AAFP wary of hospital-based ICU standards

Medical and business groups agree patient safety needs improvement but disagree on where to start.

By Andis Robeznieks, AMNews staff. Feb. 18, 2002.

Much has been made of how dozens of hospitals were working to implement three patient-safety standards proposed by a prominent business consortium, but at least one physician group wasn't joining in the cheering.

The American Academy of Family Physicians, which has about 93,500 members, said the Leapfrog Group missed the mark by issuing standards that are "complex and costly" and affect a relatively small percentage of Americans.

The Leapfrog Group is composed of more than 90 Fortune 500 firms providing health care benefits to about 28 million people. It has called on U.S. hospitals to implement computerized physician order entry systems, staff intensive care units with trained specialists and use volume standards to base referrals for some high-risk procedures. These include: coronary artery bypass (at least 500 a year), coronary angioplasty (at least 400 a year), abdominal aortic aneurysm repair (at least 30 a year) and esophageal cancer surgery (at least seven a year).

Leapfrog members such as Empire Blue Cross and Blue Shield, IBM, Verizon Corp. and Xerox have announced their intention to award quarterly bonus payments to hospitals that their employees use if those hospitals implement the computerized order entry and ICU standards.

The AAFP took great pains to praise the effort undertaken by Leapfrog, but the praise was tempered with a big "however."

"Their efforts would be better directed toward low-complexity, lower-cost options based on solid evidence," said AAFP president Warren A. Jones, MD. "Let's not pick the Rolls-Royce issues when we have all these Volkswagen problems and day-to-day needs." [...]