Promoting Hospital Patient Safety
Blue Cross Blue Shield of Illinois
Most health plans have limited information about their hospitals. With this program, Blue Cross and Blue Shield of Illinois (BCBSIL) collects and analyzes new data, which are combined with existing data in a comprehensive report of hospital performance. BCBSIL provides hospitals with relevant, easy-to-use information to improve quality of care and patient safety and helps members make more informed health care choices. Analysis and reporting are done at modest cost for the health plan, and without significant cost or added administrative burden for the network hospitals.
Program Elements
- More than 44,000 people die in hospitals each year from preventable medical errors, according to data from the Institute of Medicine. These errors, such as adverse drug events and surgical injuries, cost people lives and also have financial ramifications of more than $17 billion per year.
- Data are collected and analyzed to create hospital "profiles" that assess and compare quality from as many perspectives as possible to create a comprehensive picture of quality of care and patient safety.
- Profiles are developed using at least 10 types of indicators drawn from multiple sources, including Leapfrog status, member and physician surveys, complication rates, mortality rates, process measures for acute myocardial infarction, heart failure, pneumonia and surgical infection prevention, participation in various quality initiatives and evaluation of accreditation status, board certification, utilization efficiency and administrative efficiency.
- Profiles are shared with hospitals to offer performance feedback and comparative data. Detailed reports provide actionable information to help hospitals identify opportunities for improvement.
- Public reporting of quality and safety information - through the BCBSIL website and member newsletters – enables members to formulate their own decisions regarding hospital choices.
Program Results
- BCBSIL is now collaborating with all 184 non-specialty hospitals in its network to improve quality of care and patient safety.
- BCBSIL was able to include pay for quality components in more than 60 hospital contracts.
- More than 88 percent of members surveyed after the start of the program reported "excellent" or "very good" satisfaction with network hospitals, continuing the trend of strong member satisfaction.
Contact
Carol Wilhoit, MD, MS, Medical Director, Quality Improvement, 312-653-2446, wilhoitc@bcbsil.com
