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    Saturday, April 18, 2009

    GOOD NEWS AND BAD NEWS

    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),

    Individual hospital results can be viewed and compared with other hospitals at www.leapfroggroup.org

    First The Good News:

    • Thirty-one percent of hospitals now meet the Leapfrog ICU staffing standard, up from 10 percent in 2002.
    • Hospitals with all of Leapfrog's recommended policies in place to prevent common HAIs jumped from 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 in their facility.

    Now the Bad News: Most hospitals fall short on safety measures. Survey shows low rates of adherence to hospital safety, quality standards.


    Only 7 percent of hospitals meet Leapfrog medication error prevention (CPOE) standards and few hospitals are meeting mortality standards, according to the 2008 Leapfrog Hospital Survey, released 4/15/09.

    The healthcare watchdog organization surveyed 1,276 hospitals in 37 US metropolitan areas and found that "low percentages of reporting hospitals are 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." Also, efficiency standards among surveyed hospitals "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 pneumonia care."

    Other alarming features of the 2008 hospital survey include:

    • Low percentages of reporting hospitals are 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 resections;
      • 16 percent for bariatric surgery;
      • 15 percent for esophagectomy;
      • 7 percent for aortic valve replacement; and
      • 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 meet the standards for 13 evidence-based safety practices, ranging from hand washing to nursing staff competency.
    • Only 26 percent and 34 percent of reporting hospitals are meeting standards for treating two common acute conditions, heart attacks (AMI) and pneumonia, respectively.

    Summary: Only 30 percent and 25 percent of hospitals are meeting standards to prevent hospital-acquired pressure ulcers or hospital-acquired injuries, respectively.

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