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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Campaign Resources

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