News in brief - May 5, 2003

Leapfrog revises standards - Many Texas doctors changing practice - Accreditation group will begin unannounced surveys in 2006 - Dolly's remains put on display

Leapfrog revises standards

The Leapfrog Group, a consortium of 135 employers providing health care benefits to 33 million people, has revised its three patient safety standards: intensive-care unit staffing, computer physician order entry and evidenced-based hospital referral.

For its ICU standard, Leapfrog called for staffing ICUs with board-certified "intensivists." It has been revised to include doctors who completed training before 1987, which was before subspecialty certification in critical care was available for many disciplines.

The target date for installing CPOE systems was pushed back one year to 2005, giving hospitals more time to implement electronic prescribing.

The referral standard called for sending patients to high-volume hospitals for certain high-risk procedures. Carotid endarterectomy has been dropped from this list and replaced with pancreatic resection. The original coronary angioplasty standard has been expanded to included other percutaneous interventions.

Leapfrog also announced that it was expanding its operations to include 150 hospitals in the state of Maine, and the Chicago, Ill., and Hampton Roads, Va., metro areas. The group is now in 22 regions, with 1,100 hospitals and 48% of the U.S. population.

Many Texas doctors changing practice

Nearly two-thirds of the 1,027 Texas physicians who responded to an online survey by the Texas Medical Assn. say the current climate in medicine forced them to deny or refer high-risk cases in the past two years. More than half of the physicians said they've stopped providing certain services to their patients.

More than half of the physicians said professional liability insurance pressures were "very important" or "somewhat important" in their decisions, according to the TMA.

Texas is one of 18 states that the American Medical Association has said is in the midst of a medical liability crisis because physicians there are reducing the number of high-risk patients they see, retiring early and leaving Texas to practice in other states.

Accreditation group will begin unannounced surveys in 2006

The Board of Commissioners of the Joint Commission on Accreditation of Healthcare Organizations recently announced that the group would begin conducting all regular accreditation surveys on an unannounced basis starting in January 2006.

The Joint Commission plans to introduce a new accreditation process in January 2004 and has discussed it with accredited health care organizations over the past year. The proposal to change to unannounced surveys was an outgrowth of those discussions and approved by the board in March.

During 2004, the Joint Commission expects to initiate pilot testing of the unannounced triennial survey process in up to 100 hospitals that have volunteered to be among the first participants. In 2005, it will continue to conduct voluntary unannounced surveys on a limited basis, opening up the option to all accredited organizations.

Through the end of 2005, the commission will conduct one-day, random, unannounced surveys in an annual 5% sample of the health care organizations it accredits. It will transition to the unannounced survey program in 2006.

Dolly's remains put on display

The stuffed remains of Dolly the sheep, the first cloned adult mammal, were put on display at the Edinburgh Science Festival being held in Scotland to celebrate the 50th anniversary of the discovery of DNA.

Dolly was born in July 1996 after being cloned from genetic material contained in a frozen mammary cell taken from a sheep that had died several years earlier. Scientists had attempted to clone 276 sheep embryos, and Dolly was the only one to survive.

She was euthanized in February after developing a lung infection. Previously, she had problems with arthritis and showed signs of early aging.