Does the Leapfrog program help identify high-quality hospitals

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This is a review of Jha's 2008 paper, Does the Leapfrog program help identify high-quality hospitals?.


This study was conducted to see whether hospitals that make improvements to their patient safety practices provide better care and achieve better outcomes for their patients. The Leapfrog Group was founded in 2000 and has gained lots of attention in healthcare industry for its efforts to encourage hospitals to adopt evidence-based practices to improve patient safety. The focus of the study was to examine hospitals targeted by the Leapfrog Group, a coalition of 65 employers and agencies that purchase health care for approximately 34 million Americans. [1]

The data studied was from the April 2006 Leapfrog Group survey of 1,860 hospitals in 29 regions, focusing on implementing computerized physician order entry (CPOE) systems, staffing intensive care units (ICUs) with intensivists (physicians specially trained in critical care) and relying on evidence in making referrals and treatment decisions. The researchers combined these data with the Hospital Quality Alliance's quality performance scores for management of acute myocardial infarction (AMI), congestive heart failure (CHF), and pneumonia. Additional information on hospital characteristics and patient demographics from the American Hospital Association's annual survey and the 2003 Med PAR survey of Medicare beneficiaries were also taken into account. 1,860 hospitals were targeted by Leapfrog, 790 chose not to disclose their patient safety practices. The 682 hospitals that had begun to implement at least one Leapfrog patient safety practice tended to be larger, private not-for-profit, or teaching hospitals located in urban areas, compared with hospitals that did not report or had not implemented any of the practices.


Results indicated that hospitals that had begun to implement CPOE had higher performance on AMI and CHF measures than those that chose not to report. The differences were much smaller in pneumonia care though. It also indicated that hospitals with ICUs staffed with intensivists or those that used evidence-based referrals generally had better care for AMI and CHF. The hospitals that used these patient safety practices had lower risk-adjusted mortality rates for patients admitted with AMI or pneumonia. These hospitals also had lower mortality rates for patients admitted with pneumonia. Mortality rates for CHF did not show much difference. Similar patterns were observed in hospitals staffed ICUs with intensivists and which used evidence-based referrals.


  1. Does the Leapfrog program help identify high-quality hospitals? Jha AK, Orav EJ, Ridgway AB, Zheng J, Epstein AM.Department of Health Policy and Management, Harvard School of Public Health, Boston, USA. Jt Comm J Qual Patient Saf. 2008 Jun;34(6):318-25.