Blue Cross Blue Shield of Massachusetts   2005 Annual Report

Breaking New Ground: Children's Hospital Boston

The Centers for Disease Control and Prevention estimate that each year nearly two million patients get an infection while in the hospital and almost 5 percent are fatal.⁵ A critical question in health care is: How can we eliminate these infections?

Even the finest hospitals in the world face an ongoing challenge from inpatient infections. The very best hospitals—such as Children's Hospital Boston—tackle the problem aggressively. Working with our provider partners at Children's, we have developed an innovative contract aimed at an array of quality improvements, including reducing infections.

Our contract provides significant incentives for Children's to implement proven safety measures that reduce the risk of infection. Research shows, for example, that prophylactic antibiotics administered at precisely the right time before surgery significantly reduce the likelihood of infection. That's why our agreement provides incentives to Children's doctors and nurses to make sure the antibiotics are given at exactly the right time.

Another major source of inpatient infection comes from central venous lines, which can remain in patients for days, weeks, and even months at a time. The contract calls for our partners at Children's to implement recently established protocols that guard against the possibility of infection. The preliminary results are encouraging. To date, central venous line infections have been reduced by more than a third in the initial unit targeted.

We are also breaking new ground by providing an incentive in an initiative to create a Computerized Physician Order Entry system that supports pediatric care. This system alerts doctors when a medication may pose a dosage, interaction, or allergy danger. While many teaching hospitals for adult patients have Computerized Physician Order Entry systems, today there is no comparable readily available system for pediatric hospitals.

Once fully implemented, this system at Children's will:

• Improve quality
• Increase efficiency and safety in administering medications
• Reduce doctors' administrative burdens

John Mayer, a cardiac surgeon who was involved in the development of the contract, says, "We were excited to work with Blue Cross Blue Shield of Massachusetts to design a contract that provides incentives and financial support for our efforts to improve quality and safety. These efforts require a significant investment of intellectual and financial resources; we have been impressed with Blue Cross Blue Shield's commitment to work with us."

Our collaboration with Children's is among the most advanced in the country in that it pays for and rewards quality and results—rather than the traditional method of paying only for a series of procedures, whether they are effective or not.

 

By working together, Children's Hospital and Blue Cross Blue Shield of Massachusetts are reducing the rate of infection and creating a Computerized Physician Order Entry system for pediatric care. Our shared hope is to build systems and develop protocols that not only elevate the quality of care at Children's Hospital Boston but can also be replicated at other hospitals to raise the standard of pediatric care worldwide.

 

 

Read further about our collaborative efforts…