Federal Employee Health Benefit

2005 ConnectiCare Patient Safety Strategy

As a managed care organization, CCI is one step removed from the actual delivery of care. However, CCI has the responsibility of identifying opportunities and implementing activities that will reduce the risk of CCI members being exposed to errors of commission as a result of unsafe medical practice or care. The 2004 strategy is managed by the Patient Safety Committee, which is comprised of the Chief Medical Officer, the Senior Medical Director, the Medical Director, the Director of Quality Improvement, the Manager of Credentialing, and the Director of Pharmacy Services.

Activities in 2005 include:

• Survey participating hospitals concerning Leapfrog Compliance and encourage them to voluntarily report their data. Inform members which hospitals meet the Leapfrog Standards by establishing a hyperlink from the ConnectiCare member page to the Leapfrog site
• Review Connecticut State Hospital Quality Report of 10 National Quality Forum measures in 3 domains, Acute MI, CHF, and Pneumonia. Establish a hyper-link to the CCI website.
• Educate contracted physicians about patient safety Heart Failure
  • Contract with Subimo to provide patient safety information and education will be effective June 1, 2004.
  • Establish a hyperlink from the ConnectiCare provider page to the Leapfrog site
• Develop and disseminate information to members about patient safety, including activities that will reduce their chance of being subject to a medical error.
  • Publish patient safety articles in each Housecall member newsletter
• Ensure that we have selected qualified practitioners and organizations to provide care to members by conducting rigorous credentialing and recredentialing processes
• Monitor physician medical records to ensure compliance with elements critical to safe care. This includes:
  • Legibility
  • Problem List
  • Medication List
  • Past Medical History documentation
  • Follow up Plan
  • Evidence of communication with specialists
  • Notation of labs, x-rays, consult notes and other diagnostic tests
  • Follow up on abnormal lab and x-ray results
• Monitor physician offices sites for safe practices which includes:
  • Proper medication storage
  • Presence of an emergency plan
  • Proper disposal of medical waste
  • Proper sterilization of equipment
  • Safe treatment area
• Conduct Pharmacy Safety Initiatives which includes:
  • Polypharmacy monitoring
  • Controlled substance use monitoring
  • Member notification regarding inappropriate medication in the elderly
  • Encouraging appropriate antibiotic use
  • e-Prescribing project
  • Sending prescription alert messages/letters when appropriate
• Evaluate quality of service and care complaints against practitioners and providers by conducting a rigorous investigation and resolution of complaints