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Groundbreaking Survey of Efforts to Reduce Avoidable Medical Errors Helps Consumers Choose a Hospital

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California Hospitals Dominate National Survey

San Francisco, CA, January 17, 2002 - According to the Institute of Medicine, between 44,000 and 98,000 people die each year and many more are injured from preventable mistakes made in hospitals. Californians and other consumers now have unprecedented access to information on which hospitals have implemented three pioneering practices proven to reduce such mistakes. New survey results, available online today, of 150 hospitals in California and 147 others from five regions in other parts of the U.S. reveal their progress in implementing the practices.

In California, the survey was completed by 44 percent of the 338 eligible and invited hospitals (urban acute care hospitals). However, because participants included nearly all the major hospital systems in the state, as well as California's largest hospitals, they account for an estimated 60 percent of annual discharges from eligible hospitals.

"Patients in California can be proud of the many California hospitals that completed the Leapfrog survey," said Peter Lee, president of the Pacific Business Group on Health (PBGH), leader of Leapfrog's California effort. "We realize our state's hospitals face many special issues, including seismic retrofitting and staffing shortages. Despite this, these hospitals have shown extraordinary leadership in public accountability by participating in the first year of this ongoing initiative."

"This information, along with outcomes for coronary artery bypass graft surgery and patient experience at the hospital level, is now available in a user-friendly way on HealthScope, our consumer Web site. This is a huge leap forward in standardized, comparable hospital information available to Californians," Lee said.

The participants represent all segments of the California hospital industry, including non–profits, for–profits, systems, independents, children's facilities and academic medical centers.

"For a health care organization, there is no more important goal than the reduction of medical errors," said Van R. Johnson, President and CEO of Northern California–based Sutter Health. "We applaud PBGH for its leadership in taking this important first step on behalf of its constituents. Sutter Health is fully committed to the Leapfrog initiative and in doing all that we can to reduce medical errors and promote practices that ensure the safety of our patients."

According to Michael Langberg, MD, Chief Medical Officer at Cedars–Sinai Health System, "Cedars–Sinai is pleased to join the collaborative efforts of hospitals nationwide which participated in the Leapfrog Group survey. Additionally, we are pleased to share our results with the public so our local communities may have the information available to make the most informed choices in their healthcare decisions."

The Leapfrog Group, of which PBGH is a founding member, is supported by the Business Roundtable. Leapfrog conducted the survey among urban hospitals in California and five other areas: Atlanta, Minnesota, Eastern Tennessee, Seattle and St. Louis. The five areas outside California invited a total of 159 hospitals and yielded 91 participants, often achieving high percentages of participation in local communities. Hospitals in the rest of the U.S. were also welcome to participate, and 56 did so.

Survey results on California hospitals are available to consumers online at PBGH's consumer health information Web site, www.healthscope.org. Survey information for all the regions can be found at www.leapfroggroup.org.

For the first year of an ongoing survey, Leapfrog asked hospitals whether they currently:

  • Use or plan to install systems called "computerized physician order entry" (CPOE). CPOE could significantly reduce the approximately one million medication errors that occur in hospitals each year. In California, six responding hospitals have instituted CPOE, and another 41 have specific plans to implement such systems.

  • Staff or plan to staff the Intensive Care Unit (ICU) with trained specialists called "intensivists." Studies show that at least 10 percent of patients who die in the ICU would have lived if intensivists had managed their care daily during their stay. In California, 10 responding hospitals have intensivists overseeing care in the ICU at least eight hours a day. Another 14 are in the planning stage.

  • Meet recommended volume thresholds for five high-risk surgeries, as well as a minimum daily census in the neonatal ICU. "Evidence–based hospital referral" links a hospital's likely success when performing a surgery with how often the hospital performs it. Measuring actual outcomes is the best way to predict success, but outcomes data is rarely available to the public (the exception in California is mortality associated with bypass graft surgery). The next best method is level of experience. More than a hundred studies have shown, on average, a strong correlation between high volume and good outcomes. In California, 48 percent of responding hospitals meet at least one of the recommended volume thresholds.

Research shows that widespread adoption of the Leapfrog practices could save nearly 60,000 lives and prevent more than 500,000 medication errors annually. In California, that translates into more than 7,000 lives and 63,000 medication errors per year, or one life and seven medication errors every hour.

Because CPOE and ICU staffing by intensivists are cutting–edge practices, Leapfrog developed a way to recognize steps hospitals are taking towards full implementation. The Web sites and consumer tools identify "good progress," meaning that the hospital has developed a clear action plan and devoted the resources to implementing the practice, and "good early stage effort," meaning the hospital has developed a plan and is committed to implementing the practice in the next few years, but has not yet committed resources.

The three "leaps" were chosen not only because of their potential impact to reduce preventable medical mistakes, but also because they are easily understood by consumers, feasible to implement in the near future and discernible to purchasers, health plans and consumers.

"The era of the passive consumer in health care is over," said Barbara Decker, Benefits Manager for Southern California Edison. "People want and need information on quality at all levels of the health care system. Leapfrog is a giant step forward in helping consumers make better informed decisions about where they go for care."

"Through the PBGH performance measures for health plans, we have asked the plans to encourage contracting hospitals to participate in Leapfrog," said Decker. "This includes providing in-network coverage for hospitals using these three practices."

California's health plans played a major role in encouraging hospitals to participate in the survey. "The Leapfrog initiative supports our commitment to more consumer information on quality," said Gifford Boyce'Smith, MD, director of quality management at Blue Shield of California. "These survey results represent a major advance in useful information on individual hospitals. And they strengthen our ability as a health plan to differentiate among hospitals on the basis of quality, not cost alone."

Pacific Business Group on Health (PBGH), a major non–profit coalition of 44 public and private purchasers, is dedicated to improving healthcare quality while moderating cost. Its members annually spend more than $3 billion to provide health coverage to approximately 3 million employees, retirees and their families. PBGH seeks to promote health plan and provider accountability and to provide consumers with standardized, comparable data to make the best health care decisions at all levels of care. PBGH also operates PacAdvantage, a small group purchasing pool providing health insurance to more than 11,000 small employers in California.

Clark Miller
Senior Communications Manager
Pacific Business Group on Health
Telephone: (415) 615–6302
E–mail: This e-mail address is being protected from spambots. You need JavaScript enabled to view it


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Nicole Kohleriter
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