The voluntary survey provides the most complete picture of hospital quality and safety vailable in the U.S., and asks hospitals about their performance in four crucial areas, or “leaps”:

• Do physicians enter prescriptions and other orders into computers linked to medication error prevention software? And are those systems tested to assure that users are warned about serious prescribing errors?

• How well do hospitals perform seven complex high-risk procedures* and care for high-risk deliveries? (*Coronary artery bypass graft, percutaneous coronary intervention, abdominal aortic aneurysm repair, aortic valve replacement, pancreatic resection, esophagectomy, bariatric surgery.)

• Are hospital intensive care units (ICUs) staffed by qualified specialists?

• Do hospitals have safety practices and policies advocated by the National Quality Forum to reduce harm and errors?

“Top Hospitals demonstrate an exceptional level of performance and serve as a model for other hospitals,” said Leah Binder, CEO, The Leapfrog Group. “However, all participating hospitals deserve praise for their willingness to raise the veil on how well they perform.”

Leapfrog encourages continual improvement in hospital safety and each year raises the bar on what’s required to become a Top Hospital. “Last year’s Top Hospitals are all still excellent performers, but this year’s class has taken additional steps to earn the right to be recognized as Top Hospitals,” said Binder.

Binder pointed out that as all hospitals improve performance, it becomes more difficult to be among the top performers.

Top Hospitals in 2008:

• Fully meet Leapfrog standards for not only implementing computer physician order entry (CPOE) systems that help prevent medication errors, but have also carefully tested their CPOE systems with Leapfrog’s CPOE Evaluation Tool;

• Fully meet stringent performance standards for at least one of the complex, high-risk procedures (such as heart bypass surgery) done in that particular hospital;

• Fully meet the ICU staffing standard;

• Fully meet or demonstrate “substantial progress” on 13 additional nationally recognized safe practices, such as preventing pneumonia or bloodstream infections.

“This year we added a requirement that Top Hospitals evaluate their CPOE systems with a tool that ensures that their systems are alerting physicians to common, serious prescribing errors,” said Binder.

In addition to the four “leaps”, the Leapfrog Hospital Survey asks hospitals to report progress on other important patient safety areas:

• Participating in other public reporting initiatives;

• Adhering to the Leapfrog “Never Events” policy;

• Measuring how efficiently resources are used for coronary artery bypass graft (CABG), percutaneous coronary interventions (PCI), acute myocardial infarction (AMI), and pneumonia;

• Helping patients avoid pressure ulcers and other hospital-related injuries.

A study published in the June issue of the Journal on Quality and Patient Safety found that hospitals that perform well on the Leapfrog Hospital Survey have lower mortality and better quality of care than those who either didn’t perform as well on the survey or who chose not to complete the survey.

“Every day, hundreds of patients are receiving hundreds of different procedures. Medical mistakes are a leading cause of death each year, causing more deaths than car accidents, breast cancer and AIDS combined,” said Binder, who pointed out that the survey continually adds new measures that fairly demonstrate a hospital’s capacity to provide safe, high quality care.

This year’s top hospitals are located in 10 states: Arizona, California, Illinois, Maryland, Michigan, New Jersey, New York, Ohio, Pennsylvania, and Washington:

• Mayo Clinic Hospital; Phoenix, AZ

• California Pacific Medical Center (California, Davies, Pacific Campuses); San Francisco, CA

• Kaiser Permanente Bellflower Medical Center; Bellflower, CA

• Kaiser Permanente Harbor City Medical Center, Harbor City, CA

• University of California UCI Medical Center, Orange, CA

• Evanston Hospital; Evanston, IL

• Northwestern Memorial Hospital; Chicago, IL

• Sinai Hospital, Baltimore; MD

• University of Maryland Medical Center; Baltimore, MD

• Detroit Receiving Hospital & University Health Center; Detroit, MI

• Harper-Hutzel Hospital, Detroit; MI

• Henry Ford Macomb Hospitals, Clinton Township; MI

• Saint Mary's Health Care, Grand Rapids; MI

• Sinai-Grace Hospital; Detroit, MI

• University of Michigan Hospitals & Health Centers; Ann Arbor, MI

• Robert Wood Johnson University Hospital; New Brunswick, NJ

• University Medical Center at Princeton; NJ

• NYU Hospitals Center; New York, NY

• Summa Health Systems Hospitals - Akron City Hospital; Akron, OH

• The Christ Hospital; Cincinnati, OH

• University Hospitals Case Medical Center; Cleveland, OH

• Lehigh Valley Hospital; Allentown, PA

• Lehigh Valley Hospital Muhlenberg; Bethlehem, PA

• Virginia Mason Medical Center, Seattle, WA

Top pediatric hospitals are located in District of Columbia, Massachusetts, Michigan, Ohio, Pennsylvania, and Tennessee.

Top children’s hospitals:

• Children National Medical Center; Washington, DC

• Children’s Hospital Boston; MA

• Children’s Hospital of Michigan; Detroit

• Cincinnati Children's Hospital Medical Center; OH

• Rainbow Babies and Children’s Hospital; Cleveland, OH

• Children’s Hospital of Pittsburgh of UPMC; PA

• Monroe Carell Jr. Children's Hospital at Vanderbilt; Nashville, TN

“The Leapfrog survey is a vital tool for hospitals seeking to be more transparent and to demonstrate publicly their commitment to excellence in quality and patient safety. Through its partnership with employers and health care purchasing organizations across the country, Leapfrog is helping drive significant improvements in hospital care," said Jill Berger, Chair of The Leapfrog Group and Vice President, Health & Welfare for Marriott International, Inc.