All Entries Tagged With: "patient safety"
Is H1N1 hype clogging your ED?
Is it a cold or something worse?
The nightly news is teaming with stories about seemingly healthy young people becoming critically ill from the H1N1 virus, and people are worried.
I am no exception. When I hear a coworker cough of sniffle, I get a little uneasy. I have been able to stay healthy during this young flu season. However, should I find myself running a fever and coughing, my unease might turn to worry. And where do most folks go when they are worried about their health? The doctor, or if they can’t wait for an appointment, the ED.
EDs are crowded as is. The last thing ED staff members need is people presenting to the ED that are afraid their head cold could kill them. That is why Emory University and Microsoft have teamed up to create a the H1N1 (Swine Flu) Response Center.
The H1N1 (Swine Flu) Response Center is a Web-based assessment tool that asks site visitors a series of questions, including:
- Age
- Gender
- Geographic location
- Severity of symptoms
- Length of symptoms
After answering these questions, users receive symptom management advice. In severe cases, the tool instructs users to consult a physician immediately. In less severe scenarios, the tool may instruct users to visit a walk-in clinic or stay in bed and drink fluids.
Site sponsors hope people with less severe symptoms will use this tool’s advice instead of visiting the ED, but is it enough? Some folks might be satisfied by this tool opinion, but others might not trust the advice, after all, there is no better cure for worry than the clinical judgment of a real, live healthcare professional, right.
Tell us about what is going on at your facility. Is your ED crowed with people with flu symptoms, looking for a little reassurance that they are not facing peril? Has your facility developed a system to handle the expected surge in visitors?
Speak up: CMSA urges case managers to contact local legislators
You may have heard, but Congress is attempting to enact some type of healthcare reform in the near future. Although the extent of that reform is still up for debate, the conversation about how to improve the current healthcare model is not going away.
What better way to celebrate National Case Management Week than to contact your local legislator and tell him or her about how case managers can improve the healthcare system?
Healthcare reform will have a huge impact on the way you do your job, which is why The CSMA Public Policy Committee is encouraging case managers to speak up and share their experiences.
“We want case managers to share their stories with their local legislators,” said Carol A. Gleason, MM, RN, CRRN, CCM, LRC, BCPC Chair of the CMSA Public Policy Committee.
Gleason says she and the committee are not asking people to talk politics, but rather share what works with the current model and what needs improvement. The idea is that if case managers and other healthcare professionals share their wealth of knowledge with lawmakers, who have likely never worked in a hospital, than our government will be better equipped to create reform that works.
You can also think of it as another form of patient advocacy. Case mangers know how the system affects certain populations because they deal with difficult case everyday. This is a chance to tell the story about the time it broke your heart to tell someone, “I’m sorry but that’s just how the system works.”
The Case Management Model Act
The public policy committee has also created a Case Management Model Act which defines the case management role and explains how the case management principles can be the building blocks for successful healthcare reform. You can download a copy of the Model Act at the CSMA Web site. While you are there, check out the sample letter you can send to your representative and the list of talking points you can use to call him or her directly.
What do hospital case managers do, anyway?
This is a question frequently asked by patients, family members, physicians, and other members of the medical staff.
Many people think that case managers are discharge planners, and that the only time a patient needs a case manager is when he or she has discharge needs. Case management is much more than that. It is important that we make sure that, not only do patients and families know what case management is, but that the nursing staff members know also.
Case managers work in forces behind the scenes, much like the crowd of people in the Verizon commercials. Case management is a hidden resource for patients. Often, the case managers work in the trenches, with their heads in charts, communicating with an interdisciplinary team of healthcare professionals to make sure that the patient is moving smoothly through the continuum of care, and there are no delays or detours in their care. This is usually an unknown aspect of case management.
Hospital personnel and the public need to be aware that case managers are advocates for all patients; they ensure that their healthcare facility and professionals are doing what is truly right for the patient, in the right setting, receiving the most appropriate care, and in the most cost-effective manner. Case management follows the patient’s plan of care to make sure that it is appropriate and timely, that their hospital admission status is appropriate, that their discharge planning is initiated, and that goals are set to meet the discharge plan. It is imperative that the case manager build a relationship with the patient and their families in order to reach a mutual goal of discharge.
It is also important for the bedside nurses to know that case managers are an excellent resource for them in planning the patients’ care and goals. One thing I did at our institution while we were redesigning our case management model was to do a mandatory in-service to nursing staff on how case management affects not only patient outcomes, but the financial outcomes for hospitals.
At our institution this year, we included a station on case management and interdisciplinary rounds at the nursing annual competency testing. Case management had a display booth with information about what case management is and the importance of interdisciplinary rounds. We also had a test for the nurses to complete. The comments we received from staff were very interesting.
Does your institution do anything like this? Are you confident that nursing staff members truly understand what case management is?
And one more important question: Do your physicians really know what case management is?
Patient safety month: Free tips and tools
March is patient safety month, and to celebrate, below are some tips for hospitals to increase patient safety from the Agency for Healthcare Research and Quality (AHRQ). Use these tips to educate your staff, or to pass on to others.
- Assess and improve your patient safety culture. AHRQ provides a free survey tool along with an entire toolkit.
- Build teamwork and communication. Communication between hospital staff is vital for ensuring patient safety. AHRQ and the Department of Defense have created a customizable, evidence-based toolkit to increase effective communication and other important teamwork skills in any healthcare setting.
- Limit shifts for hospital staff, if possible. Evidence shows shorter shifts (less than 12-16 hours) can reduce medical errors.
- Use reliable decision-support tools at the point of care. Ensure that computerized physician order entry or personal digital assistant-based drug information is readily available at the point of prescribing or ordering.
- Set up a safety reporting system. AHRQ provides additional research and advice on how to implement a Web-based safety reporting system in the ICU.
- Minimize unnecessary interruptions. Reduce distractions faced by the nursing staff, especially during critical times such as shift changes. Encourage staff to speak up when necessary, but create a “zone of silence” near medication preparation carts and other areas where concentration is essential.
For the entire list of tips and available tools, visit the AHRQ Web site.
