The first ambulatory patient safety initiative from the Leapfrog Group will not start this year because HHS is trying to make sure the recommendation fits within the parameters another healthcare quality program the federal agency is pushing, Leapfrog officials say.
In a Tuesday conference call with reporters, Leapfrog Group Executive Director Suzanne Delbanco said the Washington-based coalition of large healthcare purchasers hopes to have a draft ambulatory safety proposal out within the next couple of months. However, because the Washington-based organization is working with CMS and the HHS Agency for Healthcare Research and Quality, Delbanco says it "might be another year before it's final."
The proposal, believed to call for advanced ambulatory electronic medical records systems with integrated prescribing tools that send prescriptions directly to pharmacies via electronic data interchange, likely will be part of a Medicare demonstration project that will require a public comment period, Delbanco says.
HHS also wants to make sure that Leapfrog's outpatient CPOE standard is "completely synchronized" with treatment regimens under the CMS Doctors Office Quality (DOQ) project, Delbanco says.
CMS has said DOQ would determine the effectiveness of various strategies for measuring clinical quality, systems of care and patient experiences. That test, which had been set to begin this summer, is on hold while the government negotiates to use AMA-developed performance measures for at least eight ambulatory procedures and conditions.
Instead of an ambulatory plan as the fourth "leap," Delbanco says the Leapfrog Group likely will adopt a recommendation from a list of 30 safe practices published by the National Quality Forum, a patient safety advocacy group headed by former Veterans Health Administration chief Kenneth Kizer, M.D. The NQF list includes the three existing Leapfrog acute care initiatives.
Also today, the Leapfrog Group announced that it now has data from 1,012 hospitals that have reported whether they comply with the Leapfrog safety recommendations: CPOE, intensivist care and evidence-based hospital referral for seven high-risk procedures and conditions. That is 58.9% more than the 637 facilities that had answered the ongoing survey at this time last year.
The respondents include 377 hospitals outside the 22 geographic areas that Leapfrog has targeted for safety improvement to date.
According to the latest results, nearly 39% of the more than 1,000 hospitals meet at least one Leapfrog standard.
Just 4.1% of the hospitals in the 22 rollout regions have fully implemented CPOE, though 17.2% say they will complete implementation by 2005, according to the Leapfrog Group.
Additionally, 22.3% of those facilities with intensive care units have implemented an intensivist program--twice the rate of a year ago, the group says.