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    Healthcare Plan Information

    Independent Health Patient Safety Intiatives

    While Independent Health has always promoted a supportive environment to assist practitioners and providers in improving the safety of their practices, the scope of this effort was expanded in 2002.

    Ongoing initiatives to promote patient safety include the following:

    • Monitoring safety related criteria for facility management including on-site reviews and medical record reviews of practitioners at the time of credentialing and recredentialing to improve safety of medical office practices. For facility management, this includes criteria such as handicapped accessibility, infection control practices, safe storage of potentially abusable supplies, and proper storage of medications. Medical record reviews include screening for legibility of records, documentation of allergy status, and consultant reports sent from specialists to PCPs. In addition, Skilled Nursing Facilities are screened for patient falls, pressure ulcers and catheter infections.

    • Activities to improve continuity and coordination of care through appropriate and timely communication to the PCP from various sites of care (i.e., hospitals, ambulatory surgery centers, and sub-acute rehabilitation facilities).

    • Investigating, tracking and trending of all member complaints and quality concerns pertaining to patient safety issues.

    • Pharmacy Drug Utilization Review (DUR) process to decrease medication errors and to ensure appropriate pharmaceutical use. This process includes: (1) a prospective review pre-authorization process (2) a concurrent review of claims to check for drug/drug/diagnosis interactions, duplications, age appropriate pharmacy and (3) a retrospective review that screens for FDA warnings/recalls, polypharmacy, narcotic abuse and PCP prescribing patterns to maximize safety/efficacy and cost. In 2002 our pharmacy implemented two new DUR screens: (1) quantity limit for acetaminophen, in which claims for prescription pain medication containing acetaminophen will reject if the maximum daily dose (4 GM) is exceeded. The communication of this information also includes a note to remind patients to avoid use of over-the-counter products containing acetaminophen when taking these prescription medications and (2) an edit was designed to avoid or reduce narcotic over-utilization, by preventing early refills, as well as duplicate therapies.

    • Pharmacy policy for authorization of medication for in-office infusion, which may be associated with acute infusion-related reactions. The policy outlines criteria requiring availability of appropriate staff, equipment, and medications to treat infusion-related reactions.

    • Pharmacy Electronic Prescribing Project - Independent Health recognizes that medication errors can occur due to several reasons, one of which is transcription errors. We are actively evaluating prescribing errors as well as reviewing how to minimize drug-drug interactions by providing the prescribing physician with the drug profile history of patients for whom a prescription is being considered. An electronic prescribing project was piloted and evaluated in 2001, and we are continuing to work towards implementing this project.

    • Pharmacy Drug Utilization Review process continues to expand. The screening for drugs contraindicated in pregnancy will be initiated.

    • The Fall Prevention Project targets persons with high fall risk based on medications. When patients are identified a notice is sent to the physician requesting review of the patient's pharmacy and the correspondence offers suggestions for safer pharmacy alternatives. Health education for fall risk prevention is included in provider and patient newsletters.

    • The Hospital Patient Safety Project targets network hospitals that are asked to identify their patient safety initiatives so we can understand and work collaboratively with hospitals to support national patient safety guidelines.

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