Reaping rewards for optimal care

Minnesota Bridges to Excellence drives improved care and outcomes for patients

Public reporting of performance data by health care providers has produced startling findings, such as the recent study on safety lapses in same-day surgery centers and the annual Department of Health report on “never events.” But, that same data has also revealed more promising news for patients and the health care industry⎯like the Minnesota Bridges to Excellence results.

Minnesota Bridges to Excellence is a BHCAG program that provides financial rewards for clinics that meet or exceed optimal care measures for patients with diabetes, vascular disease and depression. This year, as we celebrate the 5^th anniversary of Minnesota Bridges to Excellence, we acknowledge the commitment these health care providers have made to data reporting and improving patient care, and we applaud them for their efforts.

Tonight, BHCAG will host a recognition event to pay tribute to 39 medical groups and 124 clinics from various parts of the state who have qualified for “achievement” (meeting or exceeding optimal care guidelines) or “improvement” (did not meet optimal care goals, but showed improvement of 10 percent or more over last year) through the Bridges to Excellence program. We look forward to recognizing their efforts and successes and hope that you will join us for the event.

I’m very pleased and encouraged to report that the number of clinics that qualified for rewards has more than doubled since 2009.

This means that more people who are living with these chronic conditions are receiving better care. As for clinical outcomes, physicians point to a decrease in the number of referrals being processed as a sign that improved care delivery is having a real-life impact on patients. To quote Dr. Kenneth Ripp of the Raiter Clinic in Cloquet, Minn.:

“Prevention is the unsung hero in health care. It’s the heart attack that never happened because a patient’s condition is being appropriately managed. In the end, we know our efforts are making a difference if we’re sending fewer patients to specialists to treat heart attacks and other medical emergencies.”

In addition to an increase in the number of clinics that qualified for rewards, I was also encouraged that more clinics outside of the Twin Cities metro area qualified for rewards this year.

Geography can complicate quality improvement efforts for clinic systems in greater Minnesota, as they attempt to bring disparate clinics together under a unified, systematic quality improvement program. The fact that more clinics in greater Minnesota qualified for Minnesota Bridges to Excellence rewards shows a high level of commitment to their patients and innovation on the part of these clinics.

“Because we’re small, we can do quality in a different way,” said Dr. Ripp. “We can do things on a much more personal level and incent physicians on a personal basis. We’ve found that a little incentive can go a long way to getting people’s attention.”

The value that programs like Minnesota Bridges to Excellence brings to the table is not so much in the financial reward, but in the focus that it lends to quality improvement efforts. Physicians and Minnesota Bridges to Excellence reward winners tell us that the program helped them focus their efforts and got everyone at various clinic locations singing the same song.

“It’s difficult for a mid-level practice to do 14 different quality initiatives really well,” said Dr. Tim Hernandez, Family HealthServices, White Bear Lake, Minn. “Having key initiatives that everyone supports and is aligned with is a huge help to us. And getting public recognition for developing the infrastructure and tools needed to measure outcomes provides valuable reinforcement to our staff.”

While these most recent Minnesota Bridges to Excellence results are encouraging, there is still much progress to be made in the area of care delivery. But the efforts of this year’s winners set a prime example of the dedication and innovation that is needed to improve care and to put the focus in health care on quality instead of quantity. This level of collaboration and leadership is essential to the success of individual clinics and the health care marketplace as a whole.

In the spirit of collaboration,

Carolyn Pare

President and CEO

Buyers Health Care Action Group

Patient safety requires vigilance

Infections in surgery centers show need for ongoing focus on patient safety and quality

You’ve heard the reports of misdiagnoses, botched surgeries, and now, a report from the Centers for Disease Control and Prevention that shows a serious problem with infection control in same-day surgery centers across the country.

The report, which was conducted by the Centers for Disease Control and Prevention and published first in the Journal of the American Medical Association and last week in the Washington Post, reflected unsafe practices that were observed in same-day surgery centers in Maryland, North Carolina and Oklahoma. The safety lapses were very basic, from failure to wash hands or wear gloves, to reusing devices meant for one patient on multiple patients. At the end of the day, 67 percent of the centers in the study had at least one lapse in infection control and 57 percent were cited for deficiencies.

While it is not known whether the safety lapses identified in this study led to infections in patients, we do know that infections in the surgical and hospital settings are a very real, very serious matter. In March 2010, the Leapfrog Group (of which BHCAG is a founding member) released a report on central-line associated blood stream infections, or CLABSIs, which cause at least 30 percent of the estimated 99,000 hospital-infection related deaths in the United States and account for billions of dollars in avoidable health care costs every year.

The Leapfrog report, which targeted 926 hospitals in Minnesota and across the country, was significant not only because of what it revealed about the CLABSI rates in hospitals. It was significant because it demonstrated the real-life value that comes from public reporting of performance data by health care providers. In this case, the public learned of the serious health problems a central-line infection can present and whether their hospital was up to par in preventing them.

However, many hospitals, including six in Minnesota chose not to respond to requests for data regarding their CLABSI rates. This failure to publicly report performance data robs individual health care consumers and health care purchasers of their ability to make informed decisions about where they receive care. It also stunts efforts to transform the health care reimbursement system from one that rewards for quantity of services performed to one that rewards for quality outcomes achieved.

And that’s where the commonality lies between the CDC study and the Leapfrog report. Both examples shine a light on the need for greater patient safety measures in health care facilities. BHCAG and its member organizations believe that patient safety is not a topic that should be pulled off the shelf and paraded around once a year. Patient safety should always be front and center in the health care reform debate.

It is equally important to remember that the key to improving patient safety is public reporting of data, such as shown in these studies. Whether data is voluntarily submitted through programs like BHCAG’s Minnesota Bridges to Excellence initiative, Minnesota Community Measurement, or through reports such as those mentioned here; business leaders, the health care community, and political leaders need to work together to generate greater momentum and compliance for public reporting among health care providers. And, since we’re talking about public reporting, let’s not forget to recognize those health care providers that have been leaders in this area and that have, as a result, realized notable improvements in care delivery and patient outcomes.

Look for more on the topic of rewards for improving care delivery and patient outcomes later this month as we celebrate the fifth anniversary of the Bridges to Excellence program.

In the spirit of collaboration,

Caroyln Pare
President and CEO
The Buyers Health Care Action Group