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First the bad news: Hospitals are flawed and make mistakes. Now, the good news: Hospitals are willing to admit it.

Sometimes the flaws are glaring. In the area of preventing hospital-acquired infections, for example, 87 percent of the hospitals in a recent survey said they are not in compliance with all recommendations for preventing infections.

"Unfortunately, many hospitals are missing the mark, and that spells trouble for everyone: the patient, the hospital and the healthcare system," said Marriott International Inc. Health and Welfare Vice President Jill Berger, chairwoman of the Washington, D.C.-based nonprofit Leapfrog Group, which releases the Leapfrog Hospital Quality and Safety Survey.

Separate investigations over the past few years have uncovered serious mistakes within hospital systems. In the most egregious cases, patients have lost their lives, and the tragedies have cast a shadow over hospitals in particular and the medical profession more generally.

On the bright and clean side, Leapfrog was able to designate 41 out of 1,256 hospitals across the country as "Leapfrog Top Hospitals" for 2007.

Hospitals that made it into that category were able to implement computerized physician order entry, staffing of intensive care units by specialists and numerous other safety practices.

A total of 96 percent of hospitals reported divulging information on quality and safety measures to Leapfrog and at least one other agency, according to the survey results.

"It starts with getting information about the patient in a form that's accessible," said James Steven, chief medical officer for Children's Hospital of Philadelphia, which plans to spend $60 million over the next five years implementing an online access to patient records.

While the hospital has had computerized physician order entry for years, the online initiative is expected to improve patient safety and the ability of doctors and nurses to communicate about the status of patients, thereby reducing mistakes.

Steven said he believes hospitals are building systems that will reduce medical-error rates because doctors as a group don't like to trifle with risk. "I think physicians by their nature are risk averse, and I think they take risk very seriously," Steven said.

The Leapfrog Group, a volunteer association, was formed in 2000 with the goal of giving businesses and public agencies more accurate information with which to purchase medical services and coverage.

It tracks hospitals using a list of recommended safety procedures, and rates them on their adherence to the list.

In the 2007 Leapfrog Hospital Quality and Safety Survey, hospitals for the first time talked about the degree to which they report their safety procedures and incidence of errors.

November 1, 2007

Copyright 2007© LRP Publications