Share, don’t hide, your adverse outcomes

Create a formal format and get ahead of the game

When Sandy Berkowitz, RN, JD, talks to physicians about what kind of adverse outcomes screenings they do, she rarely gets many answers.

"Among most physician practices, monitoring patient safety incidents is a pretty minimal activity. They obviously assume that they don’t make mistakes, but there is pressure on the managed care plans, and they are going to be forced to ask questions of their physicians," says Berkowitz, senior vice president and practice leader with Marsh Inc. in Philadelphia.

Health plans don’t want to know about adverse screenings, and providers don’t want to tell, and both parties are assuming that no one will really push them into sharing information. But with the new emphasis on patient safety and possible legislature, that’s likely to change, she adds.

Physician practices are going to be in a position of having to share some kind of patient safety information with their insurers, and they would be well advised to start now to look at ways to do it, she says. "Practices should create a format that demonstrates they tracked these events on an ongoing basis and get the jump on it."

Create a report you will be comfortable with that covers adverse outcomes. Indicators might include these scenarios:

- one patient being seen by more than one provider in the same office;

- a patient calling more than three times for the same issue during a 24-hour period;

- an asthma patient who shows up in the emergency room after three office visits with marginal peak flows.

Look at that data knowing that at some point in the future, you may have to share it, Berkowitz says. "Whatever these indicators are, the practice could be challenged to come up with a [formal] format," she says.