Monday, May 3, 2010

Closing the quality gap

Patient safety must remain a key component of value-based purchasing

Addressing gaps in the quality of care and outcomes for Minnesota’s hospitals is an issue that BHCAG has been involved in for many years. Since first lending our support to the Minnesota Alliance for Patient Safety in 2000, BHCAG has continued to advocate for transparency at the hospital level by collaborating with employers and other health care organizations to establish The Leapfrog Group (also in 2000). And later, in 2003, BHCAG joined forces with the Minnesota Department of Health to introduce the state’s first adverse events report.

These initiatives have contributed to community and statewide improvements in outcomes and pushed Minnesota to the forefront of public reporting in health care in very meaningful ways:

  • BHCAG was a founding member of The Leapfrog Group, collaborating with employers and health care organizations to address a report on medical errors by the Institute of Medicine. The Leapfrog survey, which focuses on specific safety measures that hospitals can take to avoid some of the most common medical errors, is now completed by hospitals in 31 regions of the United States. In addition, this initiative has prompted many hospitals to respond with their own quality initiatives. The Leapfrog survey provides consumers with information about specific steps that hospitals in their community are taking to improve quality and to avoid common medical mistakes.
  • The Minnesota Alliance for Patient Safety (MAPS) is a partnership between the Minnesota Hospital Association, the Minnesota Medical Association, the Minnesota Department of Health and organizations, like BHCAG, that are committed to improving patient safety. MAPS strives to promote optimum patient safety through collaborative and supportive efforts among all participants of the health care system in Minnesota. Among other things, MAPS offers awareness campaigns for hospital employees, pilot programs, and tools to assist staff in their quality improvement efforts. BHCAG representatives serve on the MAPS steering committee, which guides the ongoing strategy and direction for this organization.
  • Minnesota was the first state to adopt by legislative action all 27 (now 28) of the National Quality Forum’s adverse events. This requires Minnesota hospitals to develop an action plan for improving their performance and holds them accountable for regular reporting of outcomes to the public. BHCAG was instrumental in establishing the adverse events report in Minnesota by providing funding for the development of the reporting protocol. BHCAG also facilitated ongoing discussions with hospitals and health plans to identify ways to improve outcomes and reshape the reimbursement system. By targeting deadly, and avoidable, medical mistakes the adverse events report keeps consumers informed about the performance of providers in their community. This supports individual decision making and gives hospitals an extra incentive to improve.

But there is still much room for improvement. A recent article in the Star Tribune drove this point home by citing the gaps in quality that can exist between hospitals that are part of the same hospital system, much less across different care systems.

Understanding and eliminating these gaps will become even more important in the coming months and years as the new Patient Protection and Affordable Care Act is implemented. The legislation’s focus on increased public reporting will put more emphasis on reporting by all hospitals and will shift the focus for comparing facilities to a value-based purchasing approach.

What to expect from BHCAG

As the details become known for how the new health care legislation will be enacted, BHCAG will continue to bring together employers, health plans and health care providers to push for widespread compliance with patient safety and reporting initiatives like Leapfrog and the adverse events report. More specifically, we will advocate for a universal and standardized reporting format that is meaningful and useful to employers and individual health care consumers. Meanwhile, we will continue our involvement in Aligning Forces for Quality (AF4Q) a grant from the Robert Wood Johnson Foundation that aims to align provider performance, public reporting and quality improvement.

If you are looking for a way to become more involved in patient safety and public reporting, please contact me. And watch for an upcoming BHCAG Community Dialogue session on this topic.

Remember that, together, our collective voice can have a profound influence on the future health care marketplace.

In the spirit of healthy change,

Carolyn Pare
President & CEO