Survey and CPOE Materials

2023 Leapfrog Hospital Survey (PDF) (version 2, Updated July 21, 2023)

 

2023 Leapfrog Hospital Survey (Word) (version 2, Updated July 21, 2023)

 

Download the Summary of Changes to the 2023 Leapfrog Hospital Survey here.

The hard copy of the Survey contains important information that you will need to accurately respond to the Survey questions and can be used to collect the information you will need to complete the Online Hospital Survey Tool. The questions in the hard copy of the Survey match the Online Hospital Survey Tool exactly, so responses can be recorded on the hard copy of the Survey and then entered into the Online Hospital Survey Tool. The hard copy of the Survey includes:

  • Survey Questions and Endnotes
  • Reporting Periods
  • Measure Specifications
  • Frequently Asked Questions 

Any changes to the 2023 Leapfrog Hospital Survey that are published after April 1 will be listed here:

June 13, 2023

  • Section 4D Episiotomy and Section 4E Process Measures of Quality: Added APR-DRG and Tricare DRG codes used to identify vaginal deliveries and cesarean deliveries for reporting on Episiotomy in Section 4D and DVT Prophylaxis in Section 4E. Please review the updated measure specifications on pages 163 and 165 of the Survey.

  • Section 5 ICU Physician Staffing: Updated endnote #36 Certified in Critical Care Medicine to reflect updated pathway to certification offered by ABNS for neurointensivists. Please review updated endnote #36 on pages 311-312 of the Survey.

  • Section 9C Volume of Procedures: Added 14 adult and 18 pediatric CPT Codes used to identify Other Hernia Repairs and added one adult and one pediatric CPT Code used to identify Nasal/Sinus Procedures that were previously noted as removed. Updates are reflected in the Outpatient Procedure CPT Code workbook for Other Hernia Repair in the Adult and Pediatric General Surgery tab and for Nasal/Sinus Procedure in the Otolaryngology tab.

    Please download an updated copy of the Outpatient Procedure CPT Code workbook from the Survey Dashboard. Instructions for downloading the workbook are available on page 285 of the Survey.

July 21, 2023

  • Section 6C Nursing Workforce Total Nursing Care Hours per Patient Day, RN Hours per Patient Day, and Nursing Skill Mix: Updated exclusions for medical, surgical or med-surg units with fewer than 15 patient days per month for all three months during a quarter and units that were closed for an entire quarter of the reporting period. Please review updated specifications on page 202 of the Survey.

 

Other Supporting Materials

The following documents provide critical information that you will need to complete the Leapfrog Hospital Survey. Please review each document carefully before you begin.

Section Materials

Section 1: Basic Hospital Information

Section 1C: Informed Consent

AHRQ Training Module

CMS Toolkit for Making Written Material Clear

Section 2: Medication Safety

Section 2A: Computerized Physician Order Entry (CPOE)

 

Medication Reconciliation Implementation Toolkit (free)

The MARQUIS Collaborative (fee)

Taking a Good Medication History Video

Section 3: Adult and Pediatric Complex Surgery

Sections 3A: Hospital and Surgeon Volume


CPT Code Workbook available via Online Survey Tool

 

Section 3C: Safe Surgery Checklist for Adult and Pediatric Complex Procedures

File Safe Surgery Checklist Workbook

Section 4: Maternity Care 

Sections 4A-4E

CMQCC Instructions

 

Section 4F: High-Risk Deliveries 

VON Data Sharing Authorization

Section 6: Patient Safety Practices

Sections 6A-6B

 

Section 6B: NQF Safe Practice #2 – Culture Measurement, Feedback, and Intervention

Section 7: Managing Serious Errors

Section 7A: Never Events

CANDOR Toolkit

RCA2 Improving Root Cause Analyses and Actions to Prevent Harm

 

PACT Driver Diagram

PACT Process Map

PACT Communication Tip Sheet

PACT Patient & Family Pathway

 

Section 7B: Healthcare-Associated Infections 

Instructions and FAQs for Joining Leapfrog's NHSN Group

Section 8: Pediatric Care

Section 8B: Pediatric Computed Tomography (CT) Radiation Dose

Section 9: Outpatient Procedures 

Section 9C: Volume of Procedures

CPT Code Workbook available via Online Survey Tool

 

Section 9D: Safe Surgery Checklist for Adult and Pediatric Outpatient Procedures

File Safe Surgery Checklist Workbook

 

Section 9E: Medication Safety

FileMedication Safety Workbook

 

Leapfrog Hospital Survey Binder

The Leapfrog Hospital Survey Binder document is available for use by all hospitals to collect, organize, and record information during the completion of the Leapfrog Hospital Survey. The document can be printed and placed in a binder. The information is helpful when completing subsequent years' Surveys, in staff and leadership transitions, and as a historical record. The use of the binder also acquaints hospitals with the elements of Leapfrog’s verification protocols.

 

 

 

 

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