Leapfrog Top Hospitals raise bar on safety

Forty-one U.S. hospitals have been named 2007 Leapfrog Top Hospitals, based on results from the Leapfrog Hospital Quality and Safety Survey, a rating system that assesses a hospital's quality and safety.

The survey by The Leapfrog Group, a patient safety organization based in Washington, DC, collects data from hospitals on their progress toward implementing practices in four categories: computerized physician order entry (CPOE), ICU physician staffing (IPS), evidence-based hospital referral (EBHR), and the Leapfrog Safe Practices Score (SPS), which measures how well hospitals are progressing on 27 other safe practices endorsed by the National Quality Forum.

Seventy-four percent of participating hospitals have fully implemented the practices in at least one of these four safety and quality categories. The 2007 Top Hospitals list is based on 1,285 hospitals that responded to the Leapfrog Hospital Quality and Safety Survey as of Aug. 31, 2007. The survey results from those hospitals revealed these significant findings about the state of health care quality and safety in the nation's hospitals:

  • CPOE. Only 10% have fully implemented CPOE. Another 4% plan to implement it by 2008, which represents slow progress since Leapfrog began tracking implementation in 2002, when the figure was 2.5%.
  • IPS. Among hospitals with one or more ICUs, 29% enlist intensive care specialists to manage patients in the ICU, and another 6% plan to do so by 2008. This is a significant jump since 2002 when just 10% met the Leapfrog standard.
  • EBHR. Thirty-two percent have neonatal intensive care units that meet Leapfrog's specifications for certain high-risk deliveries, 24% meet the standard for bariatric surgery, 7% meet the standard for pancreatic cancer resection, 5% meet the standard for esophageal cancer surgery, 3% meet the standard for percutaneous coronary interventions, and 1% meet the standard for aortic valve replacement.
  • SPS. Twenty-five percent fully meet the standard for the SPS, which means that these hospitals have implemented the vast majority of each of the 27 National Quality Forum Safe Practices that comprise the SPS.

In addition, 44% have implemented procedures to avoid wrong-site surgeries, 36% have an adequate hand-washing policy for employees, 35% have a satisfactory policy for preventing pressure ulcers, and 29% require a pharmacist to review all medication orders before medication is given to patients. (For more on the results of the Leapfrog survey and the list of top hospitals, go to the Leapfrog Group's web site at www.leapfroggroup.org and select "2007 Leapfrog Top Hospitals and Survey Results" on the home page.)