The Leapfrog Group is an initiative driven by health care purchasers who aim to promote improvements in the safety, quality, and affordability of health care (Leapfrog Group, 2021). The Institute of Medicine’s (IOM) 1999 report on medical errors gave the Leapfrog founders an initial focus of reducing preventable errors. One of IOM’s recommendations was that large employers provide more market reinforcement for the quality and safety of health care (Leapfrog Group, 2021). The Leapfrog Group was initially focused on four patient safety practices, namely to reduce preventable medical errors through computer physician order entry, evidence-based hospital referral, intensive care unit (ICU) physician staffing and National Quality Forum (NQF) safety practices that constituted 34 safe practices (McBride & Tietze, 2016). 

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