Leapfrog's New Safety Report Card Alarms Hospitals

Cheryl Clark, for HealthLeaders Media , November 28, 2012

"Across the board, we're at or near national and Georgia averages, and in some cases above."

"It appears that Leapfrog takes great pride in using the facilities that do report on their other [Leapfrog] measures, which they chose. I don't disagree with the importance of intensivists and electronic medical records and things like that, but if you don't, it impacts on your scores adversely."

Binder refutes much of the criticism, saying that after some objections were raised in June, the methodology committee changed the weights so that hospitals that report to the American Hospital Association for CPOE and intensivists receive the same amount of credit, 65 points, as they would if they reported those functions to Leapfrog. In the June scoring, a non-Leapfrog-reporting hospital received only 15 points for each of those measures.

But she's aware that hospitals receiving low grades will still say that the methodology is invalid. "We have no problem, and are expecting that they will be critical of our methods," she says.

"But I would strongly suggest that they not lose focus on what's important, which is reassuring the public they serve that they care about patient safety.

"And they should take a lesson from other industries outside hospitals that are very accustomed to very high levels of transparency. The auto industry has lots and lots of publications that compare different autos from different automakers with negative or positive ratings. But I rarely hear automakers complaining that a particular rating is bad or uses a bad methodology. They wouldn't waste their breath, because that's not going to get them more sales. What they do is they get better."

Some executives for smaller, rural hospitals felt they were disproportionately affected by the methodology. For example, James Barrett, CEO of 38-bed Richardson Memorial Center in Rayville, LA, says that not only did Leapfrog fail to contact him, but smaller, more rural hospitals are disproportionately represented among the low-scoring hospitals.

For example, he lamented, "a lot of the things they surveyed for we don't have. It's not a fair process." Because of that, one bad score on a measure that they are scored on can skew the entire grade downward, he says.

Binder deflected criticism that the methodology is flawed, saying that it was developed by a team of the nation's leading healthcare quality experts, such as Ashish Jha, MD, Sara Singer, and Lucian Leape, MD, all of Harvard University; John Birkmeyer, MD, of the University of Michigan; Arnold Milstein, MD, of Stanford University; and Peter Pronovost, MD, of Johns Hopkins University.

Binder also says that Leapfrog's safety score now has its own free mobile app that patients who travel may download so they know with a few clicks the safest nearby hospitals to get care if they're away from home.

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9 comments on "Leapfrog's New Safety Report Card Alarms Hospitals"

Roberta Hughes (12/1/2012 at 9:17 AM)
Interesting article, thank you for sharing. Whether LeapFrog rating system is flawed or not, it raises the awareness of patient safety and will influence where patients choose to receive care. As a healthcare image consultant, I "see" many safety and security issues. The appearance of healthcare professionals also impact patient safety. While on-site consulting with a client about their healthcare image and uniform program (or lack there of), a bomb threat occurred and 150,000 patient financial records were stolen. Hospital's relaxed uniform dress policies make it difficult to discern between patient and care provider, and between physician, nurse, or medical assistant, creating significant safety issues. While conducting an on-site image assessment, to the dismay of the hospital, we witnessed visitors enter restricted hospital areas. The appearance of the hospital and hospital staff play also play a key role in patient safety.

rn (11/30/2012 at 5:34 AM)
I communicated with LeapFrog and was impressed. I like the integrity of the people at LeapFrog. I think LeapFrog's compassionate ethics and skill comes across in the explanations and information given by Ms. Binder. The background of the people on staff at LeapFrog is superior and will give patients confidence in LeapFrog's opinions. Think about all the required patient safety defenses that UCLA doctors and administrators breach to receive an F from LeapFrog. UCLA's "F" is not about uninsured people draining the resources of a taxpayer funder hospital. An F from LeapFrog should frighten everyone into action – encouraging people to speak up and not let your family be a victim. Health care consumers' personal funds and taxpayer money should not result in preventable suffering. A score of F takes a "team effort" and bad leadership to become that bad and stay that bad. UCLA's organized pattern of patient abuse is beyond random chance and qualitatively different from negligence. LeapFrog's info. shows that the danger to patients is the quid pro quo amongst hospitals, health plans and California government that is supposed to be monitoring hospitals – especially taxpayer funded hospitals. Their tit-for-tat seems to include negligently retaining employees willing to harm patients. Other readers here may be interested in these MD's experience about UCLA. I think it will help people to understand how UCLA received an F Joseph A. Stirt, MD http://www.bookofjoe.com/2006/04/behindthemedspe_6.html www.anesthesiologyexpert.com/ Peter T Banos MD http://tryingforsense.blogspot.com/

concerned consumer (11/29/2012 at 7:04 PM)
I applaud what Leapfrog is trying to do, but what John Q. Public does not realize is that you cannot compare hospitals in the way Leapfrog is attempting. Their methodology does not take into account how sick or injured a patient is and they don't account for patients who don't follow doctors orders or who have language, cultural or socio-economic challenges. What Leapfrog doesn't tell the public is that they are a watchdog group funded by employers who want to use the scores to extort hospitals and insurance companies. As someone who lost their father because of an HCA-owned hospital's inappropriate care (that does not meet the legal definition of negligence), what I want to see is more transparency from regulatory bodies like CMS, the states and The Joint Commission. Any rating system from publicly-reported data is going to be skewed because the data is out-of-date by the time its published. Regulatory bodies are the ones who need to score hospitals and health systems, not an Angie's List type of organization like Leapfrog.




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