The Leapfrog Group is national leader in measuring and reporting hospitals' adoption of computerized provider order entry (CPOE), physician staffing in intensive care units (ICU), evidence-based referrals for high-mortality surgeries, and the National Quality Forum's Safe Practices. Past studies have suggested that adoption of these standards is associated with higher quality of care for specific diagnoses, but does not impact inpatient mortality. This study similarly found no evidence that patients undergoing major surgery at hospitals with higher scores on the Leapfrog Safe Practices Survey had improved mortality rates. Furthermore, CPOE and ICU physician staffing were also not associated with mortality rates. The authors conclude that using Leapfrog Safe Practices Score as a standalone quality measure may have limited capacity to truly distinguish between high- and low-quality hospitals.