Leapfrog's impact slight in enhancing patient safety

FRAMINGHAM (03/02/2004) - The Leapfrog Group, a business-backed organization set up to reward hospitals that implement quality improvement measures, has had little impact over the past two years in prompting change, according to a new report that nonetheless lauded the group's effort.

The Center for Studying Health System Change (HSC) found that of the primary measures Leapfrog established to evaluate quality - notably, the use of computerized physician order-entry systems and the staffing of critical care doctors in ICUs - hospitals in areas of the country targeted by the Leapfrog effort weren't statistically more likely to have made those quality changes.

"What we found was that the Leapfrog campaign had raised hospital awareness about these patient safety practices, but there are a lot of barriers on the ground to implementing these practices," said Alwyn Cassil, the HSC spokeswoman.

The report cited the usual barriers to technology investment, noting that "organizational capacity - including time, money, managerial and clinical leadership, and expertise - is a significant barrier," and said that some hospital officials questioned whether quality-improving practices could be implemented quickly without alienating doctors.

Still, the report found that hospitals in the 12 Leapfrog regions were working to meet the spirit of the Leapfrog standards, even if they would not meet the actual requirements, and that the effort had "sparked national awareness" of quality improvement efforts.

Leapfrog officials acknowledge that many hospitals are not meeting its standards, but emphasized that the group has worked to make sure its standards are rigorous. "Leapfrog has always been clear that our safety standards are set high, they are 'big leaps' in patient safety, and therefore not easily attainable," said the group's spokeswoman, Claire Turner, in a statement.

Turner said the endeavor has been gathering steam with more than 1,100 hospitals returning data to the group.

The HSC suggested that additional research and incentives - including government efforts - could help advance the Leapfrog agenda by making such investments more fiscally desirable.

The Leapfrog Group consists of about 150 public and private organizations that provide healthcare benefits. It works with medical experts in the United States to identify problems and propose solutions that it believes will improve hospital systems. It was founded by The Business Roundtable, a national association of Fortune 500 CEOs.

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