ABSTRACT
BACKGROUND: Rapid response teams (RRTs) help in delivering safe, timely care. Typically they are activated by clinicians using specific parameters. Allowing patients and families to activate RRTs is a novel intervention. The University of Pittsburgh Medical Center developed and implemented a patient- and family-initiated rapid response system called Condition Help (CH). METHODS: When the CH system is activated, a patient care liaison or an on-duty administrator meets bedside with the unit charge nurse to address the patient's concerns. In this study, we collected demographic data, call reasons, call designations (safety or nonsafety), and outcome information for all CH calls made during the period January 2012 through June 2015. RESULTS: Two hundred forty patients/family members made 367 CH calls during the study period. Most calls were made by patients (76.8%) rather than family members (21.8%). Of the 240 patients, 43 (18%) made multiple calls; their calls accounted for 46.3% of all calls (170/367). Inadequate pain control was the reason for the call in most cases (48.2%), followed by dissatisfaction with staff (12.5%). The majority of calls involved nonsafety issues (83.4%) rather than safety issues (11.4%). In 41.4% of cases, a change in care was made. CONCLUSIONS: Patient- and family-initiated RRTs are designed to engage patients and families in providing safer care. In the CH system, safety issues are identified, but the majority of calls involve nonsafety issues. Journal of Hospital Medicine 2017;12:157-161.
Subject(s)
Family , Hospital Rapid Response Team/standards , Patient Safety/standards , Professional-Patient Relations , Adult , Aged , Female , Humans , Male , Medical Errors/prevention & control , Middle AgedABSTRACT
This study analyzed registered nurse workarounds in an academic medical center using bar code medication administration technology. Nurse focus groups and a survey were used to determine the frequency and potential causes of workarounds. More than half of the nurses surveyed indicated that they administered medications without scanning the patient or medications during the last shift worked. Benefits of this study include considerations when implementing bar code medication administration technology that may minimize the development of these workarounds in practice.
Subject(s)
Electronic Data Processing/statistics & numerical data , Medication Systems, Hospital/statistics & numerical data , Nursing Staff, Hospital/psychology , Practice Patterns, Nurses'/statistics & numerical data , Workflow , Academic Medical Centers , Attitude of Health Personnel , Focus Groups , Humans , Medication Errors/prevention & control , Medication Errors/statistics & numerical data , Nursing Evaluation Research , Nursing Methodology Research , Surveys and QuestionnairesABSTRACT
A significant number of medical errors occur during patient handoffs, leading to less than optimal care, patient harm, and even death. The Joint Commission National Patient Safety Goals require hospitals to implement a standardized approach to "handoff" communications. The authors describe an initiative that focuses on standardization of the physical and informational handoff during hospital transport; outcomes are promising in terms of both patient safety and patient satisfaction.