Federal Employee Health Benefits

HIP of Greater New York Patient Safety Initiatives

During the past few years, the healthcare community has stressed the importance of a culture of patient safety. While there have been mixed results in implementing effective strategies in dealing with safety, we believe it is an important topic for FEHB consumers. Therefore, we are asking that you provide an update on your patient safety initiatives and programs, and we will add them to the FEHB website. Since we need a consistent format in order to compare the patient safety efforts of different plans, we are asking you to use our framework:

1. Describe, in plain language, suitable for web posting, the activity you want FEHB consumers to know about.

   HIP will continue to participate in the New York Partnership for Improving Patient Safety (NYPIPS) working with all regional health plans to encourage reporting and enhancement of Leapfrog Measures. HIP will identify hospitals with positive safety records, appropriate volume of procedures, and good outcomes in the provider directory as an incentive to hospitals to participate in the Leapfrog initiative.

   As a participant in the Leapfrog Group, HIP was the first health plan in our region to communicate to our participating doctors about these hospital-based programs. We have educated our doctors to expect questions on the outcomes of the specialists they use. HIP will continue to inform providers on the key issues of patient safety through the HIP Connection, hipusa.com® and the Provider Manual.

   The following HIP pharmacy programs for physicians will continue:

   • Drugs contraindicated in the elderly and polypharmacy.
     Physicians with one or more members identified in this category receive outbound reminders that their members may be at risk. If there is not an adequate documented rationale for medication choice, the case is referred to the Peer Review Committee.
   • Pharmacy Case Management will continue.
     Members with more than 12 medications are referred to the case management program.
   • Education of network physicians in use of flow sheets to reduce medication errors.
     As part of our continuing efforts to empower our members, we have developed member-friendly patient education materials that encourage active participation in health care decision-making.

2. Explain the goal or expected outcome you anticipate from this activity.

   The expected outcomes of this effort are that a higher proportion of our members will obtain elective procedures in hospitals that have appropriate experience, as evidenced by volume.

3. Describe the specific tools you will use to evaluate the results of this activity.

   Our hospital profile indicates the frequency of particular surgeries by hospital. Thus, we are able to track the proportion of surgeries that are done in hospitals with appropriate volume.