Health Care Issues

Helping Health Care Be Even More Accountable

You might remember that I’ve addressed the “Saving 100,000 Lives Campaign” and periodic references to “The Leapfrog Group.” These major initiatives are in collaboration with leadership from all components of health care, including hospitals and extended care facilities, outpatient facilities, physician practices, and health insurance companies.

Why? Because we in health care want to help those who come to us for care with no harm coming to anyone. Documenting and reporting how well we care for patients with some of the more common reasons for hospitalization, like pneumonia and heart attacks, along with sharing our progress on adopting proven processes that will reduce the risk for mistakes and adverse events, helps us be more accountable to our patients, residents, and members, as well as to our payers. One significant group of payers is represented by The Leapfrog Group.

According to its Web site, The Leapfrog Group was founded by a group of large employers in late 2000, primarily Fortune 500 Companies that includes Caterpillar Inc. and more than 160 other major corporations that provide health benefits to more than 34 million Americans in all 50 states. The Leapfrog Group is working to initiate breakthrough improvements in the safety, quality, and affordability of health care. The Leapfrog Group identified and has since refined four hospital quality and safety practices that are the focus of its health care provider performance comparisons and hospital recognition and reward. The quality practices are:

• Computer Physician Order Entry (CPOE). Hospital staff enters medication orders via computer linked to prescribing error prevention software. CPOE has been shown to reduce serious prescribing errors in hospitals by more than 50 percent.
• Evidence-Based Hospital Referral (EHR). Consumers and health care purchasers should choose hospitals with extensive experience and the best results with certain high-risk surgeries and conditions. By referring patients needing certain complex medical procedures to hospitals offering the best survival odds based on scientifically valid criteria, research indicates a patient’s risk of dying could be reduced by 40 percent.
• ICU Physician Staffing (IPS). Staffing ICUs with doctors who have special training in critical care medicine, called “intensivists,” has been shown to reduce the risk of patients dying in the ICU by 40 percent.
• The Leapfrog Safe Practices Score. The National Quality Forum-endorsed 30 Safe Practices cover a range of practices that, if utilized, would reduce the risk of harm in certain processes, systems, or environments of care. Included in the 30 practices are the original 3 Leapfrog leaps. For this new leap, added in April 2004, hospitals’ progress on the remaining 27 safe practices will be assessed.

The Leapfrog Group quality and safety results can be accessed at www.leapfroggroup.org/cp. In 2004, Leapfrog’s 23 regions accounted for almost half of the U.S. population and encompassed 1,664 urban, suburban, and rural hospitals. At the end of 2004, 55 percent of targeted hospitals had responded. In addition, more than 240 hospitals outside of the 23 regions had responded to the survey on their own initiative. We in health care are committed to being more accountable, and we’re appreciative that The Leapfrog Group provides us one avenue to illustrate such. IBI