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Safety Counts!, a newsletter highlighting safety at Hallmark Health System
Safety Counts December 2013 - Download entire PDF by clicking
Statistically, a hospital stay is riskier than an airline flight. It’s been shown that hospitals that adapt and implement the kinds of safety checks and procedures used in the airline industry can measurably improve patient safety.
This was the main theme of the Hallmark Health System (HHS) Cornerstone Academy on Oct. 30, attended by nearly 250 managers, physician leaders and members of the HHS Board of Trustees.
John Nance, a respected expert on aviation and patient safety, was the featured speaker. Many of his remarks were based on his book Why Hospitals Should Fly. Among the key take-away lessons from this Cornerstone Academy were:
The day-long event also included a screening of the documentary film Chasing Zero: Winning the War on Healthcare Harm, hosted and narrated by actor Dennis Quaid,whose newborn twins nearly died from a medication error. The film supports a call to action for health care leaders to create systems that protect patient safety. The 50-minute film is available for viewing in department meetings and as a link on NetLearning.
Across the U.S., more than 5,000 children are injured each year after falling from windows, and young children are most at risk.
Dave Nelson probably didn’t know this statistic, but he did know a potentially dangerous situation when he saw one. And he did something about it – within days.
Hallmark Health System (HHS) Director of Engineering and System Safety Officer Justin Ferbert tells the story of Dave Nelson, an HHS carpenter and locksmith.
Earlier this year, Dave was on Maternity 6 at Melrose-Wakefield Hospital and was asked by a family with small children who were visiting a new mom to help them open a window to get some fresh air. Typically, windows in a hospital aren’t operable, both for safety and energyefficiency reasons. But in some cases – trying to balance these factors with positive patient experience – windows can open, usually with permission and with a hospital employee helping to open them.
On Maternity 6, the windows opened all the way. Dave determined that this posed a safety hazard, particularly because young children often visit the unit. So within a couple of days, he installed blocking mechanisms on all 20 or so windows so they can’t open more than 3 inches.
Diana Richardson, HHS vice president for Facilities, Support and Professsional Services, added that “as a result of this, we reviewed other
windows as well and did the same retrofit to the windows on the Labor and Delivery Unit on the second floor. Thanks to Dave for spotting the
potential hazard and making sure it got resolved.”
Imagine an employee whose job description is to search for patients in the hospital who might have infections. That would make the hospital a safer place for patients, staff and visitors, right? But given the numbers of patients in a hospital, to do it right would take many employees and still they might not see a pattern.
At Hallmark Health System (HHS), those “employees” aren’t people but a software program called MedMined, which HHS implemented last year. Since then, it has provided automated infection surveillance support to HHS infection control nurses Elaine Boerger, RN and Sue Rowland, RN, CIC. The software is helping improve infection prevention processes, reduce the incidence of hospital-acquired infections and assess the impact of their infection control efforts.
It works by sifting electronically through lab data generated from literally tens of thousands of patient cultures and sends information to the nurses based on culture results. “It’s a huge advantage to be able to get an early alert to an infection or pattern of infection that wouldn’t have been visible in the paper-based system we were using before,” said Maureen Pierog, HHS vice president for Quality. “We’re now able to dig deeper and more efficiently look for problems.”
Finding those patterns is one of the specialties of the system. “Say the system shows positive cultures for a number of patients in adjacent rooms,” said Boerger. “That’s a heads-up for us to investigate.” The reverse is true as well. “When we get negative cultures on all the patients on a nursing unit who have catheters, for example, we can go congratulate the staff there.”
The system can track and catalog infections that must be publicly reported. It can pinpoint potential problems in areas the infection control team wasn’t able to monitor before. And its protocol library is a back-up resource for the team when dealing with an infection. “Its biggest advantage,” said Pierog, “is that we are now made aware in a timely fashion of opportunities for improvement around potential or current infections so we can act on them quickly.”
M&M (morbidity and mortality) conferences are a part of the fabric of organized medicine and have been since they were established in the early 1900s as a way to evaluate patient care. Fortunately, they are no longer like the TV version with senior physicians berating others to “shame” them into providing better and safer care. Such an atmosphere does not create a culture of safety and does not result in providers learning to improve care. Intended as a confidential peer review discussion of medical errors or near misses in the care of patients, the conferences have become an important learning tool for physicians everywhere.
At Hallmark Health System (HHS), several departments hold their own M&M conferences. But HHS clinical leaders wanted to take the concept one step further and last year established an Interdisciplinary Clinical Practice Committee. Its aim is to improve patient care by providing a venue for clinicians to discuss cases, identify areas of improvement and promote professionalism, ethical integrity and transparency. Cases discussed in the group tend to be those that are very complex, multi-disciplinary or involve multiple clinicians.
“The sessions are not just for physicians,” said Steven Sbardella, MD, who co-chairs the committee with Charles Allen, MD. “Also included are physician extenders, nurses and anyone else who was involved with the case.” Discussions that occur at the committee focus on different approaches that may lead to a better outcome for patients presenting with similar issues.
“We want to create a comfortable environment in which everyone interested in the case feels free to engage in open discussion,” he added. “The point is for all of us to gain a better understanding of what happened and how to improve. The ultimate goal is that people will begin to feel really comfortable questioning each other during the processing of a patient.”
Vol. 1, No. 5, December 2013
Vol. 1, No. 4, November 2013
Vol. 1, No. 3, October 2013
Vol. 1, No. 2, August 2013
|Vol.1, No. 1, July 2013|