Patient Safety

Patient Safety is an integral part of the overall Quality and Risk Management Program. All quality initiatives are designed with consideration given to improving safety and reducing risk for our members by assuring a safe patient-care environment in the facilities of our network providers and practitioners. Recognizing that effective medical care error reduction requires an integrated and coordinated approach, we encourage our providers and practitioners to utilize a systematic program to minimize physical injury, accidents and undue psychological stress during instances of inpatient and outpatient treatment. Chartered’s organization-wide safety program includes all activities contributing to the maintenance and improvement of patient safety.

Chartered’s leadership assumes a role in establishing a culture of safety that helps to minimize hazards and patient harm by focusing on processes of care and incident reporting. The leaders of the organization are responsible for fostering an environment through their personal example; emphasizing patient safety as an organizational priority; providing education to staff regarding the commitment to the reporting of medical care errors; supporting proactive endeavors to reduce medical care errors; and integrating patient safety priorities into the design of all relevant organizational processes, functions and services.

As an initial metric, Chartered monitors Joint Commission on Accreditation of Healthcare Organization’s (JCAHO) accreditation status and whether the JCAHO National Patient Safety Goals are met at the time of accreditation. Almost 50 percent of Joint Commission standards are directly related to safety, addressing such issues as medication use, infection control, surgery and anesthesia, transfusions, restraint and seclusion, staffing and staff competence, fire safety, medical equipment, emergency management, and security. Additional patient safety standards went into effect for hospitals in 2001, and similar standards went into effect for behavioral health care and long-term care organizations in 2003, and for ambulatory care and home care organizations in 2004. These standards address a number of significant patient safety issues, including the implementation of patient safety programs; the response to adverse events when they occur; the prevention of accidental harm through the prospective analysis and redesign of vulnerable patient systems (e.g. the ordering, preparation and dispensing of medications), and the organization’s responsibility to tell a patient about the outcomes of the care provided to the patient—whether good or bad*1.

Chartered also monitors facility participation in other patient safety initiatives. In 2006, the second metric was participation in the Institute for Healthcare Improvement’s (IHI) 100,000 Lives Campaign. The 100,000 Lives Campaign is a nationwide initiative launched by the Institute for Healthcare Improvement (IHI) to significantly reduce morbidity and mortality in American health care. Building on the successful work of health care providers all over the world, we are introducing proven best practices across the country to help participating hospitals extend or save as many as 100,000 lives*2. In 2006, Chartered’s contracted hospitals were accredited by JCAHO as noted in the chart below. Providence Hospital participated in the 100,000 Lives Campaign.

Chartered also monitors patient safety measures of our contracted Pharmacy Benefit Management vendor, Caremark. Caremark receives information from Chartered’s contracted pharmacies each time a member fills a prescription. This information is used to determine what patient safety messages a member receives at the point of dispensing. During routine oversight of Caremark’s activities, it was noted that members filling prescriptions, were being identified using only information available on the member identification card issued by Chartered. After discussion with Caremark, and review of the JCAHO Patient Safety Practices for Ambulatory Care and Office-based Surgery*3, Chartered implemented a requirement that member age and gender also be verified before filling prescriptions.

1 Downloaded from http://www.jointcommission.org/PatientSafety/facts_patient_safety.htm
2 Downloaded from http://www.ihi.org/IHI/Programs/Campaign/Campaign.htm?TabId=1