Nearly Two-Thirds of California Hospitals Complete New Patient Safety Survey From the Leapfrog Group


SAN FRANCISCO -- The latest results from the Leapfrog Group reveal that a record number of California hospitals are participating in the national Leapfrog survey on patient safety practices, and millions more Californians have access to survey results. Nearly two-thirds of California's 323 urban acute care hospitals are now participating in the voluntary online survey that measures three cutting-edge practices to reduce preventable mistakes in hospitals.

This information is increasingly making its way into consumers' hands. An estimated 13 million HMO members in the state are being provided survey results through their health plans, and many leading employers are making this information available.

The Leapfrog Group and its California sponsor, the Pacific Business Group on Health, have unveiled the latest results of the Leapfrog survey, a voluntary and ongoing patient safety survey among urban and suburban hospitals. The results, available online at, contain new information from an updated survey that hospitals were invited to complete.

To date, 201 California hospitals have completed the survey on three pioneering practices proven to reduce preventable medical mistakes. This is more than completed the survey by the end of last year, and additional hospitals have committed to reporting before the end of the year. Among current participants, 27.4 percent meet at least one of Leapfrog's recommended standards for these safety practices.

"We are very pleased that the vast majority of California hospitals are participating in this voluntary initiative," said Peter Lee, president and CEO of PBGH. "These hospitals have gone to great lengths to share their patient safety information with the community." Lee added, "Beyond the kudos for hospital participation, we're seeing huge leaps in health plans and employers making this information available to consumers. Leapfrog information is helping to spur a movement to give consumers valid tools to make better informed choices."

The survey asked urban hospitals whether they have implemented or plan to implement the following three proven patient safety practices:

1. Computer Physician Order Entry (CPOE): Physicians enter patient

prescriptions and other orders into computers linked to error

prevention software.

2. Intensive Care Unit (ICU) Physician Staffing: ICUs are managed by

trained ICU specialists.

3. Evidence-Based Hospital Referral: The survey queries hospitals about

how many times a year they perform five high-risk surgeries and asks

those with neonatal ICUs (NICUs) how many infants they typically care

for each day. In addition, for some of the evidence-based hospital

referral categories, hospitals are now able to report their adherence

to patient care processes correlated with high quality, as well as

risk-adjusted outcomes information.

"Leapfrog practices are on the cutting edge of quality improvement, and very few hospitals have implemented them all," said Suzanne Delbanco, executive director of The Leapfrog Group. "However, they have enormous potential to reduce preventable medical mistakes. Leapfrog's new survey will help Leapfrog measure more accurately whether hospitals are making progress toward meeting the standards that Leapfrog sets for these breakthrough patient safety practices."

In California the survey highlights include:

-- CPOE: 1.5 percent of the responding hospitals have instituted CPOE,

but an additional 13.7 percent of responding hospitals have indicated

specific plans to implement such systems by 2005. A full 25 percent

have made a commitment to install CPOE in the future.

-- ICU Staffing: 17 percent of responding hospitals have intensivists

overseeing care in the ICU at least eight hours a day. Another 5

percent plan to enlist intensivists by 2004.

-- The third practice, evidence-based hospital referral, indicates the

likely success a hospital will have with a particular high-risk surgery

or condition. The Leapfrog survey has good news on evidence-based

hospital referral; consumers in most urban areas, including California,

have a choice of hospitals with extensive experience treating patients

needing select high-risk surgeries or neonatal intensive care.

The survey found the following numbers of California participating hospitals meet Leapfrog's recommended criteria for evidence-based hospital referral:

-- Coronary artery bypass -- 8 out of 91 hospitals;

-- Percutaneous coronary interventions -- 6 out 97 hospitals;

-- Abdominal aortic aneurysm repair -- 12 out of 146 hospitals;

-- Pancreatic cancer resection (replaces carotid endarterectomy) -- 13 out

of 113 hospitals;

-- Esophageal cancer surgery -- 4 out of 110 hospitals; and

-- NICUs -- 28 out of 114 hospitals have NICUs that meet Leapfrog's

specifications for select high-risk deliveries.

PBGH medical director Arnold Milstein, MD, MPH, praised participating hospitals for making "a big advance in patient safety for Californians." He cited the projected 10-fold increase by 2005 in the number of hospitals with functioning computerized physician order entry (CPOE) systems.

"This is a tribute to our California hospital leadership," Milstein said. "CPOE systems have been shown to reduce the frequency of drug prescribing errors by 55 to 85 percent."

California is among 22 rollout regions for The Leapfrog Group patient safety survey. Fifty-four percent of all hospitals invited in these combined regions have completed the survey to date, and 38.6 percent of these responding hospitals meet at least one of the standards Leapfrog recommends for these safety practices.

The other regions include Atlanta, Ga.; Central Florida; Colorado; Dallas-Forth Worth, Texas; Hampton Roads, Va., Illinois; Kansas City, Mo.; Maine; Massachusetts; Memphis, Tenn.; Metro New York, N.Y.; Michigan; Minnesota; East Tennessee; New Jersey; Rochester, N.Y.; Savannah, Ga.; Seattle, Wash.; St. Louis, Mo.; South Central Wisconsin; and Wichita, Kan. Together these regions have the potential to reach nearly 50 percent of U.S. consumers with patient safety information.

The Leapfrog Group was founded in November 2000 by the Business Roundtable and has support from The Robert Wood Johnson Foundation. More than 145 Fortune 500 corporations and other large private and public sector health benefits purchasers have joined The Leapfrog Group, representing more than 34 million enrollees. The Leapfrog Group's effort was launched the same year an Institute of Medicine report revealed that tens of thousands of Americans die each year from preventable medical mistakes made in hospitals. In addition, nearly 1 million medication errors occur in hospitals each year. Research conducted by John D. Birkmeyer, MD, Dartmouth Medical School, indicates that these three improvements could save nearly 60,000 lives per year, and prevent more than half a million serious medication errors if all non-rural hospitals in the United States implemented them. In addition, the U.S. health care system could save approximately $9.7 billion annually.

Source: Pacific Business Group on Health

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