RALEIGH, N.C. (WNCN) — North Carolina has the highest rate of safe hospitals in the nation, a watchdog organization says.

Nearly 60 percent of hospitals in the state earned a grade of A based on 30 ways to measure patient safety as determined by the Leapfrog Group, which released its biannual letter grades for safety Tuesday.

The group says its grades focus on hospitals’ ability to protect patients from preventable errors, accidents, injuries and infections.

It found 59.8 percent of the 87 hospitals it evaluated in North Carolina earned the top grade, pushing it slightly ahead of Virginia at 59.2 percent. Virginia was No. 1 in the previous rankings in Fall 2021 at 56.2 percent, a fraction of a percentage point ahead of North Carolina.

The Leapfrog Group says these latest grades illustrate the impact of COVID-19 on patient safety — most notably, how strains on the health care system during the pandemic led to worse care overall for patients.

“The health care workforce has faced unprecedented levels of pressure during the pandemic, and as a result, patients' experience with their care appears to have suffered,” said Leah Binder, president and CEO of The Leapfrog Group. “We commend the workforce for their heroic efforts these past few years and now strongly urge hospital leadership to recommit to improved care — from communication to responsiveness — and get back on track with patient safety outcomes.”

The group found 52 of the 87 hospitals that were evaluated received As, with another 22 earning Bs and 12 more receiving Cs.

The only hospital in the state that did not receive an A, B or C was Granville Medical Center in Oxford, which was given an F after getting a D last fall. A spokeswoman for the hospital did not immediately return a phone message and an email seeking comment or an explanation.

Among the largest hospitals in the Triangle:

DUKE

Duke Raleigh Hospital, Duke Regional Hospital and Duke University Hospital have all received straight As since at least Spring 2019.

WAKEMED

All three WakeMed hospitals in the area — Cary, North and Raleigh — received As both now and in Fall 2021, when they got their grades up. WakeMed Cary Hospital received four straight Cs from Fall 2019 through Spring 2021, while WakeMed Raleigh Hospital had three consecutive Bs from Spring 2020-Spring 2021. The first grade WakeMed North received came in Fall 2021, and it was an A.

UNC

The University of North Carolina Hospitals in Chapel Hill received a second consecutive C after getting straight As from Spring 2019-Spring 2021. UNC Rex Hospital has received straight As since Leapfrog began issuing those report cards in 2012.

"No matter the score we receive, A to C, we are always on the quest for continuous improvement," UNC Health spokesman Alan Wolf said. "Leapfrog is one of the many metrics we use to gauge our progress and it provides us with valuable information to continually improve quality and patient safety. Across UNC Health, our clinical teams and hospital leaders share best practices and collaborate on ways to further our mission of improving the health of all North Carolinians.

"Our clinical leaders and quality improvement team at UNC Medical Center in Chapel Hill continue to make improvements in all key measurements of patient safety," he continued. "We expect its Leapfrog grade will improve soon."

CAPE FEAR VALLEY

The Fayetteville hospital received its second straight C after receiving five straight As from Spring 2019-Spring 2021.