Patient safety first... a California partnership for health

In California in 2009, Anthem Blue Cross joined forces with three regional hospital associations (RHAs) and an independent evaluator in an initial three-year, $6-million effort to address patient safety.

During Phase 1 of the Patient Safety First... a California Partnership for Health program (2010-2012), more than 180 of the 395 hospitals represented by the RHAs shared and implementated best practices in learning collaboratives. The three initial areas of focus were (1) health care-associated infections-ventilator-associated pneumonia (VAP), central line-associated bloodstream infection (CLABSI), and catheter-associated urinary tract infection (CAUTI); (2) sepsis mortality; and (3) perinatal care-reduction of elective deliveries prior to 39 weeks of gestation. To measure progress, the difference in the average rates from 2009 (baseline) to 2012 was calculated using data from hospitals that reported for every quarter from 2009 through 2012.

The rate decreases-57% for VAP cases per 1,000 ventilator-days, 43% for CLABSI cases per 1,000 central line-days, 24% reduction for CAUTI cases per 1,000 patient-days, 26% reduction for sepsis deaths per 100 sepsis cases, and 74% for elective deliveries < 39 gestational weeks-were statistically significant at the .05 level, except for CAUTI. A cost-avoidance analysis showed that these reductions were associated with a saving of 3,576 lives and an avoidance of $63.8 million in costs statewide (not limited to Anthem Blue Cross members).

The Patient Safety First program provides a long-term opportunity for collaboration among different health care sectors to share best practices to improve health care for Californians. Phase 2 will continue to addresssepsis and elective deliveries and add other initiatives.