Using Incentives to Drive Leaps in Patient Safety-Impl

描述(由申请者提供)：该项目将建立在AHRQ授予LeapFrog Group的质量规划伙伴关系赠款的基础上。最初的赠款支持多方利益攸关方努力设计财政激励和奖励，以加快采用LeapFrog建议的医院患者安全做法：计算机化的医生订单录入；针对选定的高风险条件和程序进行基于证据的医院转诊；以及为重症监护病房配备训练有素的专家。LeapFrog Group是一个由135多家大型私人和公共医疗保健购买者组成的财团，他们为3300多万美国人购买医疗福利。 现在进入该项目的实施阶段，LeapFrog已经制定了一项计划，在未来三年内在多达6个美国医疗保健市场分两波进行并严格评估财务激励或奖励试点。LeapFrog现在正在寻求AHRQ的额外支持来进行这一阶段。在LeapFrog的激励和奖励工作组(由医院、健康计划、医生、消费者和购买者代表组成)的指导下，以及Towers Perrin的精算支持和GE的项目管理和健康福利合同指导下，这些试点将在当地领导，并采取不同的方法。 LeapFrog将通过专家顾问提供技术援助，包括精算(Towers Perrin)、数据分析(MedSTAT Group)和法律咨询(ROPES&Gray)。独立评估者(宾夕法尼亚州立大学的丹尼斯·斯坎隆和埃里克·福特以及明尼苏达大学的乔恩·克里斯汀森)将通过监控每个试点实施其计划的过程并评估每个计划的结果，帮助确定成功和不成功的战略。LeapFrog将向所有购买者成员以及其他购买者、健康计划和医院广泛传播经验教训。

DESCRIPTION (PROVIDED BY APPLICANT): This project will build on an AHRQ Partnerships for Quality planning grant awarded to The Leapfrog Group. The initial grant supported a multi-stakeholder effort to design financial incentives and rewards to speed the adoption of Leapfrog's recommended hospital patient safety practices: computerized physician order entry; evidence-based hospital referrals for select high risk conditions and procedures; and staffing intensive care units with trained specialists. The Leapfrog Group is a consortium of more than 135 large private and public health care purchasers who buy health benefits for more than 33 million Americans. Moving now to an implementation phase of the project, Leapfrog has devised a plan for conducting and rigorously evaluating financial incentive or reward pilots in up to 6 U.S. healthcare markets in two waves over the next three years. Leapfrog now seeks additional support from AHRQ to conduct this phase. With the guidance of Leapfrog's incentive and reward work group, which consists of hospital, health plan, physician, consumer and purchaser representatives, as well as actuarial support from Towers Perrin, and project management and health benefits contracting guidance from GE, these pilots will be led locally and vary in approach. Leapfrog will provide technical assistance through expert consultants, including actuarial (Towers Perrin), data analysis (The Medstat Group), and legal consulting (Ropes & Gray). Independent evaluators (Dennis Scanlon and Eric Ford of Pennsylvania State University and Jon Christianson of University of Minnesota) will help identify successful and unsuccessful strategies by monitoring the process each pilot site uses to implement its program and assessing each program's outcomes. Leapfrog will disseminate widely the lessons learned to all of its purchaser members as well as to other purchasers, health plans and hospitals.