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Safety Counts! a newsletter highlighting safety at Hallmark Health System

Do you have a safety story to share? The Safety Counts team wants to hear from you. Email us at This email address is being protected from spambots. You need JavaScript enabled to view it..

Safety Counts Feb 2015 - Download entire PDF by clicking here. 

Vol 3, No. 2, Feb 2015

Trained interpreters improve patient safety and satisfactionpage 1 quote

It takes 60 hours of specialized training plus oral and written tests for a bilingual person to become a certified medical interpreter. Using trained medical interpreters not only is a critical aspect of doctor-patient communication but it’s also required by law. The statutes cover patients with limited English proficiency, the deaf and hard of hearing and their families. It stipulates that trained interpreters and not family members or friends serve as communicators.

Hallmark Health System (HHS) receives more than 4,000 requests for medical interpreters each year. The most-requested languages are Chinese/Cantonese, Haitian Creole, Spanish and Vietnamese, but there are many others. The requests are filled through trained and qualified outside interpreters. Most are in-person interactions but telephonic services are used when necessary. The service is available around the clock.

Why are trained interpreters important in health care? There is a growing body of research on the negative impacts on patient safety of poor communication – everything from adverse drug events to wrong-site surgeries.

“The primary role of interpreters is to reduce safety risks to patients through accurate, direct and impartial communication,” said Amanda Niemi, who oversees HHS’s interpreter services program. In addition, having someone who “speaks their language” often puts patients and families more at ease and increases patient satisfaction.Finally, interpretation is a two-way street. “Interpreters are important not only so that the patient can understand the clinician but the other way around, too,” she added. “Many decisions clinicians make are impacted by what the patient tells them in terms of health and family history, for example.”

Having a robust medical interpreter services program is also a mark of cultural competency. “The services and level of care we offer to English-speaking patients should also be available, and equal, to patients who have limited English proficiency,” said Niemi.



A declining concern: Making hallways safer for orthopedic patients

There’s a pronounced decline near the end of the hallway between the pre-admission testing and surgical day care areas on the third floor at Melrose-Wakefield Hospital. Collection Specialist Marilyn Ward should know, as she walks it several times a day.caseStudy photo

So do surgical day care patients, particularly orthopedic patients and the elderly. “Many of our patients are here for knee and hip replacements,” said Ward, “and some can have trouble getting around. I noticed that the end of the hallway was a particular problem and thought having handrails would help.”

Not sure how to make a request for handrails, she emailed COO William Doherty, MD, who co-chairs the HHS Culture of Safety Leadership Committee, with speedy results. “I was shocked, surprised and happy when he responded and the work was done so quickly,” she said. Handrails now have been installed along that section of hallway and flooring has been replaced as well.

“Now, when I send patients down the hall, I tell them to use the handrail,” she added. “They are pleased that we took steps to improve their safety.”

Her advice to other staff? “Keep your eyes open for opportunities to improve safety. Even something small, like handrails, could turn out to be something big if it prevents a fall.”

Staff who have patient safety suggestions or concerns are encouraged to submit an RMPro report or speak to their manager.



Making the ED safe, comfortable for all patients

Behavioral health area provides calm, private space for care

Hospital Emergency Departments (EDs) can be busy and stressful places for patients and families. The noise and bustle can be particularly challenging for behavioral health patients. “We observed that a difficult ED experience had a pronounced negative effect on how well behavioral health patients transitioned to our inpatient unit,” said Carol
Plotkin, LICSW, HHS system director of Behavioral Health.Behavioral-2 photo

Melrose-Wakefield Hospital has created a state-of- the-art private area in its ED for adult behavioral health patients, “a place where they can receive excellent care that is also safe and respectful,” she added.

Behavioral health patients comprise 6-7 percent of the hospital’s ED patients, who are most often seeking treatment for illnesses including bipolar disorder, schizophrenia, depression and co-occurring substance use disorders. As in most Massachusetts hospitals, behavioral health patients often wait several hours before an inpatient bed or appropriate community setting can be found.

To improve the patient experience, behavioral health patients are evaluated and treated in a separate 2,000 squarefoot suite within the ED that includes four private rooms, private bathroom, common room, lockers and a nursing station.

“Patients no longer are seen in bays separated by curtains, where there is little privacy or confidentiality,” said Plotkin. The suite is staffed by a psychiatric nurse on each shift and a licensed social worker on most shifts. The team is supplemented by a consulting inpatient psychiatrist, the attending ED physician and security personnel.

“This arrangement is becoming more common, but it is still not standard. Our ED area has been widely praised by others,” said Plotkin. “It requires the commitment of the organization to behavioral health and to making sure these patients receive the safe, specialized care they need and deserve.”



A badge of distinction

Wearing ID badges separates employees and staff from others

What’s in a badge? ID badges play an important role in making sure that clinical and administrative staff have a safe environment in which to work. They represent an insurance policy for patients, visitors and other staff by identifying the name and department of the wearer. In addition to its role in hospital security and safety, an ID badge can be the equivalent of a “welcome” sign for patients, introducing the wearer and stating his or her 2 quote

“The ID badge definitely helps put patients at ease,” said HHS Security Director Chris Nowak. “Because it has a photo, a name and a department, an ID badge lets patients know that this person is the right person to give them a medication or take a blood sample or vital signs.” It also can help maintain confidentiality – “patients can see whether a staff member is from nursing or food services or the pharmacy so they can direct private health information only to those who should know it.”

Besides introductions, another function of the ID badge is logistical. “It lets others know that this person is supposed to be where he or she is,” said Nowak. “This is  particularly important in our maternity areas. Badges for staff there are a different color, indicating that they are authorized to be in the nursery unit.”

Finally, the badge should be treated as though it were a key to an important door. “Badges should never be left unattended, and employees should take them home,” said
Nowak. “In a weather emergency, for example, an ID badge may identify you as ‘essential personnel’ if you need to get to work when there is a ban on driving.”




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