Carolinas HealthCare System
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Carolinas HealthCare System Patient Safety Network Saves $17 Million in Healthcare Costs

Using an integrated, aggressive clinical approach, Carolinas HealthCare System has prevented over 4,400 patient safety events in two years, a 30 percent drop equivalent to more than $17 million savings in related care costs. These outcomes are the result of strong work by hospitals in a collaboration known as the Carolinas HealthCare System Hospital Engagement Network (HEN), developed to catch errors at the point of care and prevent patient harm from happening.

The Carolinas HealthCare System HEN is part of the prestigious national Partnership for Patients HEN initiative led by the Centers for Medicare & Medicaid Services (CMS). The national HEN is a public-private partnership of only 26 health organizations aimed at reducing preventable patient harm by 40 percent and 30-day hospital readmissions by 20 percent by the end of 2014.

“We feel proud to be making a difference in the lives of patients and to be contributing our knowledge and successes to this partnership,” said Roger Ray, MD, MBA, FACPE, executive vice president and chief medical officer for Carolinas HealthCare System. “The work of our teams has for years led to top successes in safety and high quality care, and we look forward to continuing our improvements in key clinical areas, regionally and nationally.”

Teams in the System’s HEN work together and find clinical areas in need of improvement, applying evidence-based practices to improve care across hospitals. This collaborative approach has helped them exceed their goals in several priority areas, including readmissions and adverse drug events.

In 2013, Carolinas HealthCare System hospitals saw as much as a 22 percent decrease in 30-day readmissions for all-cause heart attack, heart failure and pneumonia diagnoses and 14 percent decreases for all-diagnoses. Advanced analytics technologies are helping these hospitals predict high-risk patient readmissions with nearly 80 percent accuracy, helping clinicians determine which patients need comprehensive follow-up care after leaving the hospital.

The System HEN has also further coordinated the way medication safety teams across hospitals prevent patient harm related to high-risk medication use. Care teams have standardized the way they prevent complications from diabetes by better managing patients’ levels of glucose and the possibility of excess bleeding associated with the use of warfarin. Providers are more rigorously reviewing out of range laboratory tests results for glucose and INR which allows them to work on preventing them in the future. As a result the System has seen decreases of 14 percent and 23 percent in the number of patients with harmful levels of blood-clotting factors and glucose.

Other noted improvements of Carolinas HealthCare System HEN hospitals include:

  • A 73 percent reduction in early elective deliveries between 2012 and 2013, exceeding national benchmarks in 2013.
  • A 51 percent reduction in pressure ulcer rates between 2012 and 2013, exceeding national benchmarks.
  • A 53 percent reduction in number of patients who developed ventilator associated pneumonia in 2012, exceeding national benchmarks for the same year.

In recognition of Carolinas HealthCare System’s achievements in the HEN partnership, CMS recently awarded additional funding to the System through the Leading Edge Advanced Practice Topics (LEAPT) project. A select group of CMS HENs are working to achieve additional quality improvements in five additional clinical areas to reduce patient harm, including reducing number of patients with severe sepsis and expanding antimicrobial stewardship. Participation in the LEAPT project was based on achievement in the HEN partnership and Carolinas HealthCare System was one of just two healthcare providers selected for participation in LEAPT.