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Addressing Patient Safety in an Ambulatory Care Setting : The KP Georgia Region ’ s Experience

Introduction The 1999 Institute of Medicine (IOM) study, To Err is Human, and its March 2001 follow-up report, Crossing the Quality Chasm: A New Health System for the 21st Century, have heightened public awareness (and alarm) about errors in medical practice. These publications contained three main recommendations for all health care organizations in the United States: • identify and learn from medical errors (omission or commission); • create safety systems (change health care design) inside our organizations through implementation of safe practices at the health care delivery level; and • transform the health care system to be evidence-based, patient-centered, and systems-oriented, initially by focusing on the top 15 to 25 most common chronic conditions. Much of the 1999 IOM report centered on processes that surround medication errors. The National Committee for Quality Assurance (NCQA)—the accrediting body for managed care organizations (MCOs)—has suggested that two main themes underlie the need for MCOs to improve patient safety: medicationrelated clinical errors and level of both continuity and coordination of care. These two areas are also a major focus of the Kaiser Permanente (KP) Medical Care Program, which serves more than eight million members nationally. As part of its Quality Improvement (QI) Plan, each KP Region was charged with developing a Patient Safety Plan for 2001-2003. Each KP Region has a different model of care delivery. In KP Georgia, the Medical Group focuses on delivery of primary care and on selected core specialty services in full-service ambulatory centers. NonPermanente physicians provide an important part of specialty care in the KP GeorAddressing Patient Safety in an Ambulatory Care Setting: The KP Georgia Region’s Experience By Yancy Y Phillips, MD Thomas M Judd, MS, PE, CCE, CPHQ