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Leapfrog safe practices survey may have captured 'excessive noise'

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Safe Practices Survey
Nationwide Inpatient Sample
National Quality Forum
Leapfrog Group
Journal of the American Medical Association
JAMA

A survey of hospital performance conducted by the Leapfrog Group in 2006 may suffer from "excessive noise" according to a study published in the Journal of the American Medical Association. The Safe Practices Survey gives hospitals an opportunity to "report efforts toward implementing the National Quality Forum's Safe Practices for Better Healthcare." The survey then ranked those hospitals by quartiles, with the safest hospitals in the highest quartile, and the most unsafe hospitals in the lower quartiles. 

However, the study, which used information from a 2005 Nationwide Inpatient Sample database to back up its findings, found that the quartiles failed to be a good predictor of mortality. 

The survey "gives hospitals credit for creating systems that could eventually support full implementation of a given safe practice," say the study's authors. The authors go on to point out that credit for improving your hospital's administrative structure "raises the possibility that the survey is capturing excessive noise." 

Furthermore, the survey only looks at 13 safe practices--down from 27--which the study's authors warn "are unlikely to be significantly associated with inpatient mortality, even if scoring is limited to the actions taken." 

For more on the study's findings:
- here's the Healthcare IT News article

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