BWH Gains Perfect Scores on Leapfrog

Brigham and Women’s Hospital recently gained perfect scores on the Leapfrog Group’s hospital ranking system of safety and overall value for consumers, making BWH the only hospital out of more than 1,200 facilities that participate with Leapfrog to implement fully recommended leaps.

“This is a tremendous accomplishment for the entire Brigham and Women’s community,” BWH President Gary Gottlieb, MD, MBA, said. “In addition to continuous self-evaluation, BWH shares patient-related and outcomes data with dozens of public and private organizations that specialize in benchmarking health care safety and quality to improve our care.”

Leapfrog is just one of many organizations already making quality care measures public on the Internet. Benchmarking and public reporting are expected to become more prevalent in coming years. State and federal lawmakers, payers and patients are demanding more details from hospitals, and BWH is in a strong position as this trend continues.

The health care reform package recently passed in Massachusetts calls for the Executive Office of Health and Human Services to collect and make public more quality data and more physician data. On the federal level, the Center for Medicare Services this fall will incorporate surgical infection prevention (SIP) measures to the current list of Medicare measures. In 2007, CMS also will make public hospital inpatient satisfaction scores gathered through the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey instrument. BWH is currently working with Press, Ganey to incorporate these questions in an ongoing random sample of recently discharged patients.

The Leapfrog Group, a consortium of more than 100 public and private health care payers, providers and purchasers, gathers data from participating hospitals and issues rankings based on four safety and quality standards: Computerized Physician Order Entry (CPOE); evidence-based hospital practices and volumes; physician staffing in intensive care units; and implementation of known patient safety best practices.

BWH has fared well, according to Leapfrog’s standard. According to the organization’s CPOE standards, 75 percent of physician medication orders must be made via CPOE and the system must alerts physician to at least 50 percent of common and serious prescribing orders. Less than 5 percent of hospitals nationwide have CPOE completely or partially available to their physicians.

Leapfrog’s measures on evidence-based hospital referral (EHR) reports are based on making sure patients with high-risk conditions are treated at hospitals with better outcomes. Leapfrog analyzes outcome measures on the following: coronary artery bypass, percutaneous coronary intervention, abdominal aortic aneurysm repair, esophagectomy, pancreatic resection and high-risk deliveries and neonatal ICUs.

Leapfrog’s ICU physician staffing standard calls for ICUs to be managed or co-managed by intensivists during daytime hours, and for appropriately trained ICU staff to be able to respond within 5 minutes 95 percent of the time. Leapfrog estimates that only 10 percent of ICUs worldwide meet that standard.

The safe practices score is based on the National Quality Forum’s (NQF) 30 safe practices that, if utilized, reduce risk of harm for patients. NQF practices relate to creating a culture of safety, evidence-based quality initiatives, staff communication and teamwork, specific care processes and safe medication use.

Leapfrog’s scores are based on ‘leap’ measures that come from hospitals’ answers to survey questions. Hospitals’ scores are displayed online ranging from an empty circle to a full circle, and BWH has all perfect circles on www.leapfrog.com.