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TakeCare Insurance Company is committed to providing its members with safe, quality health care. TakeCare upholds the highest standard of practice and puts the welfare of the members first by ensuring that these safety standards are reflected in all its work processes. Patient safety, as defined by the Agency for Healthcare and Research Quality, is the freedom from accidental or preventable injuries produced by medical care. Risks and threats to patient safety can occur in any setting from a wide variety of causes. These risks can result to unfavorable, iatrogenic outcomes, mortality and morbidity, that can increase healthcare costs to both patients and the healthcare organization.

TakeCare has developed a multi-year Patient Safety/Risk Management Program that focuses on organizational and departmental efforts to identify and reduce actual and potential risks. The goal of the program is to develop systems/processes that can guide the identification/reduction of actual and potential risks, and maintain the quality of healthcare services provided to our members. The program is responsible for creating a comprehensive patient safety plan that addresses ambulatory care, inpatient care, pharmaceutical use, and member actions.

The Patient Safety/Risk Management Program has identified the following objectives for 2007-2008:

1. Perform periodic audits of specific aspects of patient care services based on referred or suspected clinical and safety issues of TakeCare's patient population. The audits will provide the basis for action plans developed to ensure on-going quality improvement and safe practice in high volume, high risk, and problem- prone areas.
2. Develop a comprehensive practitioner education program designed to educate and inform contracted practitioners and providers about patient safety and opportunities for improvement.
3. Enhance TakeCare's existing care management system to improve the quality of life of our members with chronic care conditions through the coordinated work of our team of providers, nurses, pharmacists and case managers.

Program Details:

1. Patient Safety Audits:
   Activities related to this objective include:
   1. Identification of three key areas of concern; Design and completion of each audit with specific action items and focused follow up based on findings.
   2. This may include areas of medication errors, incomplete medical records, lack of clarity concerning care plans, and other high-risk areas.
   3. Corrective actions will include policy updates on process change communicated on an organizational level.
2. Practitioner Education Program:
   Activities related to this objective include:
   1. Medication Safety Initiative involves providing information to all TakeCare network providers on prescription writing safety practices.
   2. Providing pharmacy counseling programs through the FHP pharmacy to patients to better understand instructions for taking medications.
   3. Ongoing training and education for FHP clinic providers and practitioners on principles of adequate and appropriate documentation.
   4. Providing guidelines to all TakeCare network providers and practitioners on reporting process and analysis of potential risks and quality related issues.
   These audits will commence in 2007 and will investigate two specific clinical issues to be identified as high-percentage problems among TakeCare's member population.
3. Chronic Care Management:
   1. Increase referral to case management program that targets members with chronic conditions like diabetes and coronary heart disease.
   2. Effective utilization of Anti-coagulation Management Services to assist members on anticoagulation therapy.

In addition to the Patient Safety/Risk Management Program, TakeCare is developing a Health Improvement Program. The Health Improvement Program is designed to enhance the health and quality of life of TakeCare members through the identification of unhealthy behaviors and lifestyles of our members. Once identified, these lifestyles can be changed through the application of specific programs designed around the improvement of lifestyle and improved health outcomes.

This goal will likely be accomplished through - health initiatives such as the following:

• Smoking Cessation program
• Healthy Heart program
• Diabetes Management program
• Weight Management program
• Cholesterol and Lipid Management program

TakeCare encourages the utilization of health maintenance guidelines that have demonstrated improved preventive health care. These health maintenance guidelines focus on both adult and pediatric patients, and prenatal/post-partum care. These guidelines promote practices that address key areas of improved health through prevention of disease. This includes:

• Childhood and adult immunizations
• Breast and Cervical Cancer screening
• Prenatal and Postpartum Care

TakeCare is committed to providing safe, high-quality, and cost-effective health care to its members. TakeCare recognizes the link between safety and quality and has made a committed effort to embrace safety as an organizational core value.