Another example of public reporting of quality and safety data here in the United States is by an organization called the Leapfrog Group. The Leapfrog Group is a healthcare purchaser based organization. So these are employers who buy healthcare benefits on behalf of their employees. And the Leapfrog Group was formed 17 years ago by large purchasers of health care who were interested in driving quality and safety improvements in US hospitals. The Leapfrog Group conducts an annual survey of hospitals quality and safety practices, and that information is made publicly available. If you google or search the Leapfrog Group, you will find them as hopefully the first listing. The URL is leapfroggroup.org. Up here in the top is an ability to compare hospitals. It's highlighted in green, and you would go ahead and click on that. Similar to the hospital compare website, there's the option to search for hospitals based on location or by hospital name. I'm going to go ahead for purposes of this exercise, search for hospitals in Baltimore Maryland, and go ahead and click on search. This brings up a list of hospitals that are located in or around Baltimore Maryland. And I'm actually going to choose three hospitals to compare. Those three hospitals are going to include Johns Hopkins Bayview Medical Center, the University of Maryland Medical Center. And as a third hospital, let me choose the Johns Hopkins Hospital. Soon as I've selected those three, I can then hit on compare selected, and that will fill out the results just down to the hospitals for which I'm interested in. Leapfrog Group reports out information for each hospitals into four categories. Information falls into inpatient care management, medication safety, maternity care, and infections and injuries. I'm going to detail what's located under each of these four tabs. So, inpatient care management includes processes and structures that the hospital had put in place to ensure high quality safe care. This includes things such as using intensivists to manage or co-manage the care of patients in the ICU. Whether or not hospitals have put in protocols and procedures to keeping patients safe from harm, the Leapfrog uses a cell phone bar methodology to report out its results. A hospital that fully meets the standard for that particular area has the four force cell phone bars. A hospital that is substantially towards meeting the standard gets three cell phone bars, some progress two and willing to report, i.e., the hospital was going to be transparent, receives one. Hospitals that choose not to respond to a survey or a section of the survey get labeled as declined to respond. Underneath medication safety, Leapfrog shares information on whether doctors order the medications through a computer, this has been referred to as computerized physician order entry, and whether or not a hospital uses bar code medication administration in administering its medications. Leapfrog actually has quite a bit of information around the maternity care provided in hospitals, including information on early elective deliveries, cesarean sections for low risk first time moms, episiotomies rates for women who undergo vaginal delivery, adherence to maternity care processes, and how well hospitals do with caring for high risk deliveries. Leapfrog also shares information around healthcare associated infections and also shares information on some injuries, included hospital acquired pressure ulcers and hospital acquired injuries, including falls, burns, and trauma.