Six out of 21 hospitals in Orange County, California received “A” grades for hospital safety while two received “Ds,” according to a report released May 3 by The Leapfrog Group, a nonprofit healthcare watchdog organization.

Those receiving A grades were:

And those receiving Ds:

The bi-annual report—which first started in 2012—is based on statistics and data from the federal agency Centers for Medicare and Medicaid Services, public data, and Leapfrog’s own surveying.

Specialty hospitals, such as children’s or cancer centers, and critical access medical centers are not included in the analysis.

The grading system—created by a panel of patient safety experts from around the country—evaluates inpatient injuries, infections, medical and medication errors, structural soundness of the staff, and technology quality.

Grades do not consider death rates for various procedures, public ratings for specialty aspects of hospitals, and readmission rates.

According to the report, hospitals experienced a surge in healthcare-associated infections—such as those that occur with the use of a catheter, during surgeries, or when a patient receives injections—during the COVID-19 pandemic.

“The dramatic spike in [hospital associated infections] reported in this Safety Grade cycle should stop hospitals in their tracks,” said Leapfrog Group CEO Leah Binder in a statement. “We recognize the tremendous strain the pandemic put on hospitals and their workforce, but alarming findings like these indicate hospitals must recommit to patient safety and build more resilience.”

The report also showed nationwide declines in patient experience and medical communication from staff.

Other grades for Orange County hospitals were:

B Grade

C Grade