WHA's Patient Safety Program

WHA is committed to promoting the delivery of safe, effective health care to its members and to implementing quality improvement initiatives that monitor and improve the safety of care in both inpatient and outpatient settings. The following is a summary of WHA's major patient safety activities:

Medication Safety - WHA has a comprehensive and innovative Medication Safety Program that includes the following components:

• Retrospective Drug Utilization Program - A joint collaborative between WHA and its pharmacy benefits manager, Medco, Inc., designed to address safety issues in the pharmaceutical arena. The program focuses on therapeutic categories of drugs with the potential for high abuse, over-utilization, and the misuse of medications that may result in poorly coordinated care or drug abuse.

Medication Management - WHA and its contracted Medical Groups/IPAs monitor and report the following HEDIS and Pay for Performance measures annually to identify opportunities to improve safe clinical practices for members:

• Annual Monitoring for Patients on Persistent Medications - addresses therapeutic monitoring of patients to prevent avoidable adverse drug events related to specific high-risk drugs. Certain medications, such as ACE inhibitors or angiotensin receptor blockers (ARB), Digoxin, and Diuretics post a concern due to associated increased rick of harm from drug side-effects, especially from long term use. The potential harms include electrolyte imbalance which may lead to hyperkalemia or hypokalemia and renal failure.
• Avoidance of Antibiotic Treatment in Adults with Acute Bronchitis and Appropriate Treatment for Children with Upper Respiratory Infection addresses appropriate antibiotic use. This continues to be an important opportunity for improvement as resistance increases to commonly prescribed antibiotics. Diminished efficacy of antibiotics against bacterial infections is a significant patient safety and public health concern.

Leapfrog Hospital Quality and Safety Survey - WHA regularly monitors the performance of hospitals through the Leapfrog Hospital Quality and Safety survey and encourages its contracted hospitals to participate in this annual quality and safety initiative. In July of each year, the Leapfrog Group posts on its website the survey results for all the hospitals completing the survey. Annually, WHA's Quality Improvement Committee reviews the survey results from each of WHA's contracted hospitals to identify improvement opportunities.

Cal Hospital Compare - WHA supports California's effort to standardize hospital quality measurements and provide hospitals with data for quality improvement purposes. Cal Hospital Compare data which is similar to Leapfrog is used to enhance WHA's strategic safety plan.

Clinical Complaints - WHA tracks and trends adverse events to identify system issues that contribute to poor safety. WHA conducts a thorough investigation and takes action on complaint and satisfaction data related to clinical safety.

Contracted Providers - WHA works closely with its contracted medical groups/IPAs, hospitals, practitioners and/or delivery systems to improve systems and processes that impact patient safety. On a quarterly basis, WHA verifies the hospital licensure and accreditation status of all contracted hospitals. WHA supports and promotes the adoption of various health information technologies, such as electronic patient registries, e-prescribing and electronic health records, which have all been shown to reduce errors and/or improve compliance with evidence-based guidelines for patient care.

Member and Provider Education - WHA educates its members about their roles and responsibilities in protecting themselves from preventable medical and medication errors. WHA develops and publishes educational articles for both member and practitioner newsletters and websites that address overall concepts of patient safety and medication error prevention. WHA also develops and disseminates clinical practice guidelines to improve safe practices.

For Additional Information

Providers can use the information from the websites listed below to make informed decisions about which WHA facilities to consider when referring patients for hospital care. All of WHA's contracted hospitals participate in both surveys.

• Leapfrog Quality Index Ratings (www.leapfroggroup.org).
• California Healthcare Foundation (www.calhospitalcompare.org).
• The Joint Commission National Patient Safety Goal Ratings (www.jointcommission.org).