The Leapfrog Group has loosened three controversial patient-safety standards in an acknowledgement of new research and a steady stream of concern from providers. As a result, hospitals should have an easier time demonstrating progress toward meeting the criteria: computerized prescribing, use of intensivists in critical care and handling minimum volumes of certain high-risk procedures. Hospitals were given an extra year -- until 2005 -- to begin using prescription-ordering information systems that alert physicians and other clinicians to drug interactions or allergies. The business coalition also simplified its definition of full implementation of computerized prescribing and will give partial credit for systems implemented in at least one area of the hospital. Industry feedback convinced the group that computerized prescribing systems cannot be implemented quickly, with the high-dollar investment requiring board approval and physician acceptance requiring significant advance work, said Leapfrog board member Arnold Milstein, medical director of the Pacific Business Group on Health.
Leapfrog also broadened its definition of intensivist to include physicians who have a long record of full-time experience in intensive care but might not be board-certified in the specialty. And, it yanked a volume-based measure of proficiency for one high-risk procedure, carotid endarterectomy, after new research countered previous findings of better outcomes at higher-volume hospitals. -- by John Morrissey