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HealthMart 2003
Quality Improvement Initiatives Conference

"Making the Business Case for Quality Improvement: Perspectives of Employees, Employers, Providers, Government, and Health Insurers"

Session 2 Description: Local Initiatives on Patient Safety

Quality of care is a noble goal, yet it takes imagination and commitment to create positive change in the health care environment. Practical solutions and best practices will be highlighted at the Consortium’s Oct. 24 HealthMart 2003 conference by panelists discussing "Local Initiatives on Patient Safety" and "HIPAA Community Solutions Update."

As moderator of the "Local Initiatives" panel, Nancy Achin Audesse, Executive Director of the Board of Registration in Medicine, aims to identify and answer the major areas of confusion among physicians about the role of the Board in promoting patient safety.

Joining her on the panel will be Paula Griswold, Director of the Massachusetts Coalition for the Prevention of Medical Errors; Lawrence Gottlieb, MD, Executive Director of the Alliance for Health Care Improvement; and Diane L. Dick, Assistant Vice President of Quality and Case Management for Northeast Health Systems.

Ms. Audesse said that she intends to explain the different programs and activities of the Board of Registration in Medicine, particularly the Patient Care Assessment (PCA) program.

"PCA, unlike the enforcement activities of the agency, is a confidential, non-disciplinary program to drive continuous quality improvement efforts in all health care facilities. We believe that Massachusetts has the best doctors in the world, and the Board believes it can help to create a safe practice environment for these talented and dedicated physicians," she said.

The Board is investing in technology to reduce the "administrative hassle factor" for physicians, according to Audesse. These changes will contribute, in a small way, to the goal of allowing physicians more time to practice medicine by reducing the time required to process paperwork. The agency hopes to become more of a resource for the data collection and analysis that support credentialing, patient safety, and physician availability research and policy.

One of the initiatives to be discussed by Ms. Audesse’s panel is MedsInfo-ED, an Emergency Department point-of-service patient prescription/drug history information access program sponsored by the Alliance for Health Care Improvement. The Alliance is a collaborative of the five not-for-profit health plans based in Massachusetts: Blue Cross Blue Shield, Fallon Community Health Plan, Harvard Pilgrim Health Care, Neighborhood Health Plan and Tufts Health Plan.

"Emergency Department providers often have difficulty obtaining accurate and complete medication information about the patients they care for," said Dr. Gottlieb, who will discuss the Alliance initiative. "Current methods of obtaining the information are time consuming, and therefore costly. These limitations are also risky for the patients in terms of potential medication errors and adverse events."

Dr. Gottlieb will explore the Alliance’s experience and lessons learned in building a broad-based collaborative effort focused on developing an information technology solution for a narrowly defined but clinically important information access problem. "At the same time we are laying the groundwork for and assuring future compatibility with much larger-scale and broader-based clinical information exchange efforts," he said.

The technology solution will address data sourcing, transmission and display, according to Dr. Gottlieb. The Alliance also is looking at Issues related to confidentiality and data security and will develop a solution that is easily disseminated and adaptable.

"As far as we know, this will be the first time anywhere that health plan data will be made available at the point of service in emergency departments to improve patient care," said Dr. Gottlieb. "We have several hospitals already interested in participating in the pilot and/or implementing the system soon after the pilot efforts demonstrate the feasibility of the concept. The Massachusetts College of Emergency Physicians (MCEP) has expressed enthusiastic support for the project, and we are building a strong collaboration of the key stakeholders, including the health plans and hospitals, the Massachusetts Division of Medical Assistance, the pharmacy benefits managers and the Massachusetts Coalition for the Prevention of Medical Errors."

Ms. Griswold, of the Massachusetts Coalition for the Prevention of Medical Errors, will discuss her organization’s emphasis this year on supporting Massachusetts hospitals in implementation of safe practices for reconciling medications and communicating critical test results.

"We currently have more than 75 percent of acute care hospitals participating in these initiatives," she said.

An advisory group of hospital representatives chose to focus on these two areas because of the potential for making substantial improvements in patient safety. They address communication, teamwork and information-transfer issues, all fundamental system factors linked to patient safety, according to Ms. Griswold.