Leapfrog Hospital Safety Scores 'Depressing'
Nancy Foster, Vice President of Quality and Patient Safety Policy for the American Hospital Association, wrote in an email: "Leapfrog is one of many organizations that issue hospital quality rankings. While some of the survey data they use is current, much of the data they use from Hospital Compare is at least three years old, which in this era of rapid change and quality improvement, does not accurately reflect the current state of hospital safety."
Leapfrog's 26-measure algorithm includes data reported to its voluntary quality program, to the Centers for Medicare & Medicaid Services' pay-for-reporting programs, or to the American Hospital Association. They include:
- Two structural measures such as whether the hospital has intensivist professionals working in its intensive care unit, a measure shown to reduce ICU mortality, and whether a hospital uses a computerized physician order entry system.
- Eight safe practices, such as care for patients on ventilators, hand hygiene, and steps taken to assure medication reconciliation.
- Five Surgical Care Improvement Project (SCIP) measures, such as whether appropriate antibiotics are given to patients undergoing surgery and whether a urinary catheter is removed after day one or day two of the procedure.
- Eleven outcome surgical or procedural measures, including foreign objects retained, air embolism, falls and trauma, postoperative pulmonary embolism or deep vein thrombosis, and accidental punctures or lacerations.
The Leapfrog Group was formed in the year 2000 as a non-profit watchdog by employers and others concerned that payers needed a better way to track avoidable hospital errors that caused harm to their insured employees. Asked if providers might now start to see their Leapfrog safety score influence their third party contract rates, Binder said that they might.
"Providers can use their score in contract negotiations, and they should, because it's backed by and created under the guidance of the foremost experts on safety. On the other hand, does a poor score mean they'll be punished by payers? I don't see that happening yet, but it may in the future."
Leapfrog does not charge hospitals to be scored, but if they want to use their A or B scores in commercial marketing campaigns or advertisements, Leapfrog charges $12,500 for hospitals with 300 or more beds, and $5,000 for hospitals with fewer.
The Leapfrog Group's eligible list excludes hospitals that have 25 or fewer beds (critical access hospitals) specialized hospitals, children's hospitals, outpatient surgery centers, or are located in Maryland.
Cheryl Clark is senior quality editor and California correspondent for HealthLeaders Media. She is a member of the Association of Health Care Journalists.
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