September 19, 2016 | | Comments 0
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Isolation room occupancy notification? Do tell!

I know there’s been a lot of “official” activity of late occupying my thoughts, but there’s one discussion I’ve been pondering for a bit and, as something of a change of pace, I thought I would kick this one out to you.

One of the struggles I’ve noticed over the years is the intermittent disconnect when it comes to the management of patients that are on one type of precaution or another. Now I recognize that sometimes those precautions are for the benefit/protection of the patient and other times they are for the benefit/protection of everyone else. As near as I can tell, that’s a pretty clear set of considerations. And (also as near as I can tell), the successful management of that set of considerations often hinges on appropriate and timely communications to support staff that precautions are in place so they can plan accordingly.

But I still encounter instances in which the communication of a patient’s precaution status is incomplete and/or not particularly timely, which increases the potential for a gap in protection (again, staff or patients can be at greater risk). For example, staff on the unit removing the precaution sign from the door when the patient has been discharged, but before the folks from Environmental Services have cleaned the room and made it ready for the next patient. Or a patient is transported somewhere for testing and the precaution information is not shared at the outset of the process—sometimes folks don’t find out until after the testing/procedure has been completed. I know in this age of electronic medical records, etc., this type of information is “available”, but just because something is “there” doesn’t necessarily mean that the person at the other end of the process actually “saw” the information.

In noting that the National Patient Safety Goal regarding handoff communication is 10 years old this year (2006 seems like such a long time ago!), I was poking around on the interweb to see what resources, etc., might be available and  couldn’t help but notice that the focus of a lot of the information is for communications between caregivers, so building on the paradigm shift that we are all caregivers, I think it points out the importance of ensuring that everyone along the care continuum receives the information they need to do their job safely. And in doing so, we have to work under the thought that unless we specifically communicate something to the “next step” in the process (and yes, that “step” can be a person), we are responsible for letting that person know what’s going on—every time. Things can change outside of our “field of vision”; maybe there’s someone who’s just returned from vacation or was off for a couple of days and wasn’t here for the patient’s stay up to this point. It is just as important for them to be brought up to date as it would be if the patient were just arriving. Given everything that goes on between the four+ walls of our organizations, I don’t think anyone can afford the luxury of assuming (and I think the risks of the “assume” have been very well-established) that everyone has a complete idea of what’s happening.

And I know that we are by no means perfect when it comes to this stuff—just look at your patient satisfaction scores—a great majority of the improvement opportunities relate to how effectively we communicate with: our patients, our patients’ family members, each other. Humans tend to be a rather social bunch of folks and I don’t think it hurts anyone in the process to make sure that everyone has a clear understanding of what is going on.

On that note, I will leave you with one quote, attributed to Stephen Hawking (I consider him a pretty bright guy): “For millions of years, mankind lived just like the animals. Then something happened which unleashed the power of our imagination. We learned to talk and we learned to listen. Speech has allowed the communication of ideas, enabling human beings to work together to build the impossible. Mankind’s greatest achievements have come about by talking, and its greatest failures by not talking. It doesn’t have to be like this. Our greatest hopes could become reality in the future. With the technology at our disposal, the possibilities are unbounded. All we need to do is make sure we keep talking.”

So let’s follow the Hawk’s lead and keep talking!

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Filed Under: Hospital safetyThe Joint Commission

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Steve MacArthur About the Author: Steve MacArthur is a safety consultant with The Greeley Company in Danvers, Mass. He brings more than 30 years of healthcare management and consulting experience to his work with hospitals, physician offices, and ambulatory care facilities across the country. He is the author of HCPro's Hospital Safety Director's Handbook and is contributing editor for Briefings on Hospital Safety. Contact Steve at stevemacsafetyspace@gmail.com.

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