Interview Series: Leapfrog leverages collective purchasing power for big leaps in patient safety

To kickoff our interview series with today’s thought leaders in patient safety, we spoke with Leah Binder, CEO of The Leapfrog Group.

Launched in 2000, Leapfrog is a unique initiative because it is driven by organizations that buy healthcare with the aim of mobilizing their employer purchasing power to alert America’s health industry that big leaps in healthcare safety, quality and customer value will be recognized and rewarded.

Among other initiatives, Leapfrog works with its employer members to encourage transparency and easy access to health care information, as well as rewards for hospitals that have a proven record of high quality care.

How is The Leapfrog Group working to improve patient safety?

Leapfrog represents the interests of the nation’s large employers, formed by a group of CEOs who were very disturbed by the 1999 IOM report that estimated that up to 98,000 Americans die unnecessarily every year from preventable medical errors (PMEs), with millions more harmed as a result of hospital-acquired infections (HAIs). So our founders wanted to see if we could make major change to address that problem--and they named it “Leapfrog” to make giants leaps forward, not just incremental change.

What Leapfrog does is survey hospitals and we ask them questions based upon NQF’s well-established, evidence-based measures that tell us about the quality and safety of hospitals. We then score them and place the information online so that employers may use that information to work with health plans and structure pay-for-performance (PFP) programs.

Employers have not traditionally used their purchasing power to influence healthcare services they purchase--they haven’t been able to simply insist that they deserve a certain level of quality for what they’re spending. Leapfrog is employers’ answer to that. In addition to asserting employers’ standards as purchasers of healthcare, Leapfrog advocates transparency so that people can choose hospitals based on safety practices and quality of care.

In your opinion, what are the “top priorities” that will move the industry much closer to eradicating PMEs and HAIs?

There are three top priorities. The first priority is to transform financing, because we currently have a financing system that too often rewards the wrong things. We tend to reward what we don’t want to happen and we tend to under-finance what we do. For example, right now--though not for long--the hospitals that have the highest levels of HAIs are probably getting the highest reimbursements from Medicare. Another example: our healthcare system tends to pay inadequately for prevention but readily spends huge sums for emergency or acute care that might have been avoided through better prevention. So we as a country are often financing at odds with our values.

The second top priority is that we have to support hospitals and recognize how difficult it is to change. It’s a comprehensive systems change to decrease HAIs and involves a change across the board and everyone--from doctors to administrators to those that register the patients--needs to play a role in that change. Employers, like our organization’s members, are the first to recognize how hard change is because they understand it from the standpoint of their own companies--but they also understand that we are in the business of enforcing accountability.”

The third top priority is transparency. Purchasers and consumers need to have information on the safety of providers in order to choose the best. Having more consumers using information about quality helps drive change in the system.

Which educational and outreach programs is Leapfrog sponsoring?

Leapfrog’s annual Hospital and Safety Survey Results report is published in July of each year, with awards for the nation’s Top Hospitals occurring in September.

We are hosting a panel discussion in July about Leapfrog’s testing of computerized medication ordering systems at hospitals, called Computerized Prescriber Order Entry (CPOE). We’ve always asked hospitals to report on whether they have such a system--proven to reduce medication errors by 50-100%. This year’s survey for the first time includes a simulated model and exercise, so hospitals with CPOE can test if their CPOE systems are working properly. We will present new findings from the 2008 survey. We think the panel will be of interest to CPOE system vendors as well as hospital IT executives interested in improving safety of medication ordering.

• For more information on The Leapfrog Group: please go here.
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• For all interviews with today's patient safety thought leaders, please go here.