An annual survey from The Leapfrog Group, a coalition of large employers working to improve care quality and safety at lower costs, shows some impressive gains during the past year but also some worrisome backsliding.

For instance, of the 1,437 hospitals participating in the 2013 survey, which Castlight Health developed for Leapfrog, 43 percent were meeting Leapfrog’s standards for use of computerized physician order entry. But problems persist with failures of CPOE systems to trigger alerts on potentially fatal medication errors.

The rate of early elective deliveries dropped dramatically to 4.6 percent in 2013 compared with 11.2 percent a year earlier, but only 24 percent of hospitals met Leapfrog standards for high-risk deliveries, compared with 37 percent in 2011.

In 2013, 605 surveyed hospitals met the Leapfrog standard of a rate of episiotomy during childbirth of 12 percent or less. In the fight against Stages III and IV pressure ulcers, 692 hospitals met the standard of zero per 1,000 inpatient discharges and another 597 had no more than one. The standard for hospital-acquired injuries is close to zero per 1,000 discharges, and 232 hospitals had none and another 939 had no more than one. Hospital efforts to combat hospital-acquired conditions continue to show high variability of success.

Sufficient progress remains elusive in other areas of quality and safety, according to a report on survey results from Leapfrog. “We still see significant variation in predicted survival rates for high-risk procedures across hospitals, suggesting it is wise for consumers to research Leapfrog Hospital Survey results when considering one of these procedures. For abdominal aortic aneurism repair there is a seven-fold difference between the predicted survival at the best performing hospital and the predicted survival at the worst performing hospital. For pancreatectomies the predicted mortality rate varies from 0% to almost 21%, while for esophagectomies the predicted mortality rate varies from 2.5% to 12%. The predicted survival rates for aortic valve replacement show the smallest variation.”

Other findings include hospitals in better compliance with recommended ICU staffing standards and 79 percent rate of hospitals complying with Leapfrog standards for responding to “Never Events,” the same rate as in 2014.

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