I have written before about the pitfalls of reporting systems and grades for hospitals. Here is an article I just read from a newsletter I received from PHTS – a risk management organization that we belong to. I was tempted to delete the last sentence, but I think this is a critical point. Self-reporting has some limitations and inherent conflict of interest, in that it can be self-promoting.
Leapfrog measures fall short. Hospitals that comply with safety standards pushed by the Leapfrog Group, and endorsed by the National Quality Forum, don’t necessarily have lower mortality rates or lower incidence of hospital-associated infections, report researchers in Archives of Surgery.
The authors reviewed outcomes in a nationally representative sample of level I and level II trauma centers. They report that neither the total score on the Leapfrog Safe Practices Survey, nor full implementation of computerized physician order entry, nor full implementation of intensive care unit physician staffing led to lower mortality or fewer hospital-associated infections.
“We did find, however, that a hospital disclosure policy for informing patients and families of systems failure or human errors leading to unanticipated outcomes is associated with lower mortality,” the researchers reported.
Earlier research on safe practices also turned up equivocal results. For instance, researchers found that computerized physician order entry and ICU physician-staffing levels improved outcomes for heart attack patients but not for patients with congestive heart failure or pneumonia. Another study found no correlation between a high score on safety practices survey and lower mortality.
Dr. Laurent Glance, who led the work, told Reuters Health the findings don’t indicate the safety practices aren’t effective. It could be the Leapfrog survey is falling short. “You can’t just rely on what the hospital executive says. You’d probably also need to have some sort of auditing in place,” he noted.