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Hospital Safety Grade is a simple but powerful way that Leah Binder and Leapfrog Group help make patients safer

By | May 25 th,  2017 | Healthcare, ambulatory care, Leah Binder, maternity, Modern Healthcare, patient safety, president, Blog, CEO, children's hospitals, employers, Hospital Safety Score, Leapfrog Group, outpatient, Top 25 Women in Healthcare | Add A Comment


One in a series of interviews with Modern Healthcare's Top 25 Women in Healthcare for 2017. Furst Group and NuBrick Partners, which comprise the companies of MPI, sponsor the awards.


Sometimes, the simple things are the easiest to understand. Perhaps that’s one reason that the Leapfrog Group’s Hospital Safety Grade has caught on in such a big way – even with hospitals, who largely weren’t all that thrilled when it was initially launched five years ago.


“The response of hospitals has been one of the brightest spots for me in my career,” Leapfrog President and CEO Leah Binder says. “Hospitals are approaching their Hospital Safety Grade constructively. They’re talking about what they are going to do to improve and how proud they are of this ‘A.’ They talk about how they’re not going to stop their efforts to ensure that patients are safe, and describing what those efforts will be.”


Every six months, Leapfrog assigns an A, B, C, D or F grade to 2,600 general, acute-care hospitals, rating their performance on safety. It uses standardized measures from the Centers for Medicare & Medicaid Services, its own hospital survey, the Agency for Healthcare Research and Quality, the Centers for Disease Control and Prevention and the American Hospital Association.


“Many people – even if they’re on the board of a hospital – don’t realize the problem of safety,” Binder says. “When they look into it, they realize how many things can go wrong in a hospital, and that makes a big difference. That’s why I think it’s been important for us to highlight this in a way that’s easily accessible to laypeople.”


While everybody wants an “A,” Binder has seen unfavorable grades spur some action.


“We see boards get very upset. We see community members get upset. We see repeated articles in newspapers about poor grades,” Binder observes. “We’ve found that it gets their attention, which is a good thing. In fact, we’ve seen hospitals just completely turn around their safety programs when they get a bad grade.”


What people outside the healthcare industry don’t always recognize is that the Leapfrog Group was founded by large employers and groups who purchase healthcare and wanted to see some changes in the quality of the care they were paying for.


“Employers are not in the business of healthcare,” says Binder. “They’re in the business of doing other things. They make airplanes, and they make automobiles and they run retail department stores. And so, they don’t have a staff of 500 to figure out what’s going on in healthcare, so they rely on organizations like us to try to pull all those resources together for them and help them make the right strategic decisions.”


Leapfrog has some compatriots in this area, including the National Business Group on Health, regional groups, and a newcomer called Health Transformation Alliance, in which 20 major employers are teaming up to lower prescription costs, review claims together, structure benefits and create networks.


“There’s probably at least 50 organizations that represent specialties for physicians alone,” Binder says. “I don’t think there are nearly enough organizations that are advancing purchaser concerns about healthcare delivery. The purchasers pay for about 20 percent of the $3 trillion healthcare industry, which is a lot of money.”


Despite the increased scrutiny, Binder says she thinks the healthcare industry has taken its eye off safety, given the myriad deaths still linked to errors each year.


“I think the industry has not been focused on patient safety enough. They’ve been distracted by the compliance with the Affordable Care Act, value-based purchasing, bill payments, new models for financing and delivering care, and change in state and CMS regulations. While those efforts are important, nothing is as critical as making sure people don’t die from preventable errors. Safety has to come first, every minute of every day. Otherwise, patients will suffer.”


Binder is doing her best to keep the priority on patients. – in fact, the organization is broadening its reach at the request of its members to take a closer look at other sticky matters in safety:


  • Maternity. “Employers pay for half of all the births in this country. Childbirth is by far the number-one reason for admission to a hospital. A C-section is the number one surgical procedure performed in this country. So, we now have some incredible data on maternity care, and employers are starting to meet with hospitals and design packages that encourage the use of hospitals with lower C-section rates based on the Leapfrog data.”

  • Outpatient and ambulatory care. “We’re going to start rating outpatient surgical units and ambulatory surgical centers. That’s a big priority for purchasers because they are sending a lot of employees to ambulatory surgical centers because they tend to be lower-priced. That’s great – some of them are excellent – but we don’t have enough good data nationally to compare them on safety and quality.”

  • Children’s hospitals. “There’s a lot of people who would never travel outside their community for their own healthcare, but will travel if they have a very sick child. This year, we added two new measures. We ask pediatric hospitals to do a CAP survey for children’s hospitals. The other thing we’re looking at is exposure to radiation. Sometimes, children have repeated imaging and it can really add up.”

    Although it is Leapfrog’s job to act as a watchdog for employers and patients, Binder says she does see some positive movement.


    “There are bright spots,” she says. “There is a Partnership for Patients program that just concluded with CMS that has demonstrated some real impact. We see reductions in certain kinds of infections and real changes in the ways that hospitals are approaching patient care to address safety. CMS has tracked some saved lives as a result of those changes, and we certainly appreciate those numbers. We’re going in the right direction; we just need a lot more push.”



    SIDEBAR: Making a difference with the mundane


    Hospital deaths and injuries from errors are not always obvious.


    “When someone dies from an error or an accident, it’s not easy to track,” says Leah Binder, president and CEO of the Leapfrog Group. “It often doesn’t show up in claims. It can be complicated – the death might be attributed to something else even though, say, there was clearly an infection that hastened the death. It’s just kind of the course of business in the hospital.”


    Nearly two decades after the ground-breaking report “To Err is Human,” far too many people are still being killed and injured in healthcare settings, Binder says.


    “More than 200,000 people are dying every year from preventable accidents in hospitals,” she says. “We believe that’s a low estimate. There’s lots of accidents and problems in hospitals we can’t measure because no one is tracking them. An example of that would be medication errors, which are the most common errors in hospitals. There’s not a standardized way of tracking that, so we don’t even know how many deaths or adverse events result.”


    What is especially frustrating for Binder and her team is that many injuries and deaths happen in spite of the fact the healthcare industry knows how to prevent them. “The fact is, patient safety requires a disciplined, persistent commitment to the mundane habits that save lives,” she says.


    “How much more mundane can it possibly be than to say, ‘Everybody needs to wash their hands all the time’? ‘We need to wear the right protective clothing.’ ‘Follow the rules – every single rule every single time.’ ‘We need to do the same checklist every time we do a surgery.’


    “Let’s face it, these sound boring. But done systematically, they save lives. And everyone in patient care needs to be disciplined about doing them.”



    Leah Binder and Leapfrog Group put pressure on healthcare providers to deliver on quality

    By | August 12 th,  2015 | Healthcare, Leah Binder, Leapfrog Hospital Survey, patient safety, president, Blog, CEO, executive compensation, Hospital Safety Score, Leapfrog Group, quality, Top 25 Women in Healthcare | 1 Comments


    One in a series of interviews with Modern Healthcare's Top 25 Women in Healthcare for 2015.



    Patient-safety organizations have proliferated in the last decade, from the respected National Patient Safety Foundation to numerous groups founded by patients or their relatives who have experienced pain and loss from medical errors. Yet few have the muscle that the Leapfrog Group does, using its research and clout on behalf of businesses that pay for their employees’ healthcare coverage.


    That marriage of safety and statistics, with a streak of blunt boldness, is personified by Leapfrog President and CEO Leah Binder, who has led the organization since 2008. She is a friend to many in the industry, but notes that Leapfrog fiercely guards its watchdog status.


    “I think a lot of people who are involved in the healthcare industry also have tentacles into a lot of different interest groups that they need to maintain strong ties to,” she says. “And while we also like to maintain strong ties to and collaborate with our colleagues in healthcare, we maintain a strong independence from the industry. And that has enabled us to talk about reality in a way that is different from what others who are within the system feel able to do.”


    While she is a champion of the quality care that many systems and physicians provide, she’s not afraid to take them to task when she feels U.S. consumers and their employers aren’t getting stellar treatment. Leapfrog’s voice has been getting louder and more urgent lately, Binder notes, because it hasn’t always seemed that the healthcare industry has been paying attention.


    “When I am speaking from the perspective of a purchaser who is spending more money on healthcare than they earned in profits last year, they expect tough talk,” she says. “They want to make sure their employees are safe and healthy and they get the right value for their money. It’s just been very difficult to get that message out to the healthcare community that employers want change and expect it.
    “I’ve certainly had to begin to communicate in ways that make clear that the business community considers this to be serious business.”


    Binder got to know the Leapfrog Group when she was vice president of Franklin Community Health Network, a healthcare system in Maine that participated in Leapfrog’s surveys on quality and safety. Prior to that, she was a senior policy advisor to then-New York City Mayor Rudolph Giuliani. She began her career as public policy director for the National League of Nursing.


    Her life-changing encounter with the importance of safety came when her infant son was sick, and she and her husband couldn’t get their pediatrician to listen to them.


    “When he was 3 weeks old, he was misdiagnosed with acid reflux. The actual diagnosis was that he had pyloric stenosis which, if it goes untreated for too long of a period, can be dangerous if not deadly,” Binder remembers. “And it was only because of my husband’s aggressiveness in insisting on a re-evaluation of him that we were able to get him in for emergency surgery. And that probably saved his life.”


    The episode made a deep impression on Binder and her family.


    “It just showed me that when ordinary people like me make mistakes – perhaps we miss an appointment or forget to get milk from the grocery store – they don’t have a huge impact. But when you’re in healthcare, even minor mistakes can have catastrophic effects for people. That’s a lot of pressure on people who work in the healthcare system and it is a lot of responsibility. It made me realize just how important it is for us to respect that and to make sure that vigilance continues.”


    The Leapfrog Group conducts its vigilance through the Leapfrog Hospital Survey, an annual report that tracks hospitals’ performance on safety, quality and efficiency. Its Hospital Safety Score also assigns letter grades – from A to F – to more than 2,500 U.S. hospitals.


    While numerous groups create “top hospital” rankings each year – so much so that a provider can pick and choose which report shows it in the most favorable light – Binder says she believes one factor elevates Leapfrog’s reach beyond the others: transparency.


    “Our transparency is absolute,” Binder asserts. “We make everything public by hospital and there are a number of groups working with hospitals that specifically do not make that data public. They collect it in order to work with it internally to improve the safety profiles of their members, and that’s certainly one model. We believe that transparency actually galvanizes improvement faster, but we support the fact that these other groups are working on it and we know they have had success.”


    The other pressure that the Leapfrog Group brings to bear on safety and quality is financial in nature.
    “We are working from the perspective of the purchaser, so we want to bring value-based purchasing into the equation,” Binder says. “We really want to start to tie payment to performance on key safety and quality metrics. Employers want to see results.”


    Binder said she believes the industry has made significant progress on quality and safety, although she admits that the pace of change is uncomfortably slow. She is concerned about consolidation among providers and payers because she says the trend “traditionally has meant lower quality, higher costs.” But lasting change, she adds, has to come from the top, and she is not convinced healthcare CEOs have made safety the priority it should be.


    “For me, when we start seeing CEOs believe their jobs are on the line if they can’t get the safety record better, that’s when we’re going to see rapid change,” she says. “I have heard directly from some CEOs who say that it was a very significant moment in their career when they saw the Leapfrog letter grade that reflected poorly on their hospital, and that spurred them into action. I’ve also seen some hospitals or systems that are putting CEO and senior-level compensation at risk based on their letter grade or their safety record, and that’s also a very positive sign. But we’re not there yet.”



    The results are in: These are the Top 25 Women in Healthcare for 2013

    By | April 9 th,  2013 | Furst Group, Patricia Hemingway Hall, Top 25 Women, ACHE, Deborah Bowen, gala, Leah Binder, Marna Borgstrom, Modern Healthcare, Nashville, Sherrie Barch, Blog, leadership, Leapfrog Group, Marilyn Tavenner, Kathleen Sebelius, Sharon O'Keefe, Top 25 Women in Healthcare | Add A Comment



    Furst Group is proud to continue to sponsor the Top 25 Women In Healthcare awards for Modern Healthcare.


    This week's issue of Modern Healthcare has all the details on this year's honorees. First-time winners include Leah Binder, CEO of Leapfrog Group; Sharon O'Keefe, president of the University of Chicago Medical Center; Deborah Bowen, incoming president of the American College of Healthcare Executives; and Marna Borgstrom, president and CEO of Yale-New Haven Health System. Others selected include HHS Secretary Kathleen Sebelius, CMS Administrator Marilyn Tavenner, Leapfrog Group CEO Leah Binder and Patricia Hemingway Hall, CEO of HCSC.


    “The Top 25 Women in Healthcare have battled through a lot to get to this moment, and we applaud their talent and perseverance. Gender inequities remain in opportunities, compensation and societal and family expectations,” Furst Group President Sherrie Barch says. “These women are among the top leaders in our country regardless of gender.”


    The program, along with the “Top 25 Minority Executives in Healthcare” awards, also sponsored by Furst Group, continues the firm’s efforts to ensure that the leadership of healthcare organizations reflects the communities they serve. This is the fifth year that Furst Group has sponsored the awards.The awards will be presented at the gala Aug. 6 in Nashville, Tenn. We hope you will consider attending.


    To see the full list of honorees, please click here.

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