Dr. David W. Haas, associate professor of Medicine, led the study at VUMC.
Fortune 500 commends Vanderbilt patient safety
Representing tremendous health care buying power, the Leapfrog Group, a consortium of Fortune 500 companies and other large private and public employers, has singled out Vanderbilt University Hospital as being among a select few hospitals providing safety measures that the rest of the nation should emulate. The strong endorsement of VUH comes at a time of increased awareness of patient safety by purchasers and the public alike.
In the Leapfrog Group’s survey of 241 hospitals in seven regions, VUH was among a small number of hospitals commended for using computerized physician order entry and for ample physician coverage of intensive care units. In fact, VUH was one of only two hospitals to indicate full implementation of both these safety standards. Vanderbilt is also cited as exceeding patient volume criteria for various surgical procedures dealt with in the survey. Patient volume is considered a marker of how well a hospital is likely to perform a given major surgical procedure.
Members of the Leapfrog Group provide health benefits to more than 24 million Americans and spend more than $45 billion on health care annually. Sponsored by the Business Roundtable, the group was formed in response to a 1999 Institute of Medicine report attributing an estimated 98,000 deaths per year to preventable medical errors made in hospitals.
The group is limiting its focus to three initiatives—order entry, ICU coverage and surgical volume—o quickly spur major advances in safety. Leapfrog research consultants, led by well-known health systems researcher Dr. John Birkmeyer of Dartmouth Medical School, estimate that universal implementation of the three safety standards in urban centers could save up to 58,294 lives per year and avoid up to 522,000 serious medication errors.
“Vanderbilt is one of only a handful of medical centers nationwide to perform so well on the Leapfrog criteria,” said VUMC Chief Medical Officer Dr. John Sergent. “There is no question that institutions meeting these criteria will have better outcomes and lower error rates. We are committed to the premise that Vanderbilt will continue to be among the nation’s leaders in providing the safest possible environment for our patients.”
The group sent questionnaires to 497 urban hospitals in seven regions, achieving a response rate of 48 percent. The regions included Atlanta, Seattle-Tacoma, St. Louis, urban parts of middle and eastern Tennessee, and all urban areas of California, Michigan and Minnesota. The Leapfrog Group plans to recognize and reward providers that meet the standards, sharing the survey responses with their employees and using the survey results in their contracting discussions with plans and providers. The group is also sharing hospital responses with the public.
VUH was among 3.3 percent of respondents indicating use of computerized physician order entry with prescribing error prevention capabilities. (Vanderbilt recently licensed rights for commercial development and marketing of WizOrder, the crack order entry and decision support system developed at VUMC.)
Regarding physician coverage of intensive care units, VUH was among 10 percent of respondents indicating that all intensive care patients are managed or co-managed by physicians board certified in critical care medicine (or eligible for such certification) who: (1) are present in the ICU during daytime hours, eight-hours-a-day, seven-days-a-week; (2) provide clinical care exclusively in the ICU during these hours; and (3) at all other times, return more than 95 percent of ICU pages within five minutes and rely on another intensive care board certified physician (or intensive care certified physician extender) being in the hospital and able to reach ICU patients within five minutes.
• VUH was among 31 percent of respondents performing more than 400 coronary angioplasty procedures per year (VUH reported 605 cases in a recent 12-month period).
• VUH was among 21 percent of respondents performing more than 30 abdominal aortic aneurysm repair procedures per year (VUH reported 149).
• VUH was among 15 percent of respondents performing more than seven esophageal cancer procedures per year (VUH reported 56).
• VUH was among 22 percent of respondents with a neonatal intensive care unit average daily census greater than 15 (VUH reported an average census of 39).
VUH did not meet annual patient volume criteria for the remaining two procedures dealt with in the survey—coronary artery bypass graft surgery (12 percent of respondent reported more than 500 of these procedures, VUH reported 336) and carotid endarterectomy (20 percent of respondents reported more than 100 of these procedures, VUH reported 45).