The latest in a series of six reports issued by the LeapFrog Group and Castlight Health® examining quality and safety measures at U.S. hospitals has been released, and the results show that more transparency is needed to address quality of care issues, which remain a problem for the nation’s hospitals. The report, which analyzed hospital-acquired conditions, ICU staffing, safe practices, and never events, summarized the results of the 2014 Leapfrog Hospital Survey of 1,500 hospitals throughout the country.
Each year, the Leapfrog Group asks every general acute care hospital in the country to complete its Hospital Survey, and makes the results available to the public. Leapfrog uses the survey results to track hospital progress on issues that are important to health care consumers.
According to LeapFrog, compliance with its policy relating to so-called “never events,” which are “serious reportable adverse events that should never happen,” still poses a problem for some hospitals. The report found that never events policy compliance was low, with 79 percent of hospitals meeting Leapfrog’s standard from 2012 to 2014. The report stated that one in five hospitals will still not agree to apologize to patients and to waive all costs if a never event occurs. Examples of never events include a foreign object being left after surgery or an air embolism occurring.
The rates of certain hospital-acquired conditions continue to be a problem, with one in six hospitals reporting higher rates than expected for central line infections and one in ten hospitals performing poorly in preventing urinary tract infections caused by catheters.
The report also indicated that hospitals are continuing to struggle with safe practices compliance, with rural hospitals in particular having the most difficulty. Twenty percent more urban hospitals met Leapfrog’s safe practices standards and showed greater yearly improvement than did rural hospitals.
ICU physician staffing
More intensive care units across the country reported compliance with Leapfrog’s ICU Physician Staffing standard, which studies have found to reduce ICU mortality rate by 40 percent. The Leapfrog Physician Staffing standard requires that ICUs should be staffed with physicians who are certified in critical care medicine (intensivists) and who must be present in the ICUs at least eight hours a day, seven days a week. When not present in the ICU, intensivists should respond to pages within five minutes, or have another physician, physician assistant, nurse practitioner, or trained nurse reach the patient within five minutes.
While 39 percent of hospitals nationwide participated in the survey, the report calls for more hospital participation and transparency. In a released statement, Leah Binder, president and CEO of the LeapFrog Group emphasized that hospital commitment and transparency were important factors in improving the health care system. She stated, “As a result, we’ve seen a continued decrease in the national rate of early elective deliveries, as well as a number of strong improvements in key areas, including hand hygiene compliance and ICU staffing practices. Still, more work is needed. It’s essential we see this level of improvement in all areas of the health care system.”