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Cincinnati Children's Named One of Nation's Top Hospitals for Quality and Safety

Monday, January 01, 0001

Cincinnati Children's Hospital Medical Center is one of nine pediatric institutions and 59 hospitals of any kind in the nation named to the first Leapfrog Top Hospitals list.

The Leapfrog Group is an organization launched in 2000 to initiate breakthrough improvements in the safety, quality and affordability of healthcare for Americans. It is a member supported program aimed at mobilizing employer purchasing power to alert America's health industry that big leaps in health care safety, quality and customer value will be recognized and rewarded. The Leapfrog Group was founded by a small group of large employers, initially supported by the Business Roundtable (BRT) and launched in November 2000. Leapfrog is supported by the BRT, The Robert Wood Johnson Foundation, Leapfrog members and others.

Cincinnati Children's inclusion on the Leapfrog Top Hospitals list is based on results of the Leapfrog Hospital Quality and Safety Survey, a national rating system that offers a broad assessment of a hospital's quality and safety. More than 1,200 hospitals participated in the survey, which asked hospitals about their awareness and action on 30 "safe practices for better health care" endorsed by the National Quality Forum. It is the only national survey that provides such a full assessment of a hospital's quality and safety, according to The Leapfrog Group.

"We are honored to be among the nine best children's hospitals in focusing on national standards for patient safety," says Joe Luria, MD, an emergency medicine physician and patient safety officer at Cincinnati Children's. "Hospital leadership has made patient safety a priority, and our clinical staff has worked diligently over the past several years to implement computerized order entry, reduce medication errors, prevent hospital acquired infections, and vaccinate our care givers and patients against influenza. While there is still work to be done, our Leapfrog ranking demonstrates our commitment to providing the safest care possible for our patients."

Studies have shown that if every hospital in the nation adopted Leapfrog's initial three recommended quality and safety practices, it would save up to 65,341 lives, prevent up to 907,600 medication errors and save up to $41.5 billion each year.

The Leapfrog survey collects data from hospitals on their progress toward implementing practices in four categories chosen based, in part, on overwhelming scientific evidence that these quality and safety leaps will significantly reduce preventable medical mistakes. These four leaps are a practical first step in using purchasing power to improve hospital safety and quality, according to The Leapfrog Group. The leaps are:

• Computerized order entry: Do physicians enter patient prescriptions and other orders into computers linked to error prevention software?
• ICU physician staffing: Are intensive care units staffed by board-certified ICU specialists, known as intensivists?
• Evidence-based hospital referral: How well do hospitals perform five high-risk procedures and care for two high-risk neonatal conditions? Also, do hospitals meet minimum thresholds for daily volume of patients? Evidence suggests there is a direct positive relationship between higher volume and better outcomes.
• Leapfrog safe practices score: How well are hospitals progressing on the other 27 National Quality Forum Safe Practices?

Cincinnati Children's has fully implemented Leapfrog's quality and safety recommendations regarding computerized order entry, ICU physician staffing, care for high-risk neonatal conditions and Leapfrog's safe practices score. Cincinnati Children's average daily census in its intensive care units also exceeded minimum volume thresholds Evidence suggests there is a direct positive relationship between higher volume and better outcomes.

The five, high-risk treatments were not considered as part of the Cincinnati Children's score, as they pertained to adult patients and not children.

Of 1,263 responding hospitals, 60 percent have fully implemented the practices in at least one of the four Leapfrog patient safety and quality categories. Thirty percent fully meet the standard for the Leapfrog safe practices score. Only seven percent have fully implemented computer order entry. Of the 1,135 responding hospitals that have one or more ICUs, 26 percent enlist intensive care specialists to manage patients in the ICU. Leapfrog estimates that more than 20,000 lives are saved each year based on current implementation of the ICU physician staffing.

"Every hospital in the country that is not publicly reporting on their quality and safety is behind the times and out of touch with the communities they serve," says Suzanne Delbanco, CEO of The Leapfrog Group. "Americans deserve to be able to make the best decisions about their health care."

The Leapfrog ranking is the latest recognition for Cincinnati Children's in its efforts to transform the way it provides care. Earlier this year, the medical center earned the 2006 American Hospital Association-McKesson Quest for Quality Prize". Cincinnati Children's was selected by a multidisciplinary committee of health care and patient safety experts based on its culture of quality and efforts to adhere to the Institute of Medicine's six quality aims for hospitals. The American Hospital Association-McKesson Quest for Quality Prize is presented annually to honor leadership and innovation in quality, safety and commitment in patient care.

As a member of the Greater Cincinnati Patient Safety ICU Collaborative, Cincinnati Children's earned the 2005 Ernest Armory Codman Award from the JCAHO. The Codman Award showcases the effective use of performance measurement by health care organizations to improve the quality and safety of health care. Cincinnati Children's was one of 10 hospitals working together through the Greater Cincinnati Health Council to implement evidence-based practices to reduce central line and surgical site infections. According to the JCAHO, the collaborative successfully created a "community of practice" that resulted in increased innovation, sharing of successful strategies, reduced rework and decreased learning curves.

Cincinnati Children's is a 475-bed institution devoted to bringing the world the joy of healthier kids. Cincinnati Children's is dedicated to transforming the way health care is delivered by providing care that is timely, efficient, effective, family-centered, equitable and safe. Cincinnati Children's ranks second nationally among all pediatric centers in research grants from the National Institutes of Health. It is a teaching affiliate of the University of Cincinnati College of Medicine. The Cincinnati Children's vision is to be the leader in improving child health.