Leapfrog patient-safety standards are a stretch for most hospitals.

The Leapfrog Group, a national coalition of large health care purchasers, has championed three hospital patient-safety initiatives--computerized physician order entry systems, staffing of intensive care units (ICUs) with specially trained physicians and evidence-based hospital referrals for certain high-risk procedures. While Leapfrog's campaign has raised hospital awareness of these patient-safety practices and spurred some implementation efforts, few hospitals are close to meeting Leapfrog standards, according to findings from the Center for Studying Health System Change's (HSC) 2002-03 site visits to 12 nationally representative communities. Moreover, Leapfrog's focus on selected communities--known as regional rollouts-has not yet prompted significantly greater implementation of the three hospital patient-safety practices in targeted communities. Many factors, including a lack of incentives for hospitals, are hindering hospital buy in and fulfillment of the Leapfrog standards.