March 11-17 is National Patient Safety Week. This initiative first began in 2002 by the National Patient Safety Foundation and is meant to increase awareness about patient safety.
To celebrate, we want to share some information about the great work that the TeamHealth Patient Safety Organization (THPSO) is doing to assist our clinicians with improving patient safety and the quality of health care delivery. Four foundational programs that THPSO offers are:
- A safe and secure mechanism to submit patient safety events,
- A safe and secure environment to perform peer review
- Clinical quality audits of high risk clinical diagnoses; and
- Educational programs, including our newly expanded, national simulation program.
Aside from the above foundational programs, we are developing and implementing innovative patient safety activities and programs that differentiate the THPSO from other AHRQ-listed PSOs and notably, TeamHealth from other healthcare organizations.
In 2017, we launched the CT Utilization program. This program is aimed at improving patient safety, while also aligning with other stakeholders (i.e. clients and governmental and commercial payers) to assess CT scan utilization patterns and identify where quality resides. Reducing utilization may reduce cost, but that is not synonymous with quality. The THPSO has gone far beyond what other organizations have achieved. Using administrative data (billing), the median ordering rate for five commonly utilized CT scans was nationally defined (CT pulmonary angiogram, CT Abdomen/Pelvis, CT of the Brain for minor head injury in adults and children and CT of the brain for non-traumatic headache). We generate group, region, site, and even clinician- specific data, while securing the data and maintaining clinician anonymity. An extensive chart audit was performed to determine order accuracy and appropriateness, based on national guidelines. From those audits recommended ranges of practice were developed for each of the five studies and superimposed on the median utilization rates, which provides the clinician with insight into national standards, their own performance and a compass to modify their practice. This data is novel to the healthcare industry. We provide the clinicians with cost data for the five studies and evidence-based, clinical resources to assist our clinicians, including a partnership with ACEP E-QUAL, a CMS-funded learning collaborative, to provide additional resources. Well-informed ordering decisions may reduce avoidable imaging and increase the diagnostic yield of studies ordered, which both improve safety and quality outcomes.
In late 2017, we began a quality initiative in hospital medicine that focuses on decreasing 30-day readmission rates for congestive heart failure patients. This program aligns with payer expectations and external influences impacting our client hospitals with respect to CMS’s Hospital Readmission Reduction Program and other payment reform initiatives. Focused chart audits were performed to determine the common themes and timeframes associated with this population’s readmissions. Based on those themes (i.e. medication non-compliance) programs will be implemented to assist with identification of these patients and work collaboratively with all stakeholders to improve quality of care and patient safety, while reducing avoidable readmissions.
The THPSO is one of 82 AHRQ accredited PSOs. We recently successfully completed our required, three-year continued listing process. This federal appointment allows the THPSO to impact patient safety nationally with its innovative programs and collaboration with the AHRQ.
Kevin Klauer, DO, EJD, FACEP
Chief Medical Officer, Hospital Based Services
Executive Director, TeamHealth Patient Safety Organization
Chief Risk Officer