A Healthcare Insurer’s Approach to Reducing Perinatal Risk

BETA Healthcare Group (BETA) provides healthcare professional liability coverage to more than 150 hospitals and
healthcare facilities in California. As the leading choice of liability insurers for California hospitals, BETA’s longestablished commitment to California physicians continues to grow with more than 5,000 insured physicians and over 50 medical groups. Whether it’s hospitals, medical groups, clinics, or hospices, BETA has earned a reputation for financial strength, rate stability, quality service, and breadth of coverage that is unparalleled in the industry.

BETA initially learned of Advanced Practice Strategies (APS) through a state-wide initiative that took place in 2008 and 2009. Under this initiative, APS educated California hospitals about the design and benefits of its content and the concept of regional hospitals joining together to achieve a combined volume discount. In 2008, as part of its mission of providing member organizations with innovative and comprehensive risk management products and services, BETA allied its Quest for Zero initiative with APS.

A Quest for Zero: Excellence in OB

Since 2008, BETA has championed its Quest for Zero obstetrical safety initiative with APS as its Perinatal Safety
Curriculum partner for ongoing education and competency requirements in Electronic Fetal Monitoring, Shoulder
Dystocia, and Postpartum Hemorrhage. BETA’s Quest for Zero initiative is focused on eliminating preventable
errors, improving reliability and reducing risk, and rewarding participating facilities with premium reductions if they comply with the initiative’s criteria.

The Quest for Zero initiative provides a 5% premium discount for compliant participants in year one, and 7-9% in
subsequent years depending on the level of compliance with all components. While participation in the Quest for
Zero initiative is not mandatory, currently 27 of the 36 BETA-insured hospitals with obstetrics facilities take
advantage of the initiative and its subsidized access to the APS curriculum, including several hospitals that are
piloting APS’ newest innovation, GNOSIS™.

GNOSIS™ for Obstetrics

After years of success working with APS, a subset of BETA hospitals representing a quarter of the group’s covered
births, have now upgraded to GNOSIS for Obstetrics. BETA has always cited expert content, accreditation,
relevance for both doctors and nurses, and ease-of-use as reasons for choosing APS but with GNOSIS these
benefits are significantly enhanced. Heather Gocke, BS, RNC-OB, CPHRM, C-EFM, Director of Risk Management
& Patient Safety said, “GNOSIS introduces an assessment, which drastically sharpens the learning experience. It helps us identify the core issues first, and supports clinicians with information specifically targeted to those high-risk areas.

Further, GNOSIS measures judgment – not just knowledge or facts. Judgment is so very difficult to capture
but so important to understand. We can now see multiple opportunities for improvement and direct our efforts
accordingly. GNOSIS has helped us see a more detailed picture of risk – but more importantly, opportunity.”

A Carrot not a Stick

BETA’s Quest for Zero initiative, including GNOSIS and other APS content, is appreciated and viewed positively
by BETA’s insured hospitals and clinicians. This proactive initiative is in place to drive excellence in care, improve perinatal safety, and reduce the risk of preventable errors before events happen. Clinicians and hospitals are encouraged to address their specific needs and are supported to excel. In turn, APS content has been met with interest and appreciation as clinicians understand it is a preventive – not punitive – measure. Particularly for GNOSIS, clinicians recognize the time-optimization component. “The chunked content has a lot of fans,” Gocke continued, “Users love that they can see specifically where to focus their attention and are happy that they can table content where they are already proficient. The two to five minute segments that can be taken on-the-go have been really well received.” BETA CEO Tom Wander concluded, “BETA strives to function as a strategic partner to our member organizations. We select and deploy the best and most effective clinical resources to help mitigate risk and improve care. We are proud to work with APS to help our physicians and nurses perform to the best of their abilities and to help us gain valuable insight into opportunities for risk mitigation.”