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    Healthcare Plan Information

    Panama Canal Area Benefit Plan Administered by AXA Assistance Panama–Health Improvement and Patient Safety Initiatives

    The Panama Canal Area Benefit Plan (PCABP) is a Federal Employees Health Benefits (FEHB) program which includes preventive care, diagnostic and treatment benefits designed to maintain and improve the health of PCABP members. The Plan is administered by AXA Assistance since January 2006.

    Health Improvement Initiatives

    I. Diabetes Disease Management Program

    The PCABP Diabetes Disease Management Program provides a proactive and multicomponent approach to healthcare delivery for members with diabetes, focused on prevention of co-morbid conditions and complications and in maintaining the highest quality of life for the members. Partnering with their treating physicians it emphasizes and supports self care by providing the members educational activities that assist them in understanding and managing their disease.

    Some of the interventions included in the program are:

    1. Pharmacy benefit: medications related to diabetes and its usual co-morbidities like high blood pressure and dyslipidemia are covered at 100% of cost,
    2. Disease-specific education
    3. Nutritional assessment

    Since November 2010 the Diabetes Disease Management Program was restructured to include new medications and new glucometers and as part of the educational component of the Diabetes Program Diabetes Care Attention Centers have been created for group educational activities and Primary Care Physicians Support.

    Diabetes Care Attention Centers

    There are four Diabetes Care Attention Centers distributed in Panama and Colon cities. In these Diabetes Care Attention Centers, members receive the following services:

    1. Delivery and Maintenance of Glucometers
    2. One on One Educational Program and Nutritional Assessment: Individualized educational sessions and Nutritional Assessment about what’s diabetes, its care, its complications as well as the importance of self-monitoring.
    3. Group educational activities
    4. Printed educational materials related to diabetes

    Primary Care Physicians Support

    Primary Care Physicians are visited to promote the Diabetes Care Attention Centers as an allied in the comprehensive treatment of the patient.

    Periodic Group Educational Activities

    The objectives of the Educational Component of the Diabetes Program include:

    1. Educate PCABP- Diabetes Program members about the nature of Diabetes and how to manage it.
    2. Raise members awareness about warning signs, symptoms and special care related to diabetes
    3. Educate members about glycemic control variability through periodic self-monitoring
    4. Promote healthy lifestyles including nutrition and physical activities

    II. Social Outreach Program

    The Social Outreach Program was implemented since January 2009 with the purpose of assessing social needs for PCABP members and to identify the care, services and benefits required by them according to their health condition. Through this program Social Workers aim to involve the members, relatives and primary care physicians in the coordination of curative and preventive benefits covered by the Plan. The population under this program was defined by specific criteria such as members at social risk, on multiple medications, requiring home care, residing in nursing homes, and members on dialysis. Since May 2010 members that reside in difficult to access areas were included.

    III. PCABP Wellness Program

    PCABP Wellness Program started in January 2010 with the purpose of guiding and encouraging the members to participate more actively in their own health care and to assist them in adopting a healthy lifestyle. Through this program we promote:

    • Members Education about:
      • Healthy lifestyles
      • Health and preventive care education
      • Prevention of caregivers burnout
      • Osteoporosis
      • Others topic related to wellness and wellbeing
    • Members recognition of their needstomaintainwellbeing
    • Physical activityto promoteandmaintainwellness:

    Periodic outdoor activities like outdoor walks, stress management and relaxation workshops, postural hygiene workshops, aquatic aerobics, bicycling and dancing exercises among others are organized.

    IV. Osteoporosis Program

    Since 2010 Osteoporosis Program was conceived as a strategy to structure processes and provide the tools and resources to offer continuous and comprehensive osteoporosis management to PCABP members. Through early diagnosis, treatment alternatives, rehabilitative services, education and periodic follow ups we aim to reduce the incidence and morbidity of this disease. As part of this program, PCABP members receive an initial and comprehensive Baseline Evaluation and Assessment, educational sessions about specific related topics such as fall prevention, assessment of environmental risk factors and others and if necessary additional interventions such as:

    • Combination of educational and physical therapy sessions during which patients have the opportunity to observe, apply and practice the application of new self-care activities in a supervised environment.
    • Rehabilitative services (short-term rehabilitative physical therapy) to reestablish basic levels of functionality in needed cases.
    • Yearly bone mass density study as a comparative measure to assess the impact of the program after one year of supervised treatment and completion of the three phased program

    Patient Safety Initiatives

    “We must have a system where it is easy to do things right and difficult to do them wrong”

    Despite the best efforts by medical personnel preventable adverse events still occur. The Patient Safety initiative focuses on identifying and correcting processes issues that allow these events to happen. In the hospital environment this requires an approach in which it is “easy to do the something right and difficult to do it wrong”.  For this Patient Safety Programs must be implemented at all levels of patient care. The PCABP is a leader in Patient Safety Initiatives in the Republic of Panama.

    Some of our initiatives are:

    I. Readmission Program

    For the Plan’s purposes, a re-admission occurs when a patient is admitted to a hospital less than 30 days from his previous discharge for the same diagnosis.

    PCABP has a case management program which detects and keeps track of PCABP members with one or more readmissions for the same diagnosis from his/her previous discharge during a period of 30 days or less. Through this program we measure quality of inpatient care, do necessary coordination for disease prevention and management in order to decrease the incidence of readmissions and improve quality of care.

    Also PCABP provides homecare services in order to reduce readmissions that could be related to a wide array of causes such as:

    • Intravenous, intramuscular, subcutaneous therapies, including antibiotics
    • Wound care
    • Home visit by physician
    • Social Work visit
    • Physical, Inhalation and  Respiratory therapy
    • Insertion of bladder catheter
    • Diagnostic test, such as:
      • Laboratory
      • Ultrasounds
      • Echocardiogram
      • X-ray
      • Electrocardiogram
      • Spirometry

    II. Surgical Wounds Follow Up Program

    Surgical wounds infections are serious health care problems; patients who develop surgical wound infection can suffer extended disability, pain, loss of function or even death.

    This initiative is related to our patient safety objectives and has been implemented since August, 2010. Through this program we follow up members of the PCABP that have under gone surgical procedures, ambulatory or inpatient, in order to  detect  post-operative infections, guarantee that members receive the appropriate level of care and decrease the rate of this serious complication.

    As part of this program a Case Manager follows up all members that underwent surgery by phone calls 30 and 60 days after the surgery and try to ascertain surgical wounds infections.

    III. Oncology Drug Prescribing Initiative

    Since January 2011 PCABP and AXA have implemented a program to prevent chemotherapy errors, like administration of incorrect medication or incorrect doses, which have the potential to harm the patient and be financially costly to the Plan. With the growing number of cancer cases we need to be one step ahead in trying to prevent complications with our membership.  In order to be approved, every oncology drug(s) requested is reviewed by Medical Department to verify:

    • It’s FDA approved.
    • Meets medical indications recognized by the FDA
    • In case of off-label use, it must have at least two randomized control trials published in the peer reviewed literature supporting its use.

    IV. Hospital Acquired Events Initiative

    The PCABP has implemented a program to assist hospitals in avoiding preventable adverse events. Our Doctors review our hospitalized cases and alert the hospital staff to any patient safety breaches that are detected. The hospitals fully cooperate with our efforts and there are contractual clauses that regulate these activities.

    V. Patient Safety Protocols At Hospital Providers

    According to present contracts with hospital providers, all hospitals are required to have policies and procedures related to patient safety, such as:

    • Meeting minutes of the Patient Safety Committee
    • Universal Protocol (protocol intended to prevent wrong site, wrong procedure and wrong person surgery)
    • Monthly Report of Surgical Site Infections
    • Voluntary Discharge Format
    • Protocol to stabilize patients before transferring to another hospital
    • Protocol to inform physicians about critical results
    • Protocol to identify patients at risk for developing pressure ulcers and / or fall
    • Protocol for handling high-risk drugs
    • Protocol for pharmaceutical orders (written and incorporated into the record)
    • Policy and procedure for identifying expired supplies
    • Protocol to give follow up instructions to patients when discharged
    • Report of avoidable and never events that took place in the hospital
    • Protocol to remove expired medications or whose license for sale has been revoked
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