"Community members, leaders, parents, and grandparents are coming together and walking into hospitals and sitting down with doctors and CEOs and saying, 'What are you going to do to improve things?'"
In our annual HealthLeaders 20, we profile individuals who are changing healthcare for the better. Some are longtime industry fixtures; others would clearly be considered outsiders. Some are revered; others would not win many popularity contests. All of them are playing a crucial role in making the healthcare industry better. This is Leah Binder's story.
Watchdog organizations don't always have the best relationships with those they are watching. When asked to describe her relationship with healthcare providers and leaders, Leah Binder, CEO of The Leapfrog Group, deadpans the answer. "Some of my best friends are in hospitals," she says. She pauses and then laughs. "I promise," she says. "Some of them don't like me but I will tell you that some of them do."
The Leapfrog Group, a consortium of healthcare purchasers, uses survey data and public reporting on quality measures such as central line infection rates to help consumers and employers compare hospitals' safety, quality, and efficiency. It also recognizes and rewards hospitals that take steps to reduce preventable medical errors and that meet its tough standards for adoption of quality improvement tools such as computerized physician order entry.
In a Leapfrog study earlier this fall, 214 hospitals used a Web-based simulator to see if their CPOE systems would catch common medication errors, including potentially fatal errors. The CPOE systems on average missed half of the routine medication errors and a third of the potentially fatal errors. Leapfrog also found that nearly all of the 102 hospitals that repeated the test improved in one or more medication categories. Leapfrog has issued testing guidelines and has developed a tool to help organizations test their CPOE systems.
"It's so extraordinary to me, but Leapfrog seems to be the only one out there, at least in the public policy world, with a priority on assuring that health information technology is monitored over time. It seems like such an obvious thing that it's amazing that we have to even say it but we know from [our survey that] hospitals don't always know that when they buy technology it's not plug and play. It's something they have to monitor and carefully watch over time or else they can't be sure it's safe."
The Leapfrog Group is founded, in part, on the belief that American healthcare remains "far below obtainable levels of basic safety, quality, and overall customer value." Binder conveys that message clearly. But she doesn't just carp about what's wrong with healthcare; she talks about how to effect change. One example is the partnerships Leapfrog has built with organizations and their supporters, including the March of Dimes, which is currently working with Leapfrog to build awareness and educate providers and patients about the dangers of scheduling elective deliveries for babies before the 39th completed week of gestation, a measure that Leapfrog added to its hospital survey in 2009.
"Community members, leaders, parents, and grandparents are coming together and walking into hospitals and sitting down with doctors and CEOs and saying, 'What are you going to do to improve things?' And it's really impressive. It's a change and a new way of thinking about how we all contribute to improving healthcare," she says.
"We need to ensure that our survey's helpful in making the change. Because our survey is not about an interesting study that sits on someone's shelf. Our survey is supposed to be a dynamic way for us to make real change in a fast way—a fast leap forward."
Like many of the people her organization represents, Binder has had both positive and negative encounters with the healthcare system. She says her father was treated with compassion and received quality care while hospitalized toward the end of his life. Later, the newborn she'd named after her father underwent surgery that resulted in a medical error.
"I have had enough experience with hospitals to realize how important they are, how much I trust in them, and it creates great passion in me that I want them to perform well. Because I don't place that trust in just anything. I expect them to be the best. And all of us as Americans pay for them to be the best. And they aren't always the best."
Although Binder's relationship with the industry isn't always contentious, it's not always warm and fuzzy, either. "I think we're pretty tough and we'll stay tough. But I also understand the challenges that they face and I have a lot of admiration for hospitals. Not only the hospitals that have managed to do extremely well in this tough environment, but the hospitals that have many challenges and don't always do that well, but still manage to be transparent and give it their all," she says.
"Some of our biggest champions are hospital leaders. They have given us ideas, they have given us advice, they've given us great stories in how innovative they've been in figuring out ways to get to zero on infections or engage nursing staff more to reduce preventable injuries—just amazing stories."