Leapfrog wants to be 'information repository' for better healthcare decision-making

[NRSKarenRN, BSN, RN]

Leapfrog Group surveys urban hospitals on designated patient safety initiatives; wants to be 'information repository' for better healthcare decision-making

Launching the first wave of what it predicts will be the future of healthcare quality improvement and informed consumer and purchaser choice, the Leapfrog Group has unveiled the initial results of an ongoing patient safety survey among urban hospitals in six regions of the country. Forty-eight percent of invited hospitals (241 out of 497) in the six defined regions (Atlanta, California, East Tennessee, Minnesota, St. Louis, and Seattle-Tacoma-Everett) completed a status survey regarding the group's designated "leaps forward in patient safety." These safety practices include computerized physician order entry (CPOE); specialist staffing in the Intensive Care Unit (ICU intensivists); and evidence-based hospital referral.

According to the survey, 3.3 percent of responding hospitals have instituted CPOE, and an additional 30 percent have implementation plans (with target dates of 2004) in the works. Ten percent of responding hospitals reported having intensivists overseeing care in the ICU at least eight hours a day. Another 18 percent said they plan to enlist intensivists by 2004. With respect to evidence-based hospital referral, hospitals were asked how many times a year they perform five specific high-risk surgical procedures. In the absence of outcomes data, ("the preferred measurement"), Leapfrog argues that volume is the next best thing. (It cites numerous studies that show a strong correlation between high annual volume and positive outcomes.) Leapfrog says their survey shows that "consumers in most urban areas have a choice of hospitals with extensive experience treating patients needing select high-risk surgeries or neonatal intensive care."

A reported 15 percent of participating hospitals met at least one of the Leapfrog standards for these safety practices. Consumers can log on to the survey section of the Leapfrog Web site (http://www.leapfroggroup.org) and view hospital-specific results. Regarding CPOE and ICU intensivist staffing, hospitals are rated as follows:

Fully implemented Leapfrog's recommended safety practice

Good progress in implementing Leapfrog's recommended safety practice

Good early stage effort in implementing Leapfrog's recommended safety practice

Willing to report publicly; did not yet meet Leapfrog's criteria for a good early stage effort

Did not submit this information

Consumers may drill further into the data to reveal how often each facility performs specific surgical procedures, including coronary bypass and angioplasty, and whether they meet Leapfrog's designated standard. While acknowledging that a myriad of patient safety improvement strategies exist, and that there is no "cookie cutter" approach, Leapfrog says it chose to zero-in on CPOE, ICU intensivist staffing, and evidence-based hospital referral because they are "proven to reduce preventable medical mistakes, easily understood by consumers, and feasible to implement in the near future." The group says that its designated practices are three of other and/or larger patient safety strategies hospitals may be engaged in.

Introducing himself as the "Medicare customer service rep," CMS Administrator Tom Scully told attendees at the survey unveiling that he and HHS Secretary Tommy Thompson are "big believers in quality" and in making comparative quality data available to healthcare consumers. While fully supportive of the Leapfrog Group's efforts, Scully reiterated that the government must move at a more cautious pace than the private sector. Scully said he understood hospitals' concerns about fair treatment and applauded their efforts thus far to drive behavioral change and engage in evidence-based safety and improvement practices.

Founded by the Business Roundtable (BRT) in November 2000, the Leapfrog Group is a coalition of more than 90 public and private organizations that provide healthcare benefits. The coalition seeks to mobilize employer purchasing power to initiate breakthrough improvements in healthcare safety, and enable consumers to make more informed healthcare choices. Leapfrog says it intends to expand hospital participation in both current and new regions in 2002, becoming an "up to date repository of information" for better, more informed healthcare decision-making.

For detailed information about the Leapfrog Group's hospital survey, go to http://www.leapfroggroup.org/PressBriefing011702.htm

To access a repository of what other groups are saying about Leapfrog (pro and con), go to the Leapfrog section of the Premier Advocacy Web site at http://www.premierinc.com/advocacy/leapfrog

1/17/02

[Mijourney]

Hi Karen. Maybe I'm wrong for writing this, but Leapfrog just appears to be simply trying to carve out a niche for themselves in the healthcare arena where it's hot right now. It's time for us nurses to increase the volume when it comes to applying our brand of intelligence, skills, knowledge, foresight, and strategy in the healthcare arena.