The Leapfrog Group's annual list of Top Hospitals was announced on December 4th in Baltimore, Maryland and included Boston Medical Center in Boston, MA for the first time. The announcement came at Leapfrog's Annual Meeting, focusing on transparency as the key to improved hospital safety, and Top Hospital Awards.
"Boston Medical Center is pleased to be recognized as a patient safety leader," said BMC President and CEO Kate Walsh. "This national distinction for excellence underscores our commitment to the delivery of high-quality care in a safe environment for our patients. I am so proud of the work we have done, and continue to do, to provide exceptional care, without exception to our patients and their families."
"The Leapfrog Top Hospital distinction is by far the most competitive award a hospital can receive. Leapfrog holds hospitals to the highest standards on behalf of our purchaser members and their employees. By achieving the Top Hospital accolade, Boston Medical Center has demonstrated exemplary performance across all areas of quality and patient safety that are analyzed on the Leapfrog Hospital Survey. This hospital stands out as one consistently providing safe, high quality care, and I would be comfortable sending my family to Boston Medical Center for care," said Leah Binder, President & CEO of The Leapfrog Group.
Boston Medical Center was selected as a Top Hospital out of nearly 1200 hospitals participating in The Leapfrog Group's annual survey. This year, the Top Rural Hospital list includes a record 11 hospitals. Other hospitals reaching this achievement include academic medical centers, teaching hospitals, children's hospitals, and community hospitals in rural, suburban and urban settings. The selection is based on the results of the Leapfrog Group's annual hospital survey, which measures hospitals' performance on patient safety and quality, focusing on three critical areas of hospital care: how patients fare, resource use, and management structures in place to prevent errors. The results of the survey are posted on a website open to patients and families, the public, employers, and other purchasers of healthcare.
As a 2012 Top Hospital, Boston Medical Center met the following standards for safe, high quality care:
TOP URBAN HOSPITAL
I. A hospital must fully meet Leapfrog's standard for Preventing Medication Errors (CPOE)
Research estimates that more than one million serious medication errors occur each year in U.S. hospitals, with 7,000 deaths annually from adverse drug events (ADEs). In addition to the human price paid, each ADE adds $2,000 on average to the cost of a hospitalization. This translates to more than $7.5 billion per year nationwide in hospital costs alone. CPOE systems can reduce the number of ADEs by up to 88%, preventing three million serious medication errors in the U.S. each year.
Leapfrog's standard for Computerized Physician Order Entry (CPOE) measures the extent to which a hospital has adopted CPOE, and whether decision-support tools in the CPOE system are working effectively. To fully meet this standard, physicians must enter at least 75% of medication orders through a CPOE system; and demonstrate, via a test, that their inpatient CPOE system can alert physicians to at least 50% of common, serious prescribing errors.
II. A hospital must fully meet Leapfrog's standard for ICU Physician Staffing (IPS)
Mortality rates are significantly lower in hospitals with ICUs managed exclusively by board-certified intensivists (physicians trained in critical care medicine). Research has shown that in ICUs where intensivists manage or co-manage all patients, there is a 30% reduction in overall hospital mortality and a 40% reduction in ICU mortality.
Hospitals fulfilling Leapfrog's standard for ICU Physician Staffing must operate adult and/or pediatric ICUs that are managed or co-managed by intensivists who: a) Are present during daytime hours and provide clinical care exclusively in the ICU and, b) When not present on site or via telemedicine, return pages at least 95% of the time, (i) within five minutes and (ii) arranges for a certified physician or physician extender to reach ICU patients within five minutes.
III. A hospital must fully meet Leapfrog's standards for high-risk surgeries and procedures
(Hospitals must achieve a score of "fully meets" for 50% of the surgeries or procedures that apply) Research indicates that a patient's risk of dying is reduced by approximately two to four times, depending on the high-risk procedure, if care is obtained in hospitals that meet Leapfrog's standards.i
Hospitals fulfilling Leapfrog's standards for high-risk surgeries and procedures (heart bypass, heart angioplasty, aortic valve replacement, abdominal aortic aneurism repair, bariatric surgery, esophogectomy, pancreatectomy, and high-risk newborn deliveries) have met Leapfrog's robust volume, processes of care, and outcomes standards. The Leapfrog website provides specific details about these performance measures and the scoring (www.leapfroggroup.org).
IV. A hospital must achieve a Value Score of 69 or Better as calculated through Leapfrog's Hospital Recognition Program (LHRP Value Score)
The Leapfrog Hospital Recognition Program uses each standard from the Leapfrog Hospital Survey to calculate an overall value score for each hospital. The value score, which is a numerical value from 0 to 100, is a combination of quality and resource use, with quality weighted more heavily in the calculation. Hospitals with high value scores have demonstrated both high quality and appropriate resource use. The Leapfrog website provides specific details about these calculations.
V. Hospitals eligible for a Hospital Safety ScoreSM must receive an A on the letter grades publicly reported at the time of the Top Hospital public announcement
The Hospital Safety Score grades hospitals on how safe they are for patients. Each A, B, C, D or F score comes from expert analysis of publicly available data consumers can now use to protect their families from harm or death during a hospital stay. Some hospitals are exempted from receiving a Hospital Safety Score, including specialty hospitals like children's or surgical, Critical Access Hospitals, and hospitals in the state of Maryland. Hospitals that are eligible for a score, which includes general acute care hospitals in all other states, must receive an A on the Hospital Safety Score in order to qualify for Top Hospitals.
About The Leapfrog Group
The Leapfrog Group is a national organization using the collective leverage of large purchasers of health care to initiate breakthrough improvements in the safety, quality, and affordability of health care for Americans. The flagship Leapfrog Hospital Survey allows purchasers to structure their contracts and purchasing to reward the highest performing hospitals. The Leapfrog Group was founded in November 2000 with support from the Business Roundtable and national funders, and is now independently operated with support from its purchaser and other members.