Through innovative programs, Blue Cross and Blue Shield companies nationwide are leading efforts to help create a safer care delivery system
CHICAGO, March 11, 2011 /PRNewswire-USNewswire/ – In a nationwide effort to highlight the importance of improving patient safety, the Blue Cross and Blue Shield Association (BCBSA) is again joining the National Patient Safety Foundation and other leading healthcare organizations in recognition of Patient Safety Awareness Week, March 6-12.
"Patient safety must be a top national priority. BCBSA and the nation's 39 independent Blue Cross and Blue Shield companies have a sustained commitment to help save lives and stop preventable injuries. We must – and are partnering with the provider community on innovative programs to improve safety," said Allan Korn, M.D., BCBSA senior vice president and chief medical officer. "Today, the Blues are leading efforts in the patient safety arena, including programs that are helping to reduce hospital readmissions and healthcare-acquired conditions, and will continue to engage physicians and hospitals to work together to create a safer environment so that all patients receive the safe, high quality care they deserve."
On a national level, the Blue system is collaborating with other stakeholders and making patient safety a priority at all levels of care.
BCBSA created the Blue Patient Safety Toolkit, which provides online and printed resources, including a series of checklists, to the 39 Blue Cross and Blue Shield companies to share with their local network providers to engage hospital leadership, eliminate infections and improve safety outcomes. Toolkit resources include the Blue Surgical Safety Checklist and the Central Line-Associated Blood Stream Infections (CLABSI) Checklists. The Blue Surgical Safety Checklist, adopted from the World Health Organization Surgical Checklist, consists of steps designed to improve communication and consistency of care within surgical teams and was created to educate and encourage providers and consumers to take proactive measures to help improve safety in the healthcare setting. To help decrease blood stream related infections, which cause more than 30,000 deaths each year, the Toolkit includes CLABSI resources, which contain evidence-based guidelines for hospitals to implement.
To encourage hospitals to adopt measures that eliminate medical errors, a Blue system-wide reimbursement policy prohibits reimbursement for preventable, serious events or medical errors. Blue Cross and Blue Shield companies will not reimburse hospitals for surgery performed on the wrong patient, a wrong body part or for a wrong procedure. Additionally, members will not be charged for such incidences.
BCBSA's Blue Distinction® is a designation awarded by Blue Cross and Blue Shield companies to medical facilities that have demonstrated expertise in delivering safe and high quality healthcare in the areas of bariatric surgery, cardiac care, complex and rare cancers, knee and hip replacement, spine surgery and transplants. Blue Distinction Centers® meet and exceed hospital-wide quality and patient safety criteria. Today, there are 1,900 Blue Distinction Centers throughout 47 states and the District of Columbia.
In addition, BCBSA's Technology Evaluation Center (TEC) serves as a nationally recognized leader that produces evidence-based assessments on the effectiveness and safety of medical procedures, devices and drugs. TEC is one of only 14 Evidence-Based Practice Centers selected by the federal Agency for Healthcare Research and Quality (AHRQ). TEC assessments provide objective information, based on clinical and scientific evidence, to those who deliver and manage medical care. The assessments answer the important questions of whether a technology's benefits exceed its harms and if it improves health outcomes such as length-of-life, quality-of-life and the ability to function.
Community-based programs to reduce readmissions
One area of focus for the Blue System is reducing hospital readmission rates. According to the Medicare Payment Advisory Commission, up to 20 percent of Medicare beneficiaries are readmitted within 30 days of being discharged, with 75 percent of those readmissions being potentially preventable. The estimated cost of these hospital readmissions exceeds $18 billion annually. As a system that covers nearly 98 million Americans, Blue Cross and Blue Shield companies are developing and implementing innovative approaches to reducing the number of unnecessary readmissions and reducing harm caused to patients in hospitals.
Blue Care Advisors in Blue Cross and Blue Shield of Texas' (BCBSTX) Pre-Admission/Post-Discharge Outreach Program reach out to members before and after surgery to review medications and, if appropriate, refer the member to BCBSTX's Case, Condition or Lifestyle Management programs for additional support. Members who participate in the program had a 23 percent lower readmission rate compared to those members who did not.
Through its series of Collaborative Quality Initiatives, Blue Cross Blue Shield of Michigan (BCBSM) and a group of Michigan hospitals have launched 11 statewide patient safety initiatives to address some of the most common and costly areas of surgical and medical care. Through data collection, BCBSM is assisting hospitals across the state to share and analyze information on patient risk factors, processes of care and outcomes of care. Hospitals can then design and implement changes to improve patient care outcomes. Much of the success of these initiatives come from a three-part structure that includes: funding from Blue Cross Blue Shield of Michigan and Blue Care Network that enables hospitals to work in a collaborative environment, provides resources for data collection to generate hospital performance reports and produces timely reporting of the data to hospitals to share best practices for implementation of quality practices. This model was first rolled out to study variation in angioplasty procedures and treatment and resulted in dramatic decreases in emergency bypass surgeries and other complications and experienced an annual statewide savings of $15.2 million. Initial improvements in general and vascular surgical outcomes included a 37 percent reduction in surgical complication rates, a nearly 10 percent reduction in mortality and a 35 percent reduction in readmission rates in bariatric surgery.
Community-based programs to reduce hospital acquired infections
Another focus area for the Blues is reducing the number of hospital-acquired infections (HAI). According to the Centers for Disease Control and Prevention, approximately 1 out of every 20 hospitalized patients will contract a HAI and the annual direct medical cost of HAIs to U.S. hospitals ranges from $28.4 to $33.8 billion.
In 2009, more than 60 Alabama hospitals participating in the Alabama Hospital Quality Initiative (AHQI) saved more than 200 lives by preventing over 2,200 HAIs. AHQI is a Blue Cross and Blue Shield of Alabama partnership with CareFusionTM MedMined Services, the Alabama Hospital Association and Alabama hospitals. This collaborative effort includes technology that enables hospital-wide use of real-time monitoring of patient conditions to minimize the incidence and effects of HAIs, and has reduced HAIs among participating hospitals by more than 20 percent. Blue Cross and Blue Shield of Alabama funded this initiative for seven years from pilot stage to full implementation at eligible hospitals and is now transitioning to reward high performing hospitals.
Hospitals participating in Highmark Blue Cross Blue Shield's QualityBLUE program have saved hundreds of lives by preventing nearly 1,300 central line associated bloodstream infections (CLABSI). CLABSIs most commonly occur in a vascular catheter placed in the chest. QualityBLUE hospital program participants have been monitoring hospital-wide central line infections for four years. Highmark collaborates with hospitals and provides payment incentives to hospitals that continue to improve patient safety by eliminating healthcare associated infections.
"The Blue Cross Blue Shield Association's commitment to educating providers, staff, and patients about safe practices is to be applauded," said Diane C. Pinakiewicz, president of the National Patient Safety Foundation. "That's what Patient Safety Awareness Week 2011 is all about – involving all members of the healthcare team in the promotion of patient safety."
The Blue Cross and Blue Shield Association is a national federation of 39 independent, community-based and locally-operated Blue Cross and Blue Shield companies that collectively provide healthcare coverage for nearly 98 million members – one-in-three Americans. For more information on the Blue Cross and Blue Shield Association and its member companies, please visit www.BCBS.com.
SOURCE Blue Cross and Blue Shield Association