Leapfrog Safe Practices: A Case Study
Number of patients
• Number of patients requiring a return to surgery
• Number of patients resulting in readmission
• Mortality number
At least 75% of surgical cases are followed one year post-operatively.
Program provides an organized program of aftercare and follow-up for patients for at least 12 months.
In-Patient Facility: Rating for the Leapfrog Safe Practices Score (SPS).
The Leapfrog SPS summarizes a hospital’s adherence to 13 safety practices endorsed by the National Quality Forum, such as maintaining a culture of safety, hand hygiene, nursing workforce and prevention of infections.
In-Patient Facility: Rating for implementation of Leapfrog’s medication error prevention (CPOE) standard.
CPOE systems are electronic prescribing …show more content…
Evaluation of cost per risk-adjusted case based upon Aetna data – this data uses the last 24 months of Aetna cost data and is adjusted to take into consideration relevant risks, such as age, sex and other conditions of the patient using a product known as Symmetry Episode Risk Groups®
If one facility is more cost-effective than other comparable facilities, the more cost-effective facility will be selected – depending on network access, capacity and other competitive needs, Aetna may designate other facilities that have met the other evaluation criteria
IOQ cardiac care facilities include comprehensive heart and vascular treatment centers that provide both inpatient and outpatient procedures. They also offer medical care for cardiac conditions that do not involve surgery or procedures.
Aetna’s IOQ cardiac care program designations include:
• Cardiac medical interventions
• Cardiac rhythm disorders
• Cardiac surgery
We may designate a facility for one or more IOQ cardiac care program designations. Selected facilities meet the following criteria:
• Show evidence of significant experience in cardiac care, including a minimum of 200 open heart procedures, 200 angioplasty or …show more content…
A facility may be designated in one or more of these areas. Each service line will be evaluated individually on components relevant to that service line.
1. If a facility performs CMI and no CV surgery, the facility is still eligible if they meet the criteria for CMI.
2. If a facility performs CMI and CV surgery, the facility must meet criteria for
BOTH service lines to be selected as an IOQ.
I. Requirements for consideration
Volume:
To be eligible as an IOQ cardiac care facility, 12-month procedure volumes must meet or exceed the following:
• Cardiac medical intervention IOQ designation – 200 percutaneous coronary interventions (PCIs) (also referred to as angioplasty or stent procedures) • Cardiac surgery IOQ designation – 200 open heart surgery cases
(for example, coronary artery bypass graft surgery and heart valve replacement surgery)
• CardiacRhythm disorder IOQ designation – 125 cardiac resynchronization therapy implantation procedures (for example, pacemaker, defibrillator)
Participating status of facility and physicians delivering cardiac
• Number of patients requiring a return to surgery
• Number of patients resulting in readmission
• Mortality number
At least 75% of surgical cases are followed one year post-operatively.
Program provides an organized program of aftercare and follow-up for patients for at least 12 months.
In-Patient Facility: Rating for the Leapfrog Safe Practices Score (SPS).
The Leapfrog SPS summarizes a hospital’s adherence to 13 safety practices endorsed by the National Quality Forum, such as maintaining a culture of safety, hand hygiene, nursing workforce and prevention of infections.
In-Patient Facility: Rating for implementation of Leapfrog’s medication error prevention (CPOE) standard.
CPOE systems are electronic prescribing …show more content…
Evaluation of cost per risk-adjusted case based upon Aetna data – this data uses the last 24 months of Aetna cost data and is adjusted to take into consideration relevant risks, such as age, sex and other conditions of the patient using a product known as Symmetry Episode Risk Groups®
If one facility is more cost-effective than other comparable facilities, the more cost-effective facility will be selected – depending on network access, capacity and other competitive needs, Aetna may designate other facilities that have met the other evaluation criteria
IOQ cardiac care facilities include comprehensive heart and vascular treatment centers that provide both inpatient and outpatient procedures. They also offer medical care for cardiac conditions that do not involve surgery or procedures.
Aetna’s IOQ cardiac care program designations include:
• Cardiac medical interventions
• Cardiac rhythm disorders
• Cardiac surgery
We may designate a facility for one or more IOQ cardiac care program designations. Selected facilities meet the following criteria:
• Show evidence of significant experience in cardiac care, including a minimum of 200 open heart procedures, 200 angioplasty or …show more content…
A facility may be designated in one or more of these areas. Each service line will be evaluated individually on components relevant to that service line.
1. If a facility performs CMI and no CV surgery, the facility is still eligible if they meet the criteria for CMI.
2. If a facility performs CMI and CV surgery, the facility must meet criteria for
BOTH service lines to be selected as an IOQ.
I. Requirements for consideration
Volume:
To be eligible as an IOQ cardiac care facility, 12-month procedure volumes must meet or exceed the following:
• Cardiac medical intervention IOQ designation – 200 percutaneous coronary interventions (PCIs) (also referred to as angioplasty or stent procedures) • Cardiac surgery IOQ designation – 200 open heart surgery cases
(for example, coronary artery bypass graft surgery and heart valve replacement surgery)
• CardiacRhythm disorder IOQ designation – 125 cardiac resynchronization therapy implantation procedures (for example, pacemaker, defibrillator)
Participating status of facility and physicians delivering cardiac