Is your hospital on Leapfrog's winner list?

November 20, 2006

Suppose you were able to evaluate a hospital based on how well it has implemented quality and safety initiatives. The Leapfrog Group set out to do just that when it commissioned a survey to establish a national rating system that offers a broad assessment of a hospital's quality and safety. Fifty-nine hospitals have been named to Leapfrog's top hospitals list based on data from its survey.

Results from the survey of over 1,200 hospitals reveal significant data about the state of healthcare quality and safety in the nation's hospitals. Asked about their awareness and action on 30 safe practices, of the hospitals responding to the survey nine in 10 have implemented procedures to avoid wrong-site surgeries and eight in 10 require a pharmacist to review all medication orders before drugs are administered to patients.

According to the survey findings, however, many hospitals have a long way to go in improving quality of care. For example, more than nine in 10 facilities have not implemented computer physician order entry (CPOE) to Leapfrog's standards; seven in 10 do not enlist intensivists (intensive care unit specialists) to oversee patient care in their ICUs.

The Leapfrog survey is getting a lot of publicity in the press, and, predictably, many of the 59 hospitals on Leapfrog's leading institution list are using the recognition as a marketing tool. But what do medication safety experts think about Leapfrog's list? Michael Cohen, president of the Institute for Safe Medication Practices (ISMP), said public disclosure and recognition of hospitals that have met Leapfrog evidence-based quality criteria are an important motivating factor for hospitals to adopt safe practices and technologies that have an overall positive impact on patient safety, such as CPOE.

Cohen stated that quality and safety are an ongoing process. "By itself, being on the Leapfrog list doesn't mean that these hospitals can rest on their awards," said Cohen, adding, "I think their accomplishments overall help to make care safer for patients than those that haven't adopted the practices or technologies." Cohen asserted that no hospital-not even any of those on the Leapfrog list-is immune from serious medication errors. "We all have to constantly be working hard to recognize factors that negatively impact safety, then take action to prevent patient harm."

Saint Francis Hospital and medical Center in Hartford, Conn., is on Leapfrog's current list and has been on it several times. Mary Inguanti, R.Ph., VP operations, said the recognition by Leapfrog is an external validation of the hospital's mission and commitment to technology. But Inguanti noted that despite the use of state-of-the-art technology to improve quality and safety, "we don't want people to feel they have this force-field because of all the automation, that they are exempt from being able to commit errors."