Hospitals that participate in Leapfrog's annual survey agree to be scored stringently on quality and efficiency metrics, the use of computerized order entry and on having a fully staffed intensive-care unit. While some hospitals in the past have complained about the toughness of the survey or questioned what is measured, Binder is unapologetic about its difficulty. The hospitals at the meeting represent the top 3% of survey performers, and the addition of three top rural hospitals this year demonstrates that expecting high standards from providers does garner results, she said.
About 135 attended the conference, held Dec. 3 in Washington. The participants showed there are a number of hospitals out there “fighting the good fight,” said Frances Margolin, director of operations for Leapfrog. “It's nice to be able to recognize them.”
And hospitals can expect more changes to the survey, as Leapfrog adds new sections or removes older ones, based on what the field is focused on and what research dictates are the best evidence-based practices. For the 2010 survey, the purchasing group is considering adding new surgical scheduling questions. A public comment period on those questions is now closed.
If Leapfrog determines the questions are appropriate, hospitals will answer that section in the 2010 survey, but the scores will not count until the following year so that there is enough time to understand how to collect and report that data, Margolin said. “It's a way to give hospitals a chance to improve before being held accountable.”
Leapfrog also will be further exploring that concept of rewards and incentives through a new gainsharing project with Health Quest, a three-hospital system in Poughkeepsie, N.Y. Gainsharing typically looks at how to share savings collected by reducing medical errors and improving quality of care with various providers.
Currently the system and Leapfrog are in the planning stages of that program and are investigating specific processes and procedures that would be measured through the program and how rewards would be spread among team members, Margolin said. “We hope that we'll find out whether using certain kinds of incentives” increases the use of evidence-based measures.” A formal announcement of the plan is expected early in 2010.
Jean DerGurahian covers quality issues for Modern Healthcare.
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