Leapfrog Introduction Karen van Caulil President and CEO Ashley Tait-Dinger Director, Quality and Value Measurement Florida Health Care Coalition September 26, 2018
Agenda for today The Leapfrog Group overview Leapfrog s Two Main Initiatives The Leapfrog Hospital Safety Grade Composite Score
The Leapfrog Group Founded in 2000 by large employers and purchasers Focus on quality and safety in health care by advocating for transparency in reporting First initiative Hospital Survey Today employers, insurers, data aggregators, transparency websites, and medical information websites all use Leapfrog Data Regional Leader Model FLHCC has been a Regional Leader since 2001
Leapfrog s Two Main Initiatives Survey Introduced in 2000 Runs April 1 st to December 31 st Originally designed for purchasers Focus is inpatient care safety, quality, and efficiency General, pediatric, and specialty hospitals can participate Hospitals are scored against national targets Safety Score Introduced in 2012 Calculated bi-annually, April & October Data used is a snapshot Originally designed for consumers Focus is inpatient care patient safety only Only applicable to general, acute care hospitals Hospitals are scored compared to each other (relative performance) All results are publicly reported!
Hospital Safety Grade What is it? A, B, C, D, or F letter grade reflecting how safe hospitals are for patients Launched in June 2012 Grades are issued two times per year April (Spring) October (Fall)
Hospital Safety Grade Who is eligible? General acute care hospitals with enough publicly reported data A Safety Grade will NOT be issued if : More than 6 process measures are missing OR More than 5 outcome measures are missing Certain hospitals cannot receive a Safety Grade because they do not participate in the CMS IQR Program: Critical Access Hospitals PPS-exempt hospital (i.e. cancer) VA Hospitals Indian Health Services Specialty Hospitals (i.e. children, women)
Hospital Safety Grade How many are graded? This spring 2,479 hospitals were graded.
Hospital Safety Grade Use of an Expert Panel Task To help identify a scientifically sound scoring methodology and to ensure the science behind the score is as solid as possible Provide guidance on the mechanics of developing a composite score Defining the conceptual framework for the score Identify & recommend measures for inclusion/removal Assigning relative weights to each measure Standardizing score across different measure types Identifying approaches for dealing with missing data
Hospital Safety Grade Conceptual Framework Expert Panel discussed what the composite score intended to measure Consensus was patient safety, defined as freedom from harm Panel agreed that this focus was a narrower construct than hospital quality Panel recommended that Leapfrog included publicly-reported measures from national data sources The panel decided the Hospital Safety Grade should include the measures below as equal weights of 50% each in the composite score Recognize hospital efforts towards patient safety (process & structural) Achievements in patient safety (outcome)
Hospital Safety Grade Measure Selection Criteria Measures are publicly-reported from national data sources Leapfrog Hospital Survey Centers for Medicare and Medicaid Services data sets American Hospital Association s Annual Survey & HIT Supplement Measures are endorsed or used by a national measurement entity Measures are linked to patient safety ( freedom from harm ) Directly quantifying patient safety events Assessing processes that lead to better outcomes Identified by experts as important to patient safety
Hospital Safety Grade Process & Structural Measures (12) i AHA Annual Survey, Health Forum, LLC, a subsidiary of the American Hospital Association ii AHA Annual Survey 2016 Health Forum, LLC
Hospital Safety Grade Outcome Measures (15) * The Maryland Health Care Commission will provide HAC and PSI rates for Maryland hospitals only
Hospital Safety Grade Scoring Highlights Each measure is weighted Z-Score methodology is used Standardizes data from individual measures with different scales Missing Data Although nationally-reported measures are used, some data might be missing Did not voluntary report (Leapfrog or AHA) Unable to calculate (i.e. did not meet the minimum sample size) Not applicable (i.e. does not provide care in a specific area like intensive care) Missing measures are excluded and weight is re-apportioned within same domain A Safety Grade will NOT be issued if : More than 6 process measures are missing OR More than 5 outcome measures are missing
Hospital Safety Grade Courtesy Review Period Secure website for hospitals to review their data Even if a SURVEY was NOT submitted For each measure, it shows where the data originated from Give instruction on how to report an error to Leapfrog Provide a Hospital Safety Grade Calculator Allows preview of the preliminary numerical score
Hospital Safety Grade How is the data used Leapfrog Hospital Safety Grade public website http://www.hospitalsafetygrade.org FLHCC s Employers Toolkit FLHCC s Employer Action Report
Thank you! Questions?