Lessons from Leapfrog’s ‘Top Hospitals’

By Jennifer Larson, contributor

January 20, 2012 - At the end of every year, the Leapfrog Group awards its prestigious “Top Hospital” designation to a select group of health care facilities, based on their safety practices and outcomes. The 2011 list included 65 hospitals, and marked the 11th year of the Leapfrog Hospital Survey.

The annual survey collects data voluntarily reported by hospitals that choose to participate and recognizes hospitals for success in three critical areas: 1) how patients fare; 2) resources used to care for patients; and 3) management practices that promote quality and safety.

Last year, nearly 1,200 hospitals submitted data on certain nationally standardized measures, including their efforts to reduce hospital readmission rates and reduce pressure ulcers. The hospitals that met the highest standards were deemed “top hospitals.”

“It is something for the public to know that we really care about (providing) the absolute best care for their children and for them,” said Linda Stoverock, RN, MSN, the chief nursing officer and vice president for patient care services at Nationwide Children’s Hospital in Ohio, one of the 11 children’s hospitals that made the list.

Leah Binder, The Leapfrog Group's CEO, says that the 65 top hospitals on their 2011 list deserve to be recognized for their commitment to quality outcomes.

And all the hospitals that make that list deserve to be recognized by their peers for demonstrating their commitment to achieving quality outcomes with efficiency, noted Leapfrog CEO Leah Binder. She added that she hopes the emphasis on transparency will continue to drive improvement.

One common refrain repeated by leaders of hospitals on the list is that they do not plan to rest on their laurels, satisfied with their success. They plan to keep moving, keep working.

Brian Goldstein, M.D., executive VP and COO of UNC Hospitals, said, "For us, it's an ongoing, never-ending effort to improve."

“For us, it’s an ongoing, never-ending effort to improve,” said Brian Goldstein, M.D., executive vice president and chief operating officer of UNC Hospitals in North Carolina.

The 2011 list includes a wide variety of hospitals: urban, rural, academic, community and children’s. Binder emphasized that small and rural hospitals can provide high-quality patient care, too, which is why this year’s list highlighted several rural hospitals.

One of those rural facilities is Mariners Hospital, located in the Florida Keys. CEO Rick Freeburg noted that his hospital is 35 miles from the next closest hospital, so the surrounding community really depends on Mariners Hospital. He’s proud of the hospital staff’s commitment to providing care for the many older adults in the community, many of whom need care for one or more chronic illnesses.

“It’s important that we’re here, and that we are recognized for the quality of care we give,” he said.

Mariners Hospitals also has plans for improvement in the works, Freeburg said. The hospital, which is affiliated with Baptist Health South Florida, is in the process of opening up an oncology clinic to deliver chemotherapy treatments to cancer patients. That will save many people the long drive to Miami to get chemotherapy at a time when they are already feeling weak and vulnerable. That’s just one example of how the hospital searches for ways to meet the needs of its patients--and then takes steps to make it happen.

“If you’re sitting still, you’re being left behind,” Freeburg said.

Other notable news from the survey

The 65 hospitals on the 2011 list equals the number of hospitals that Leapfrog recognized in 2010. Two hospitals on the list--Virginia Mason Medical Center in Seattle, Wash., and the University of Maryland Medical Center-Baltimore--have received the designation every year since 2006.

Last year also marked the inclusion of a hospital’s Magnet status for the first time. Magnet status is a designation from the American Nurses Credentialing Center (ANCC) that spotlights a hospital’s commitment to excellence in nursing care, as well as high quality patient care and innovations in professional nursing practice. Thirty of the 65 hospitals on the 2011 list, including all 11 of the children’s hospitals, have Magnet status.

An emphasis on a culture of teamwork and interdisciplinary cooperation seems to be a hallmark of many of the ranked hospitals. Stoverock said Nationwide Children’s is very committed to a culture of teamwork and interdisciplinary cooperation.

“It allows dialogue between nurses and physicians…to come together to do what’s best for the patient,” she said.

UNC Hospitals’ Goldstein agreed that improving care does depend on staff cooperation and involvement. “If you don’t have all groups engaged, it’s a lot harder to have these improvements,” he said.

For example, UNC Hospitals created a pediatric sedation committee and brought together a diverse group of employees, as well as family representatives, to advise the hospital on the best ways to implement improvements.  According to Celeste Mayer, UNC Hospitals’ patient safety officer, one of the recommendations that came out of the committee was purchasing special goggles for children to wear when undergoing an MRI. When the children are distracted, they don’t need as much sedation, she explained.

Binder noted that Leapfrog has publicly posted the participating hospitals’ data so anyone can access it—for more information or for inspiration.

“Go to our results, go hospital by hospital, and see how others are doing and see if there is something you can learn from them,” she said.

Mayer suggested that hospitals that don’t participate in the survey consider using it as a guide for future improvement. The survey has helped UNC Hospitals when it comes to measuring its progress, she said.

The full list of 2011 Top Hospitals can be found on the Leapfrog Group site.