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BIDMC honored for innovative patient care initiative

Blue Cross Blue Cross Blue Shield of Massachusetts (BCBSMA) announced today that the Beth Israel Deaconess Medical Center’s Department of Obstetrics & Gynecology has been selected as the first recipient of its Health Care Excellence Award.

BOSTON - Blue Cross Blue Cross Blue Shield of Massachusetts (BCBSMA) announced today that the Beth Israel Deaconess Medical Center's Department of Obstetrics & Gynecology has been selected as the first recipient of its Health Care Excellence Award.

The award, which carries a $100,000 prize, was created to recognize exceptional achievement in improving the safety and effectiveness of health care in Massachusetts. It will be presented to the hospital on April 2 at a conference sponsored by BCBSMA that will bring together local and national leaders to explore the critical elements for delivering high performance health care: care that is reliably safe and effective.

Beth Israel Deaconess was chosen as the award's first recipient by a distinguished panel of health experts who cited its groundbreaking approach to reducing medical errors in its Obstetrics unit, an initiative launched following a tragic case in 2000 in which a series of errors resulted in the loss of a patient's baby.

Dr. Benjamin Sachs, chair of the hospital's Department of Obstetrics and Gynecology, publicly disclosed the errors and miscommunications in an article in the Journal of the American Medical Association, and led a major reorganization of the unit that looked outside the medical field for new ways to improve patient care. As a result, the hospital has experienced fewer complications for mothers and babies during childbirth.

"Beth Israel Deaconess Medical Center has successfully changed its culture and achieved significant results through this initiative," said Cleve Killingsworth, BCBSMA's President and Chief Executive Officer. "Their model is replicable and widely adaptable for other health care organizations."

"We are honored to be the first recipients of the BCBSMA Healthcare Excellence Award," said Dr. Sachs. "Our philosophy is that health care has much to learn from the science of safety and quality developed by other industries, and that the search for quality is a never-ending journey."

"We believe that we were only able to embark on this journey as a result of being willing to confront a patient's loss and accept responsibility," Dr. Sachs added. "We have learned that apologizing to patients, when errors occur, empowers us to improve and allows patients to heal."

Dr. Sachs commended the team that helped lead the reorganization: Penny Greenberg RN, Susan Mann MD, Ronald Marcus MD, Patricia McNamee RN, Stephen Pratt MD, Barbara Stabile RN, and Mary Salisbury RN. The team's quality assurance leaders are Toni Golen MD, Marc Kobelin MD, and Dorothy Mcweeney.

Following the 2000 case, Beth Israel Deaconess's Obstetrics unit began working with the Department of Defense and Harvard's Risk Management Foundation to apply the principles of Crew Resource Management (CRM), used to prevent errors in the military and in commercial aviation, to the field of obstetrics. It was the first obstetrics unit and one of the first health care operations in the country to adopt CRM.

The obstetrics staff learned how to use CRM techniques to overcome poor communications, a leading cause of medical errors, how to reorganize the delivery of care, and how to make it easier for all the staff to challenge and participate in decisions about patient care.

The Obstetrics Department also made major changes in the way it monitored patients. Previously, when doctors and nurses ended their day they provided updates only on the patients under their care to the next shift. Now, the entire obstetrics staff is knowledgeable about all patients. Because there are no accepted, clinically relevant outcomes in obstetrics, the department also developed an Adverse Outcomes Index, a measurement tool to evaluate obstetrical care.

Today, Beth Israel Deaconess has the lowest adverse event score of any comparable tertiary hospital reporting to the National Perinatal Information Center, a nonprofit organization that collects national data. As a direct result of the obstetrics unit's work, there are now statewide initiatives in Massachusetts, Maryland, and the District of Columbia to introduce obstetrical team training.

"They have made outstanding progress in improving patient care," said Andrew Dreyfus, BCBSMA's Executive Vice President of Health Care Services. "They have demonstrated that teamwork and communications are critical elements in creating care that is reliably safe and effective. We hope that others will follow this example."

More than 40 health care organizations throughout Massachusetts, including teaching and community hospitals, health centers, and state agencies, completed nomination papers for the award, part of a broad commitment by BCBSMA to work with key stakeholders to ensure that the health care system consistently delivers safe and effective care.

A selection committee named earlier this year reviewed the applications and chose the winner. The review committee was comprised of the following local and national health care experts: Maureen Bisgnano, Institute for Healthcare Improvement; Jack Connors of Hill, Holiday, Connors, Cosmopulous, Inc., chairman of the board of trustees of Partners Healthcare; Andrew Dreyfus, Executive Vice President, Blue Cross Blue Shield of Massachusetts; Lucian L. Leape, MD of the Harvard School of Public Health; Sister Mary Jean Ryan, of SSM Health Care; Richard Shannon, Professor of Medicine, University of Pennsylvania; and Frederica Williams, President & CEO, Whittier Street Health Center.

Blue Cross Blue Shield of Massachusetts (www.bluecrossma.com) was founded 69 years ago by a group of community-minded business leaders. Today, headquartered in Boston, BCBSMA provides coverage to 3 million members. BCBSMA believes in rewarding doctors and hospitals for delivering safe and effective care, and in empowering patients to take more responsibility, become educated health care consumers and become stronger partners with their doctors. Blue Cross Blue Shield of Massachusetts is an independent licensee of the Blue Cross Blue Shield Association.