Hospital Safety as a Priority: An Opportunity for Nurses to Lead
Presented by: The Leapfrog Group
October 31, 2012
Susan Reinhard, PhD, RN, FAANSenior Vice President & Director, AARP Public Policy Institute; Chief Strategist, Center to Champion Nursing in America
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Patricia A. Polansky, RN, MS Director of Policy and Communications Center to Champion Nursing in America
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www.campaignforaction.org/webinars
Today’s Webinar Will…
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1. Provide an overview of the work of the Leapfrog Group and their role in the public reporting of hospital safety scores.
2. Discuss Magnet status and public reporting of scores means for hospitals and consumers.
3. Explain Leapfrog’s role in ensuring a prepared nursing workforce and how that directly influences hospital safety and the Magnet designation.
4. Motivate you to treat hospital safety as a priority in health care.
Leah BinderPresident and CEO, The Leapfrog Group
Marsha Manning, RN, BSN, MLIRManager, Health Care Plans forGeneral Motors Global Compensationand BenefitsBoard Member, The Leapfrog Group
Hospital Safety and Quality in America
A Silent Epidemic?
Hospital Safety in America
• More than 180,000 people die every year from hospital infections, injuries, and errors (Office of Inspector General; November 2010)
• A Medicare patient has a one-in-four chance of experiencing injury, harm or death when admitted to a hospital
• One out of every six of your employees admitted to a hospital will suffer an adverse event
• Today alone, 493 people will die because of a preventable hospital error; 20 of them during this presentation
The Leapfrog Group
• Founded in 2000 by large employers interested in driving a market for safety and quality in hospitals
• Annual Leapfrog Hospital Survey reports on hospital performance
How Leapfrog is Used
• Public reporting/engaging consumers• Benefits design and contracting• Value based purchasing• Direct communication between purchasers and hospitals• Drive a market for nursing priorities
Local, Regional, National
• Regions Drive Survey Data Collection
• 45 Regional Roll Outs invite hospitals to complete the survey
• Use various incentives and recognition to drive further improvements
Transparency that Drives Markets: The Checklist
Shows variation: Show how your performance compares and contrasts to the broadest spectrum of highs and lows
Relevant: Measure what matters to consumersUnbiased: Report through an independent arbiter. An
advertisement is not an example of transparency.
Cars and Tupperware
Shows variationRelevantUnbiased
HospitalCompare.govPneumonia
HospitalCompare.govDeath rates
Hospital Compare
Shows variationRelevantUnbiased
www.LeapfrogGroup.org
Leapfrog
Shows variationRelevantUnbiased
Hospital Safety Score
The Hospital Safety Score is an A, B, C, D, or F letter grade reflecting how hospitals perform at keeping patients safe from harm and error
www.HospitalSafetyScore.org
Methodology Behind the Hospital Safety Score
• Scores assessed for 2,600 general, acute-care hospitals
• Data was gathered that is publicly reported at the national level, including measures reported by the Center for Medicare Services (CMS) and the annual Leapfrog Hospital Survey– Specialty hospitals and hospitals not required to report data
to CMS were not included
• Methodology developed by the Blue Ribbon Expert Panel
Blue Ribbon Expert Panel That Advised Leapfrog
ROLE: The Panel provided guidance to Leapfrog on calculating one numerical score for each general hospital. Leapfrog calculated the final scores and set the letter grades)
• John Birkmeyer (University of Michigan)• Ashish Jha (Harvard University) • Lucian Leape (Harvard University)• Arnold Milstein (Stanford University)• Peter Pronovost (Johns Hopkins University)• Patrick Romano (University of California, Davis)• Sara Singer (Harvard University)• Tim Vogus (Vanderbilt University)• Robert Wachter (University of California, San Francisco)
Media Coverage
• 600+ Press Mentions in first week after release– Newspaper- 250– Broadcasting- 190– Trade publications- 80– Online news- 75– Other- 75– National includes: CNN, ABC News, Kaiser, Modern Healthcare
• 600 hits per minute day one and two (similar to NYT)• 575,000 Pages Served first 3 days• 96,000 Web Visits first 3 days
• Overall, it appears consumers do care about patient safety
What Consumers Should Do
• Use the Hospital Safety Score as one tool in the process of selecting a hospital to receive care– Also consult CMS Hospital Compare, Leapfrog Hospital Survey
results, HealthGrades, etc.
• Talk to a doctor or nurse about hospital safety • Ask hospital administrators what the hospital is doing to
improve their patient safety record• Become educated on how to stay safe in the hospital
Looking Forward
• Hospital Safety Scores will be rereleased in November, 2012
• Twice a year updates going forward• Look for: a new app• The Expert Panel will continue adapt the methodology
before each release of the score• Leapfrog and the Expert Panel will search for ways to
evaluate hospitals not scored this round, including specialty hospitals, military/veterans hospitals, and hospitals in Maryland, Guam, and Puerto Rico
Nursing is Central: One of the highest weighted measures in the Hospital Safety Score
• NURSING WORKFORCE• A Leapfrog measure: if a hospital does not voluntarily report
to Leapfrog, nursing is not directly accounted for in the score
• Magnet Status automatically accounts for full credit on nursing workforce, and is highlighted by Leapfrog as well
Leapfrog Standards on Nursing Workforce : Samples
• Included senior nursing leadership as part of the hospital senior management team
• Held the Board and senior administrative leadership accountable for the provision of financial resources for nursing services
• Collected and analyzed data of actual unit-specific nurse staffing levels
• Performed a risk assessment and an evaluation of the frequency and severity of adverse events that can be related to nurse staffing.
Nursing is Central to All Safety Issues: Key Process Measures in the Hospital Safety Score
• Infection prevention• Culture of Safety• Hand Hygiene policies• Medication reconciliation• Deaths from preventable surgical complications• CPOE• Preventing falls and pressure ulcers• Leadership structures to promote safe practices
Key Outcome Measures
• Pressure ulcer—Stage 3 and 4• Falls and trauma• Central Line-Associated Bloodstream Infection• Iatrogenic Pneumothorax• Postoperative:
– Respiratory failure– Clots– Wound Dehiscence
Transparency Calls Attention to Nursing Priorities
Solutions to Safety Won’t Come From Inside the Hospital
Contact Us
Leah Binder, Leapfrog President & CEOMarsha Manning, Leapfrog Board Member, Co-Chair of the Board Committee on the Hospital Safety Score &Manager, Health Care Initiatives and Employee Benefits Public Policy, General Motors
http://blogs.forbes.com/leahbinder/
The Leapfrog Group1660 L Street NW Ste. 308Washington, DC 20036www.leapfroggroup.orgwww.hospitalsafetyscore.org
Questions?
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