Do No Harm

5 Ways Healthcare Providers can Promote Patient Safety

March 2 marked the first day of Patient Safety Awareness Week for 2014, an annual campaign that focuses on educating healthcare professionals about the importance of patient safety in hospitals and the health community at large. Patient Safety Awareness Week may have passed, but the conversation is important year-round. There are a great many healthcare organizations that have committed themselves to ensuring the well-being of the patients that come through their doors. Lets take a look at 5 ways healthcare providers of all kindssmall family practices to large hospitalscan protect and promote the safety of their patients.

1. Make equipment calibration, testing, and maintenance a priority.

As with any profession, doctors rely on their tools, but all tools require some form of maintenance. As medical technologies continue to improve, maintenance procedures have taken on a whole new standard in the form of testing and calibration. Testing and calibrating biomedical equipment has become even more important in a medical world where the slightest miscalculation could prevent accurate diagnosis or effective treatment. Testing and calibrating can also extend the life of your equipment, allowing for long-term savings that can go toward improving other areas of patient care and safety. The frequency of testing is based on what the manufacturers specify, but you should have your equipment tested and calibrated at least once a year. Almost all pieces of medical equipment can be tested and calibrated, including: Defibrillators Patient monitors Simulators Ventilators Infusion pumps Fetal monitors Pulse oxymeters

Any calibration should be carried out by a CBET-certified engineer. Engineers are not only aware of the various national and international standards, but also have the specialized knowledge and tools necessary to properly test equipment. At the end of the testing process, you are provided with documentation showing the results and a calibration report.

2. Gauge your organizations safety culture.

If youre not sure how to address the topic of patient safety, start by gauging where your organizations safety culture currently stands. You can easily measure your organizations safety performance with surveys. These assessment tools are an integral resource and can help you: Raise awareness about patient safety. Identify strengths and areas in need of improvement. Diagnose the current state of your safety culture. Identify trends and observe how they change over time. Evaluate how interventions and initiatives affect your organizations overall culture. Conduct comparative analyses, both internal and external. The best part is that there are plenty of resources for organizations looking for survey materials. The Agency for Healthcare Research and Quality offers free surveys for hospitals, medical offices, nursing homes, and pharmacies. These surveys are thorough, specific, reliable, and easy to use, giving you valuable and detailed information to maintain or improve patient safety culture. Survey questions cover a variety of topics, from team work and staffing to communication and management. The AHRQ surveys for hospitals and medical offices have 51 items, while the nursing home survey has 42 items. These shouldnt take longer than 10 to 15 minutes complete, and the AHRQ recommends that you administer the survey once every 6 to 16 months for accurate results.

3. Contribute to progress by working with a patient safety organization.

In 2005, the Patient Safety and Quality Improvement Act authorized the establishment of patient safety organizations. PSOs have the broad role of improving patient safety and health care quality. They offer a safe environment where physicians, clinicians, and other healthcare providers can report information. All communications with patient safety organizations are protected, so there is complete confidentiality that eliminates the potential risk of liability that comes with reporting patient safety events. PSOs can take this informationknown as patient safety work productand perform an aggregate analysis to identify overarching risks, hazards, and problems affecting patient care on a greater local, regional, or national scale. Patient safety organizations perform eight patient safety activities: 1. Implement efforts and initiatives to improve patient safety and delivery of health care 2. Collect and analyze patient safety work product 3. Develop and disseminate recommendations, protocols, and other information that could support better practices 4. Provide feedback and encourage a positive safety culture to reduce patient risk

5. Provide appropriate security measures 6. Maintain procedures for improved confidentiality 7. Hire, train, and work with qualified staff 8. Administer a patient safety evaluation system and provide feedback for that system With your help, patient safety organizations can contribute to the overall progress of patient safety culture.

4. Encourage patients to get involved.

While much of the onus of patient safety is placed on the doctors, clinicians, and organizations providing health care, patients arent a passive part of the equation. They can do their part to uphold safe practices and positive care. The best example of this is the Speak Up initiative, a program started by the Joint Commission. This program encourages patients to be more active in preventing errors by actually becoming a part of the health care team. Speak Up is an acronym that reminds patients what they can specifically do to become more involved. Speak up about any questions or concerns. Patients have a right to know what is happening to their bodies and should understand what you plan to administer. Pay attention. Patients should understand the type of care they get and make sure that they receive the right medicines and treatments in the correct amounts. Educate yourself. Patients should be encouraged to learn more about their illnesses and the tests and treatment plans they are assigned. Ask a friend or family member to become an advocate. An advocate can act as another set of eyes and ears, allowing for even greater diligence. Know the medicines. Patients should have a thorough understanding about which medicines they regularly take and why they are necessary. Medicine errors, whether its incorrect dosage or interaction with other drugs, are the most common type of health care mistake. Use a clinic, hospital, or other health care organization that has been professionally evaluated. The Joint Commission and other groups visit hospitals regularly to make sure they comply with quality standards. Participate in all treatment decisions. Patients should see themselves as the center of the team and shouldnt be afraid to make themselves heard.

In a recent survey of over 1,900 organizations, about 85 percent confirmed that Speak Up and similar campaigns brought greater value to the certification process. The surveyed organizations also reported that Speak Up played an important role in increasing communication between patients and staff, particularly regarding safety. The Speak Up program also offers a variety of applications. About 75 percent of the surveyed organizations reproduced or downloaded brochures and posters. Over 67 percent included the information from Speak Up programs in billboards or ads. Another 60 percent reprinted brochures in patient handbooks and other education aterials. Brochures, posters, videos, and other educational materials for the Speak Up initiative are available at the Joint Commission website for free and with no copyright or reprint requirements.

5. Support your staff.

All members of the hospital staff play vital roles in upholding patient safety, so supporting your staff should go hand-in-hand with improving safety culture. Fortunately, there are plenty of easy things you can do to help your staff. Build teamwork. Communication is everything in any kind of team structure. Make sure your team knows how to communicate effectively. The Department of Defense, AHRQ, and a wide range of other organizations offer effective training techniques and toolkits to improve communication and teamwork skills in general. Limit shifts for hospital staff. This may not always be possible based on the number of patients admitted and other factors, but consider options for minimizing shifts. Eliminate shifts lasting 16 consecutive hours. In a study at two Boston ICUs, medical errors were reduced 36 percent when the hospitals got rid of 30-hour shirts. The minimized shifts also significantly lowered needle stick injuries and motor vehicle accidents. Minimize interruptions. As important as communication is, try to keep distractions down for your staff, especially during shift changes. Create areas where nurses can work and concentrate in silence. Having somewhere to focus without distraction can reduce errors and stress for your staff.

Through the combined efforts of patients and health care professionals, organizations can improve patient safety to ensure higher quality of care. Remember that patient safety requires the participation of all parties involved. Together we can focus on supporting good health.

Images: Medical/Surgical Operative Photography by phalinn is licensed under CC BY 2.0 International Medical Graduates Doctors (IMGs) by DIBP Images is licensed under CC BY 2.0

Resources: http://www.akwmedical.com/ http://www.npsf.org/events-forums/patient-safety-awareness-week/ http://www.ncbi.nlm.nih.gov/books/NBK2681/ http://www.helixindia.com/image/calibrate.pdf http://www.ahrq.gov/professionals/quality-patientsafety/patientsafetyculture/index.html http://www.ahrq.gov/professionals/quality-patientsafety/patientsafetyculture/pscfaq.html http://www.pso.ahrq.gov/ http://www.jointcommission.org/assets/1/6/Facts_Speak_Up.pdf https://www.premierinc.com/safety/safety-share/05-07-downloads/03-ahrq-10tips.pdf