Leapfrog California Patient Safety Initiative: Reducing Medical Errors

Problem: Preventable medical errors are the fifth leading cause of death in the United States—more than vehicle accidents or breast cancer. An estimated 98,000 people die each year from avoidable errors made in hospitals alone. Adverse drug events result in more than 770,000 injuries each year. The costs are high—estimated at between $17–29 billion per year due to health care costs, disability, lost income and lost household production.

PBGH Role and Project Description: Leapfrog is a unique and bold push by purchasers to reduce preventable medical errors in hospitals and create consumer choice tools. The Pacific Business Group on Health is a founder of the national initiative and leads the Leapfrog California rollout. PBGH and California health plans encourage hospitals to complete an online self-certification survey to indicate their on implementing three practices proven to reduce medical errors: Computerized Physician Order Entry (CPOE), Evidence-Based Hospital Referral (EHR) and ICU Physician Staffing (IPS). Additionally, hospitals report on the status of implementing a set of evidence-based safe practices.  Diverse hospitals participate in the survey—non-profits, for-profits, large chains, independents, academic/teaching hospitals and children's hospitals.

The goals of the initiative are to:

• Serve as a catalyst for quality accountability and quality improvement among hospitals by recognizing and rewarding hospitals that take proven steps to improve patient safety.
• Foster value purchasing among employers by creating tools to inform network selection and reward performance.
• Activate consumers by raising their awareness of quality differences among hospitals and giving them tools to make better choices.
• Motivate health plans and physicians to inform patients about and make available better performing hospitals.

The PBGH Quality Improvement Fund supports this project. Health plans that contract with the Negotiating Alliance must support Leapfrog in measurable ways as part of the quality performance requirements on which two percent of premium is at risk.  PBGH supported the national Leapfrog Group to develop a customizable employee communications toolkit with messages proven effective through consumer testing. This material was distributed to all PBGH members as well as to other California "frogs," including General Motors, General Electric and other Fortune 500 companies.

Impact: Leapfrog seeks to hasten hospital adoption of vehicles to reduce medical errors and foster accountability as hospitals consider their capital investments. In California, implementation of the three patient safety "leaps" could save nearly 8,000 lives and prevent 63,000 medication errors every year (saving one life and preventing seven medication errors each hour). In addition, focus groups conducted with employees and retirees confirmed they appreciate employer attention to this important issue and indicated they would read employer material on the topic of avoiding medical errors.

Hospital results are available at www.leapfroggroup.org.

Current Activities: The Leapfrog hospital survey continues to be updated based on new evidence and input from key collaborators, such as the American Hospital Association. Annual updates to the Leapfrog survey are completed by June and publicly available thereafter.  Leapfrog data is used by health plans for quality tiering and consumer information tools.

The following documents explain the Leapfrog Group initiatives in more detail.

• Leapfrog Fact Sheet
• The Leapfrog Group Computer Physician Order Entry (CPOE)
• Evidence-based Hospital Referral (EBHR)
• ICU Physician Staffing (IPS)
• National Quality Forum Safe Practices (NQF-SP)
• Never Events

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