|Leapfrog Group Survey Finds Hospitals Fail To Meet Important Quality Standards
Though it has been 10 years since the Institute of
Medicine’s landmark report on the failure of U.S. hospitals to
adequately protect patient safety, too many hospitals still have failed
to implement standards known to improve quality and save lives.
According to the 2008 Leapfrog Hospital Survey, only 7
percent of hospitals fully meet Leapfrog medication error prevention
(CPOE) standards and low percentages of hospitals are fully meeting
"As the Obama administration and Congress consider
healthcare reform options, it is clear we have a long way to go to
achieve hospital quality and cost-effectiveness worthy of the
nation’s $2.3 trillion annual investment," said Leapfrog CEO Leah
Binder. "According to our data, a majority of hospitals have
significant safety and efficiency deficits."
"As the President has often stated, a reformed high
value healthcare system needs to be cost-effective. Unfortunately, few
hospitals are meeting Leapfrog’s newly established efficiency
measure standards — the first such data available in the public
domain," said Binder.
Among surveyed hospitals, efficiency standards —
defined as highest quality and lowest resource use —are met by
only 24 percent of hospitals for heart bypass surgery, 21 percent for
heart angioplasty, 14 percent for heart attack care, and 14 percent for
Other highlights of the 2008 hospital survey, include:
- Relatively low percentages of reporting hospitals are
fully meeting volume and risk-adjusted mortality standards, or adhering
to nationally endorsed process measures for eight high risk procedures,
where following nationally endorsed and evidence-based guidelines is
known to save lives:
- 43 percent for heart bypass surgery
- 35 percent for heart angioplasty
- 32 percent for high-risk deliveries
- 23 percent for pancreatic resection
- 16 percent for bariatric surgery
- 15 percent for esophagectomy
- 7 percent for aortic valve replacement
- 5 percent for aortic abdominal aneurysm repair
- Sixty-five percent of participating hospitals do not
have all recommended policies in place to prevent common
hospital-acquired infections (HAIs).
- Seventy-five percent do not fully meet the standards
for 13 evidence-based safety practices, ranging from hand washing to
competency of the nursing staff.
- Only 26 percent and 34 percent of reporting hospitals
are fully meeting standards for treating two common acute conditions,
heart attacks and pneumonia, respectively.
- Only 30 percent and 25 percent of hospitals are fully
meeting standards to prevent hospital-acquired pressure ulcers or
hospital-acquired injuries, respectively.
"In spite of huge opportunities for improvement, many
hospitals are, in fact, demonstrating quality excellence and serving as
role models," said Binder. "We need to take the lessons learned from
the best hospitals and use these to move the status quo forward so all
Americans have access to safe, cost-effective care."
Notable improvements by surveyed hospitals in 2008 include:
- Thirty-one percent of hospitals now meet the Leapfrog ICU staffing standard, up from just 10 percent in 2002.
- Hospitals with all of Leapfrog’s recommended
policies in place to prevent common HAIs jumped from just 13 percent to
35 percent between 2007 and 2008.
- Sixty percent of hospitals have agreed to implement
Leapfrog’s "never events" policy when a serious reportable event
occurs within their facility.
"Progress on patient safety is moving too slowly,"
according to Binder. "Consumers and purchasers of healthcare want
hospitals to implement safety standards and procedures known to improve
quality and reduce unnecessary injury and death. The safety goals
Leapfrog promotes are achievable. More hospitals should be meeting the
Leapfrog standards for common and high-risk procedures."
The voluntary Leapfrog Hospital Survey results are as of
Dec. 31, 2008, and include 1,276 hospitals in 37 major U.S.
metropolitan areas, representing 48 percent of the urban, general
acute-care hospitals (53 percent of hospital beds in these areas).
Address: Leapfrog Group, c/o Academy Health, 1150 17th St. NW, Suite 600, Washington DC 20036; (202) 292-6713, www.leapfroggroup.org.