Federal Employee Health Benefits

Health Net of California Patient Safety Initiatives

Health Net takes the issue of Patient Safety very seriously and has initiated a number of programs to ensure that as many Health Net members as possible receive care that meet standards set forth by the Leapfrog Group, in addition to other initiatives.

The Leapfrog Group is a nationwide collaborative effort to promote patient safety and improve quality of care, customer services and affordability in hospitals. More than 100 Fortune 500 companies, including Health Net, and other large private and public health care purchasers participate in Leapfrog. The Leapfrog Group estimates that its initiatives have the potential to save up to 58,300 lives and to prevent up to 522,000 medication errors each year. The group has chosen three initial safety measures:

1. Computer Physician Order Entry (CPOE) - Physicians enter medication orders via computers linked to prescribing error prevention software. This initiative can reduce serious prescribing errors by more than 50 percent.
2. ICU Physician Staffing - Staffing ICUs with physicians who have credentials in critical care medicine has been shown to reduce the risk of patients dying in the ICU by more than 10 percent.
3. Evidence-Based Hospital Referral - Volume criteria have been established for complex medical procedures to refer patients to hospitals with the best survival odds. By using these facilities, a patient's risk of dying could be reduced by more than 30 percent.

So what role does Health Net play in encouraging hospitals to meet Leapfrog standards? Throughout 2004, a number of activities are being undertaken with our members. Two are outlined below:

Activity 1
Educate Health Net members about the importance of Leapfrog standards by including articles in Health Net News and Seniority Plus member newsletters about the Leapfrog Group.

Goal/Expected Outcome
Health Net members will become familiarized with the Leapfrog Group, its initiatives and understand the importance for hospitals to move toward meeting Leapfrog standards.

Evaluation Tools
Health Net will utilize a variety of tools to evaluate the effectiveness of its member education initiative. These include measuring the number of Health Net members that view Leapfrog information at the Hospital Comparison Report section of the www.healthnet.com web site, as well as the percentage increase in admissions at hospitals in California that meet Leapfrog standards.

Activity 2
Inform Health Net members which hospitals meet Leapfrog standards by working with our Hospital Comparison Report partner, HealthShare Technology, to provide updated Leapfrog information to the member web site link and splash page.

Goal/Expected Outcome
Hospital admissions among Health Net's membership will shift from hospitals that do not meet Leapfrog standards to those that do.

Evaluation Tools
Health Net will continue to measure the percentage of total inpatient admissions occurring at hospitals that meet the Leapfrog Group's standards.

Participation and support of Leapfrog standards is only one way Health Net promotes patient safety. Health Net's Collaborative Care Program has been developed to address the wide variation in the utilization of health care services - both too much and too little. The program monitors and counsels doctors and Health Net members on the under-utilization of effective services, as well as the inappropriate variation and over-utilization of certain services. Health Net measures improvements of selected clinical indicators and services to monitor progress in the misuse and overuse of health care services.