Driving the Market to Reduce Medical Errors through the Leapfrog California Patient Safety Initiative

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.

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.

In 2002 PBGH worked with 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 posted on HealthScope and the national Leapfrog site, www.leapfroggroup.org.

Current Activities: Following a revision based on updated scientific evidence as well as input from the American Hospital Association, an improved version of the Leapfrog hospital survey was released in April 2003. PBGH requested that California hospitals complete the new survey by July, at which time old survey data was deleted from Leapfrog, HealthScope and other consumer health information Web sites. Responses from the new survey are being posted as they come in. PBGH is developing a comprehensive contact database to facilitate Leapfrog communications; developing health care system and hospital communication materials and working closely with California health plans to both foster submission of updated information and encourage use of Leapfrog data in quality tiering and consumer information tools. Planning for Year Four of Leapfrog California and the national effort is currently underway.

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The following documents explain the three practices selected by the Leapfrog Group (Computerized Physician Order Entry—CPOE, Intensive Care Unit Physician Staffing—IPS, and Evidence–Based Hospital Referral—EHR). Also included is a fact sheet regarding Leapfrog here in California.

• Computerized Physician Order Entry (CPOE) Fact Sheet
• Intensive Care Unit Physician Staffing (ICU) Fact Sheet
• Evidence–Based Hospital Referral (EHR) Fact Sheet
• Leapfrog California Fact Sheet

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