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Response to 'Association Between Hospital-Reported Leapfrog Safe Practices Scores and Inpatient Mortality,' Journal of the American Medical Association (JAMA); April 1, 2009
Date:3/30/2009

utcomes, including reduced mortality.

Most recently, Dr. Ashish Jha from Harvard Medical School and colleagues published a paper supporting this relationship in the Journal of the Joint Commission. A description of that publication is available at: http://www.leapfroggroup.org/media/file/Release-Lower_mortality_at_Leapfrog_hospitals.pdf

The process and structure measures in the Safe Practices Score are perfectly sensible. The idea that creating a safety culture, ensuring an adequate nursing workforce, preventing central venous line infections, and requiring hand washing, among other safety practices, would lead to a safer environment seems obvious.

But clearly we cannot assume that structural and process improvements automatically lead to the outcomes we desire. The JAMA study challenges health services researchers and measure developers to devise more direct measures of outcomes.

The Leapfrog Group will consider this study carefully and with the support of health care researchers, consider several questions about the hospital survey:

  • Should we give hospitals more credit for those items in the safe practices that require the most action?
  • Should we move away from a "training wheels" approach? Instead of providing hospitals credit for each individual step taken to achieve full implementation of a given practice, should we simply require a CEO's sign-off indicating the safe practice is being routinely followed?
  • Should we seek to raise the bar on the Safe Practices standard? Perhaps only a handful of the hospitals in the top quartile of our survey are doing enough about
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SOURCE The Leapfrog Group
Copyright©2009 PR Newswire.
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