Hospitals asked to publicly report certain quality data by the Leapfrog Group made little progress on the rate of reporting and adoption of safety standards from 2002 to 2007, according to a study in Health Affairs.
Researchers studied hospitals in 18 regions that were initially targeted by the Leapfrog Group, an organization created in 2000 by private and public healthcare purchasers. The Leapfrog Group asked hospitals in these regions to report data on three standards it believed could improve patient safety: the use of computerized drug order entry, staffing hospital intensive care units with hospital intensivists and making evidence-based hospital referrals.
The researchers used data from 2002 to 2007 to evaluate the adoption of computerized drug order entry by 849 hospitals targeted by Leapfrog and the use of hospital intensivists by 794 hospitals (55 hospitals did not operate an ICU across the entire time period).
Overall, only 60 percent of the targeted hospitals reported data at baseline, and the rate of reporting did not change significantly from 2002 to 2007. The adoption of computerized drug order entry increased from 2.94 percent to 8.13 percent over the study period, while the number of hospitals staffing intensivists in ICUs increased from 14.74 percent to 31.41 percent.
In addition to measuring full implementation of the safety standards, Leapfrog also measured hospitals' progress in implementing the standards using a four-point scale, where one is "does not meet," two is "good early progress," three is "good progress" and four is "fully meets." In the study, hospitals' average value for computerized drug order increased from 2.57 in 2002 to 2.88 in 2007, and their score for intensivist staffing increased from 2.93 to 3.33.
The authors concluded that the hospitals targeted by Leapfrog made limited and slow progress on the two outcome measures studied. The authors suggest the lack of threats to market share and changes in health plans' benefit designs, skepticism of Leapfrog's safety standards, the availability of intensivists and participation in other public reporting initiatives may have contributed to the unchanged rate of reporting and limited progress on safety standards.
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Researchers studied hospitals in 18 regions that were initially targeted by the Leapfrog Group, an organization created in 2000 by private and public healthcare purchasers. The Leapfrog Group asked hospitals in these regions to report data on three standards it believed could improve patient safety: the use of computerized drug order entry, staffing hospital intensive care units with hospital intensivists and making evidence-based hospital referrals.
The researchers used data from 2002 to 2007 to evaluate the adoption of computerized drug order entry by 849 hospitals targeted by Leapfrog and the use of hospital intensivists by 794 hospitals (55 hospitals did not operate an ICU across the entire time period).
Overall, only 60 percent of the targeted hospitals reported data at baseline, and the rate of reporting did not change significantly from 2002 to 2007. The adoption of computerized drug order entry increased from 2.94 percent to 8.13 percent over the study period, while the number of hospitals staffing intensivists in ICUs increased from 14.74 percent to 31.41 percent.
In addition to measuring full implementation of the safety standards, Leapfrog also measured hospitals' progress in implementing the standards using a four-point scale, where one is "does not meet," two is "good early progress," three is "good progress" and four is "fully meets." In the study, hospitals' average value for computerized drug order increased from 2.57 in 2002 to 2.88 in 2007, and their score for intensivist staffing increased from 2.93 to 3.33.
The authors concluded that the hospitals targeted by Leapfrog made limited and slow progress on the two outcome measures studied. The authors suggest the lack of threats to market share and changes in health plans' benefit designs, skepticism of Leapfrog's safety standards, the availability of intensivists and participation in other public reporting initiatives may have contributed to the unchanged rate of reporting and limited progress on safety standards.
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