Covenant Health Accelerates Incident Reporting and Focuses on Safety

Covenant Health, a nonprofit healthcare organization that consists of seven acute care hospitals, behavioral health facilities, cancer treatment centers, outpatient diagnostic and treatment centers, physician practices, and several other related ventures in eastern Tennessee, is faced with the labor-intensive job of tracking all incidents — whether or not they lead to claims.

The Knoxville-based organization self administers claims for general and professional liability claims, and it works with a third-party administrator (TPA) to handle its workers’ compensation claims. While Covenant Health manages only a small number of claims a year, its Risk and Claims Management department tracks hundreds of good catches and events that arise from employees, patients and visitors.

Incident reports originated on two different paper forms — one two-sided form for patient/visitor incidents and a separate form for employee injuries. The forms were filled out by employees or supervisors, reviewed by facility risk managers and then sent to the corporate office, where they were typed into the central risk management and claims system.

“The entire process used to take at least two weeks,” recalled Traci McCullough, vice president of Corporate Risk for Covenant Health. “It was difficult to know what we had in the pipeline and how many reports were sitting on a manager’s desk. We need this information as quickly as possible, but the geographic dispersion of our facilities made it a big challenge.”

A Smarter Way to Report Incidents

The workers’ compensation incident form, which ultimately was faxed directly to Covenant Health’s TPA, was often difficult to read and contained incomplete employee information causing rework and delays in the TPA’s claims processing.

With intranet access available to nearly all 9,500 employees, Covenant Health looked for a way to use technology to improve the incident reporting process. Covenant Health’s risk management team worked with CSC to develop two Web-based smart forms to handle both the reporting and approval processes.

“We had designed a process and flow on paper of how we thought the smart forms should work and we gave it to CSC,” McCullough said. “Obviously, CSC’s team had worked with other clients on incident reporting, and they were able to help us through the process. For example, they helped us design a form that would work for our healthcare-related companies and also incorporate other companies such as a day care and fitness center.”

The new reporting system expanded the amount of information that’s captured from seven to 22 different incident types including falls, surgical issues, environmental problems and equipment failures. In addition to designing the Web form for employee injuries, Covenant interfaced payroll data using the RISKMASTER Data Importer module into the Workers’ Compensation module — allowing the organization to capture all pertinent employee information and eliminating steps for verification and follow-up calls by TPA personnel.

Faster Reporting and Approvals

“The forms are intuitive and easy to use,” McCullough said. “Each form asks questions, and how you answer directs you to the next question. The forms tremendously improved turnaround time, too. I can run a report right now and know anything that happened at any hospital, up to the minute. We know what type of event it was, we have a description, and we know if the patient was injured. We can get a lot of information very fast.”

From a management standpoint, the new process provides accurate information to Covenant Health’s management team in a timelier manner. While the Risk Management department was hard-pressed to generate reports to the facility managers by the 20th of every month, the reports are now on time and more up to date.

Incident forms no longer come straggling in, requiring reconciliation with prior reports. In fact, about 80 percent of all incidents are in the system within 24 hours. “A faster response makes all the difference in the world,” McCullough added. “The investigation takes place sooner, and we can interview individuals involved in the incident while their memories are still fresh.”

The new forms also helped streamline the management review and approval process. The manager is automatically notified by email when a new incident report is submitted, and the review process and sign-off occurs electronically. If new reports are sitting in a manager’s inbox, the Risk Management team can call them to the attention of the facility manager, if needed.

Leading the Way in Patient Safety

The new smart forms were part of an overall modernization program at Covenant Health, which has been using CSC's RISKMASTER software since 2001. In addition to upgrading the system and adopting an easy-to-use reporting writing tool, Covenant Health chose RISKMASTER for Medicare, Medicaid, and SCHIP Extension Act (MMSEA) reporting.

In addition, Covenant Health is working with CSC to report patient safety incidents to its Patient Safety Organization (PSO) using the Agency for Healthcare Research and Quality’s Common Formats.

Participating in PSO reporting enables healthcare organizations to voluntarily report and share quality and patient safety information without fear of legal discovery. Covenant Health opted to use CSC’s Innovation Community program to incorporate PSO reporting into the base RISKMASTER system — ensuring that CSC will provide ongoing support for the new functionality, which will be available to other RISKMASTER clients.

“This is an exciting enhancement for us because it will allow us to share our patient safety information confidentially and aggregate that data with other organizations to support our quality improvement initiatives,” McCullough said. “We really appreciate the fact that we can handle all of these types of claims and reports with one solution. We’ve got a real workhorse with RISKMASTER.”

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