A new report from the Leapfrog Group and Castlight Health found hospitals rates of pressure ulcers, or bedsores, and patient injuries steadily decreased over the past four years. However, there remained wide variation between hospitals and the majority haven’t met Leapfrog’s prevention standards on both conditions.

The good news in the report, according to Leapfrog’s press release, was the decline in hospital-acquired bedsores and injuries. The average rate of pressure ulcers per 1,000 inpatient discharges dropped from .122 in 2013 to .102 in 2016, a 16 percent improvement. For hospital-acquired injuries, rates improved by 20 percent, going from .521 injuries per 1,000 inpatient discharges in 2013 to .419 in 2016.

Leapfrog’s standards are 0 pressure ulcers per 1,000 inpatient discharges, and 0.16 injuries per 1,000 patient discharges. 69 percent of hospitals hit the bedsore goal in 2016, up from 53 percent in 2013. The injury standard has been harder to attain, with 44 percent meeting the goal in 2016, up from percent in 25 percent in 2013. However, only 35 percent of hospitals reporting to Leapfrog met both standards in 2016.

“We are encouraged by the steady decline in hospital-acquired conditions over the last four years,” Leah Binder, president and CEO of Leapfrog, said in a statement. “We are also encouraged by growing hospital transparency. All the hospitals in this report volunteered this information on their performance, and that gives us great confidence. The hospitals to worry about are those that declined to report on these problems. Patients deserve to know.”

If all hospitals reduced their pressure ulcer and injury rates to zero between 2013 and 2016, the report said $175 million and 263 patients could have been saved.

The report also found significant variation on these standards between hospitals in the same city. For example, in one New York City hospital, the rate of hospital-acquired pressure ulcers was at 4.631 per 1,000 inpatient discharges—more than 37 times the average rate. That facility was located only one mile away from a hospital which reported zero hospital-acquired bedsores.

“While appreciating the steady progress that hospitals are making on hospital-acquired conditions, there is still considerable room for improvement, as most of these incidences are preventable by simply taking appropriate precautions, such as following recommended protocols regarding skin care and turning/repositioning patients or implementing bathroom schedules and fall-proofing hospital rooms,” the report said.