Leapfrog Issues Hospital Safety Report Cards
One reason he thinks Leapfrog's report card will help, he says, is that when Hospital Compare was first published, it revealed a level of transparency that prompted providers, including his colleagues at UCSF, to make "substantial changes in resource allocation and what we paid attention to, even though it was not really an issue of consumerism. Even though no one had the sense that a lot of patients were going to it to make decisions on where to get care based on that."
Much more important, Wachter says, is that transparency like this "increases the probability that all hospitals will improve. Hospitals will work to understand the data, and figure out how they can all make healthcare safer."
Of the 26 measures, 13 involved outcomes of care, for example the number of times patients:
- Had a retained surgical object
- Developed an air embolism stage
- Developed a stage three or four pressure ulcer
- Developed a central line bloodstream infection
- Developed a stage three or four three or stage four pressure
- Died after surgery while in the hospital
- Developed an avoidable collapsed lung.
- Suffered a postoperative respiratory failure
- Suffered a postoperative pulmonary embolism or deep vein thrombosis,
- Received an accidental puncture or laceration
- Experienced a surgical suture come apart
Other elements making up the scores include process measures that are likely to lead to safer care. These include whether the hospital uses higher levels of intensive care unit physician staffing, and computerized physician order entry systems, medication reconciliation practices, evaluation of catheter necessity and removal, and observed levels of handwashing compliance.
Leapfrog used data it received from hospitals' voluntary reports and available Medicare data.
Other members of the patient safety panel that developed the scoring system for Leapfrog include Lucian Leape, MD, of Harvard; Arnold Milstein, MD, of Stanford; John Birkmeyer, MD, of the University of Michigan; Peter Pronovost, MD, of Johns Hopkins University; Patrick Romano, MD of the University of California at Davis; Sara Singer of Harvard; and Tim Vogus of Vanderbilt University.
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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