PATIENT SAFETY SURVEY RESULTS SUMMARY

During the late summer and fall 2001, The Leapfrog Group invited urban hospitals in six regions across the country to complete a voluntary online patient safety survey. The survey queried hospitals on their efforts to implement three proven patient safety practices. The practices include computerized physician order entry (CPOE), intensive care unit staffing by intensivists (IPS) and evidence-based hospital referral for five high-risk surgeries and two high-risk neonatal conditions.

Urban hospitals in Atlanta, Georgia, California, East Tennessee, Minnesota, St. Louis, Missouri and Seattle-Tacoma-Everett, Washington were the first hospitals invited to respond to the ongoing survey. The results below reflect the data as of December 31, 2001. Survey results and more information can be found online at www.leapfroggroup.org.

Overall Results

- 48% of invited hospitals submitted responses (241 hospitals out of 497)

- 53% of submitting hospitals have fully implemented at least one of Leapfrog's recommended patient safety practices

Results by Patient Safety Practice

Computerized Physician Order Entry (CPOE)

• 3.3% of hospitals submitting responses currently have CPOE; an additional 30% of hospitals that submitted responses indicated plans to have CPOE prior to 2004
• 3 out of 6 regions have at least one hospital that has fully implemented CPOE
  6 in CA; 1 in E. Tenn.; and 1 in Minn.

ICU Physician Staffing (IPS) or ICU Intensivists

• 10% of hospitals submitting responses have fully implemented the ICU intensivist practice; an additional 18% of responding hospitals indicated plans to implement the practice fully by 2004
• 5 out of 6 regions have at least one hospital that has fully implemented the IPS practice
  14 in CA; 1 in E. Tenn; 5 in Minn.; 1 in St. Louis; 3 in Seattle

Evidence-based Hospital Referral Standards*

*Although this standard specifies that patient referrals should be based on either publicly reported risk-adjusted outcomes or hospital volume, Leapfrog is only reporting volumes at this time.

Of the submitting hospitals,

• 12% meet the coronary artery bypass graft surgery recommended level of annual experience
• All regions have at least one hospital meeting the volume recommendation for coronary artery bypass: 4 in Atlanta; 10 in CA; 5 in E. Tenn.; 4 in Minn.; 1 in St. Louis; 4 in Seattle
• 31% meet the coronary angioplasty volume recommendation
• All regions have at least one hospital meeting the volume recommendation for coronary angioplasty: 4 in Atlanta; 39 in CA; 11 in E. Tenn.;10 in Minn.; 1 in St. Louis; 9 in Seattle
• 21% meet the abdominal aortic aneurysm repair volume recommendation
• All regions have at least one hospital meeting the volume recommendation for abdominal aortic aneurysm repair: 3 in Atlanta; 25 in CA; 10 in E. Tenn.; 4 in Minn.; 1 in St. Louis; 8 in Seattle
• 20% meet the carotid endarterectomy volume recommendation
• All regions have at least one hospital meeting the volume recommendation for carotid endarterectomy: 3 in Atlanta; 24 in CA; 9 in E. Tenn.; 5 in Minn.; 1 in St. Louis; 5 in Seattle
• 15% meet the esophageal cancer surgery volume recommendation
• Five of the six regions have at least one responding hospital meeting the volume recommendation for esophageal cancer surgery: 2 in Atlanta; 23 in CA; 3 in E. Tenn.; 6 in Minn.; 3 in Seattle
• 22% have NICUs that meet Leapfrog specifications
• All regions have at least one hospital meeting the volume recommendation for NICU
• 6 in Atlanta; 32 in CA; 5 E. Tenn.; 3 in Minn.; 1 in St. Louis; 5 in Seattle

Initial Survey Results by Region

ATLANTA

- 52% of invited hospitals responded to the survey (16 hospitals out of 31)

- 9 or 56% of hospitals in Atlanta submitting responses have fully implemented at least one of Leapfrog's recommended patient safety practices

Of the hospitals responding,

- CPOE: None has fully implemented CPOE, but 6 say they plan to implement CPOE fully by 2004

- IPS: None has fully implemented the IPS practice, but 3 say they plan to staff intensivists by 2004

- Evidence-based Hospital Referral:

- 4 meet the coronary artery bypass recommended annual volume

- 4 meet the coronary angioplasty volume recommendation

- 3 meet the abdominal aortic aneurysm repair volume recommendation

- 3 meet the carotid endarterectomy volume recommendation

- 2 meet the esophageal cancer surgery volume recommendation

- 6 meet Leapfrog specifications for NICUs

CALIFORNIA

- 44% of invited hospitals responded to the survey (150 hospitals out of 338) - Responding hospitals account for an estimated 60% of total discharges from hospitals invited to participate in the survey (this statistic is not available for other regions)

- 78 or 52% of hospitals in California submitting responses have fully implemented at least one of Leapfrog's recommended patient safety practices

Of the hospitals responding,

- CPOE: 6 have fully implemented CPOE, and 33 say they plan to implement CPOE fully by 2004

- IPS: 14 have fully implemented the IPS practice and 13 say they plan to staff intensivists by 2004

- Evidence-based Hospital Referral:

- 10 meet the coronary artery bypass recommended annual volume (many California hospitals voluntarily report outcomes ata for this procedure-see www.HealthScope.org)

- 39 meet the coronary angioplasty volume recommendation

- 25 meet the abdominal aortic aneurysm repair volume recommendation

- 24 meet the carotid endarterectomy volume recommendation

- 23 meet the esophageal cancer surgery volume recommendation

- 32 meet Leapfrog specifications for the NICU

EAST TENNESSEE

- 92% of invited hospitals responded to the survey (23 hospitals out of 25)

- 15 or 65% of hospitals in E. Tenn. submitting responses have fully implemented at least one of Leapfrog's recommended patient safety practices

Of the hospitals responding,

- CPOE: 1 has fully implemented CPOE, but 12 say they plan to implement CPOE by 2004

- IPS: 1 meets the IPS practice, and 6 say they plan to staff intensivists by 2004

- Evidence-based Hospital Referral:

- 5 meet the coronary artery bypass recommended annual volume

- 11 meet the coronary angioplasty volume recommendation

- 10 meet the abdominal aortic aneurysm repair volume recommendation

- 9 meet the carotid endarterectomy volume recommendation

- 3 meet the esophageal cancer surgery volume recommendation

- 5 meet Leapfrog specifications for the NICU

MINNESOTA

- 60% of invited hospitals responded to the survey (28 hospitals out of 47)

- 11 or 39% of hospitals in Minnesota submitting responses have fully implemented at least one of Leapfrog's recommended patient safety practices

Of the hospitals responding,

- CPOE: 1 has fully implemented CPOE and 9 say they plan to implement CPOE by 2004

- IPS: 5 have fully implemented the IPS practice and 9 say they plan to staff intensivists by 2004

- Evidence-based Hospital Referral:

- 4 meet the coronary artery bypass recommended annual volume

- 10 meet the coronary angioplasty volume recommendation

- 4 meet the abdominal aortic aneurysm repair volume recommendation

- 5 meet the carotid endarterectomy volume recommendation

- 6 meet the esophageal cancer surgery volume recommendation

- 3 meet Leapfrog specifications for the NICU

ST. LOUIS

- 3% of invited hospitals responded to the survey (1 hospital out of 31)

- The one hospital has fully implemented the IPS practice and meets 5 of the volume standards

For the one hospital responding to date,

- CPOE: it does not meet the CPOE standard, but it plans to implement CPOE by 2004

- IPS: it does meet the IPS standard

- Evidence-based Hospital Referral:

- it meets the coronary artery bypass recommended annual volume

- it meets the coronary angioplasty volume recommendation

- it meets the abdominal aortic aneurysm repair volume recommendation

- it meets the carotid endarterectomy volume recommendation

- it does not meet the esophageal cancer surgery volume recommendation

- it meets Leapfrog specifications for the NICU

SEATTLE-TACOMA-EVERETT

- 92% of invited hospitals responded to the survey (23 hospitals out of 25)

- 13 or 57% of hospitals in the Seattle area submitting responses have fully implemented at least one of Leapfrog's recommended patient safety practices

Of the hospitals responding,
- CPOE: None has fully implemented CPOE, but 12 say they plan to implement CPOE by 2004

- IPS: 3 have fully implemented the IPS practice, and 12 say they plan to staff intensivists by 2004

- Evidence-based Hospital Referral:

- 4 meet the coronary artery bypass recommended annual volume

- 9 meet the coronary angioplasty volume recommendation

- 8 meet the abdominal aortic aneurysm repair volume recommendation

- 5 meet the carotid endarterectomy volume recommendation

- 3 meet the esophageal cancer surgery volume recommendation

- 5 meet Leapfrog specifications for the NICU