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Healthcare Plan Information

GHI HMO Patient Safety Initiatives

Consumers are at the center of health care decisions. Patient Safety includes awareness of being safe and taking action to encourage safe practices and environments. GHI HMO supports consumer safety through direct consumer and provider education, and through access to community and national events that promote safety.

Education

GHI HMO's (www.ghihmo.com) and GHI's (www.ghi.com) website offers educational information to consumers. These information-rich websites offer consumers a wealth of information that promotes safety, within the home, in the social and medical communities.

Patient safety information is included in the member newsletters. Articles focus on encouraging safety practices based upon the season the newsletter is distributed. Bike helmet safety, sunscreen protection, receiving flu shots are examples of some of the seasonal articles. Examples of topics having no season include domestic abuse, immunizations, men's health, and nutrition.

Members are also reminded to care for themselves via personalized letters and via general community outreach activities which GHI HMO sponsors or in which the plan participates.

Disease, Preventive Health, and Case Management

Members are encouraged to manage their medical, physical and emotional needs, thereby maintaining their health. They are encouraged to contact their doctors to address medication and treatment concerns. General medical and social work case managers assist members to address their needs. Specific programs address preventive needs and disease specific needs. Some of these programs include those that address diabetes, asthma, stress related to chronic illnesses, post partum depression, post cardiac depression, children, women and men's preventive health including but not limited to immunizations, mammography, prostate screening.

Provider Education

GHI HMO adopts and distributes evidence-based guidelines to providers for use in treatment recommendations. Additional tools used include letters to providers with their members' names who are in needed of services. Results of provider access and availability surveys, audits of medical chart documentation, and review of selected preventive health and disease management requirements are tracked with the results offered to the provider.

Clinical Quality Issues

Clinical quality issues are investigated and adjudicated, thereby addressing members' clinical complaints and needs. Drug errors and other pharmaceutical complaints are addressed through the GHI pharmacy department.

Oversight of Vendors

Regular contact and visits are made with the vendors to ensure that members receive the care within the benefit plan.

Community and National

The Leapfrog Group for patient safety https://leapfrog.medstat.com, and the www.healthgrades.com/ are two valuable sources of information consumers can access for patient safety. The Leapfrog Group collects data from hospitals from 22 regions, identifies and focuses on health provider performance. The Healthgrades website provides data by hospitals for various procedures. In addition to these websites, GHI HMO reviews information specific to patient safety, from the US Department of Health and Human Services Agency for Healthcare Research and Quality (www.ahrq.gov). Locally, brown bag lunches are scheduled in community agencies such as hospitals to address topics such as medication combinations.

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