are essential for every hospital to adhere to, hand hygiene is a newer standard that was added by Leapfrog in 2019. Here is why proper hand hygiene is necessary to keep patients and staff safe. 

The Importance of Hand Hygiene in Hospitals

Unclean hands are one of the primary ways pathogens are transmitted throughout healthcare facilities. Studies show that microorganisms can survive on hands for varying lengths of time, sometimes even hours. If those caring for patients do not properly clean their hands, these pathogens can easily be transmitted to patients. 

One of the easiest ways to prevent serious infections in the hospital is through proper hand hygiene. While there are clear guidelines for proper hand hygiene procedures, studies have shown that on average, healthcare workers clean their hands less than half of the time they should

1 in 31 hospital patients is affected by healthcare-associated infections (HAIs). It is challenging to know exactly how much improved hand hygiene affects the rates of HAIs. But, according to the Centers for Disease Control and Prevention (CDC), there is evidence that supports the belief that improved hand hygiene drastically reduces HAIs. 

A Breakdown of Leapfrog’s Hand Hygiene Survey Requirements

Leapfrog’s hand hygiene requirements adhere to best practices outlined by a national Hand Hygiene Expert Panel and the World Health Organization’s Hand Hygiene Self-Assessment Framework

The new hand hygiene standard, which applies to hospitals and ambulatory surgery centers (ASC), includes five areas: monitoring, feedback, training and education, infrastructure, and culture. To meet Leapfrog’s survey requirements for Hand Hygiene, hospitals and ASCs have two options:


Adhere to the monitoring domain by:

  • Collecting hand hygiene compliance data on at least 200 hand hygiene opportunities (or a minimum percentage of hand hygiene opportunities) each month, in each patient care unit or ASC
  • Providing individuals who touch patients or items that will be used by patients with feedback on their hand hygiene compliance
  • Using an electronic compliance monitoring system and/or direct observation methods that meet Leapfrog’s criteria for collecting hand hygiene compliance data 

Adhere to the feedback domain by:

  • Providing feedback on hand hygiene compliance data to individuals who touch patients or items that will be used by patients for monthly improvement work
  • Using hand hygiene compliance data for creating action plans
  • Providing feedback on hand hygiene compliance data to hospital or ASC leadership and holding leadership accountable for hand hygiene performance through performance reviews or compensation

Adhere to two of the other following domains:

  • Training and Education
  • Infrastructure
  • Culture


Adhere to the monitoring domain by: 

  • Collecting hand hygiene compliance data on at least 100 hand hygiene opportunities (or a minimum threshold number of hand hygiene opportunities based on unit throughput), each month, in each patient care unit
  • Providing individuals who touch patients or who touch items that will be used by patients with direct feedback on their hand hygiene compliance data.

For more information on Leapfrog’s Hand Hygiene Scoring Criteria, read page 42 of their Hospital Survey or this fact sheet authored by Leapfrog.

Cox Prosight Helps Meet Hand Hygiene Requirements With Automation

Hand hygiene is essential to maintain the health of patients and staff, but measuring compliance can be a complicated process for many hospitals. Leapfrog’s new requirements mandate hospitals to record 200 instances of hand hygiene station usage per hospital department each month, a heavy burden of work for hospital staff to shoulder manually. From collecting data to aggregating it in easy-to-access reports, there are many moving pieces to keep track of — that’s where Cox Prosight can help. 

As an RTLS platform designed for hospitals and healthcare facilities, Prosight’s automated solution offers continuous monitoring of hand hygiene stations, increasing insight into the compliance of the hospital and making it simple for facilities to meet Leapfrog’s hand hygiene system requirements. Here’s how:

  • Sensor-Based Badges - A staff member’s location is provided in connection with a hand sanitation station. When a nurse or doctor activates a sanitizing station, it’s recorded in the system software.
  • Hand Hygiene Compliance Data Collection - Hand sanitation station data is tracked and can be seen across the hospital, at the department and floor level. By breaking down data between departments, hospitals can develop new, effective hand hygiene initiatives. 
  • Streamlined, Automated Reporting - When it is time to gather data and compliance reporting for Leapfrog, Prosight eases the burden on the healthcare facility and administrators. The platform eliminates the need for manual reporting, saving staff time and helping them focus on following hand hygiene protocols. 

The Leapfrog Hospital Survey Factsheet on Hand Hygiene notes facilities that have adopted an electronic compliance monitoring system, like Prosight, are better able to determine their actual hand hygiene compliance rate, creating the opportunity for more robust quality improvement initiatives. 

Help reduce HAIs, improve cost savings, and reduce potential harm to employees by investing in Prosight to meet Leapfrog’s hand hygiene system requirements. 

Discover How Cox Prosight Can Help Your Facility Achieve High Hand Hygiene Scores

Cox Prosight is being used in smart hospitals around the country, helping them easily track and aggregate hand hygiene data for Leapfrog’s bi-annual survey. Our IoT-enabled solution is affordable, easy to implement, and seamless to integrate with other IT solutions. 

Transform the way your healthcare facility collects hand hygiene data. Contact our team today to learn how Cox Prosight can streamline your facility’s data while improving Leapfrog hand hygiene requirements and overall patient satisfaction. 

George Valentine
AVP & General Manager

George is an entrepreneurial executive and serial entrepreneur successful in launching, growing, and managing technology-based companies. George joined Cox Communication’s Innovation group in 2014 and is responsible for developing, incubating, and executing the company’s Connected Health strategy, including solution and partnership development, investments, acquisitions, and market trials. Prior to Cox, George founded two successful technology companies, performed a venture-backed company turnaround, and led large enterprise projects as a KPMG management consultant. George holds an MBA and B.S. in Finance from the University of South Carolina. George, his wife, and two children live in Atlanta, GA.