Like a standard medical record, the patient passport has basic data such as medical diagnosis and prescription drugs. But there are also places where the patients provide the information, such as how they cope with health conditions and the activities they need assistance with, as well as their concerns about being hospitalized and their quality-of-life goals for after discharge. They may request counseling to help deal with illness, understand medical terms or discuss end-of-life care.
Many patients are afraid to ask doctors questions for fear of appearing to challenge them, studies have found, and doctors often don’t take the time to listen to their input. Yet when patients and families are fully involved in medical decisions and able to express themselves, studies show it can result in better patient outcomes, lower risk of medical errors and fewer readmissions after discharge. In addition, patients incur lower costs and rate their satisfaction more highly. Over the past few years, Medicare has been basing some hospital payments on patient satisfaction surveys.
The aim of a patient passport “is to even the playing field and improve the quality of conversations that lead to deeper and more trusting relationships between providers and patients,” says Susan Frampton, president of Planetree, a nonprofit hospital membership group that promotes “patient-centered care.” Knowing a patient’s personal story and preferences “can impact the entire plan of care,” Ms. Frampton says.
When patients are harmed by medical care, the traditional response of health systems is to “deny and defend.”
Hospitals deny they are responsible for the harm, and when pressed, they defend their providers’ conduct throughout a protracted and arduous legal process. According to a recent issue of the Journal of the American Medical Association, hospital administrators say that this approach minimizes their liability.
Sometimes, when errors are egregious or there is intense media scrutiny, as in the case of the misdiagnosis and death of Texas Ebola patient Thomas Eric Duncan, hospitals eventually apologize and make financial settlements. But without media attention, routine harm resulting from errors still typically receives the “deny and defend” response.
Such behavior has failed to make the U.S. health care system safer or more humane for patients and families. The good news is better alternatives may now be available.
This past March, a study released by the New England Journal of Medicine showed that, in 2011, about one in 25 patients treated at hospitals got an infection. Dr. Ellen Farrokhi and Clinical Nurse Specialist Tracy Courtenay from Providence Regional Medical Center have been working together to make patient safety a top priority. Watch:
Top Ten Patient Safety Checklist:
Hand hygiene – Ask your caregivers to wash their hands.
Catheter – Ask when you can get your catheter out.
Central line IV – Ask when you can get your IV line removed.
Falls – Be sure to use your call button to get help before getting out of bed.
Pressure ulcers – Ask your caregiver to help turn you in bed or get out of bed. Ask about a bath for skin checks.
Blood sugar – Ask if your blood sugar is being monitored
Antibiotics – Ensure your blood has been drawn to determine the exact bacteria.
Pain control – Tell your caregiver if your pain isn’t being managed.
Nutrition – Ask if this is the rift diet for your condition. Let caregivers know of food allergies.
Speak up – Ask questions until you understand! Ask why!
The concept of high reliability is not new. And much has been written about the promise of partnering with patients and families at the bedside, throughout the care episode, in organizational design and in governance. There is synergistic potential in combining these two strategies: partnering with patients and families to build highly reliable systems. By tapping into the knowledge of patient and family advisers, hospitals can design safer, more efficient and more effective care.
Engaging patients and families in eliminating harm was the main topic of the second annual Quality & Patient Safety Roadmap at this year’s Health Forum–AHA Leadership Summit. More than 350 quality and patient safety professionals and nearly 50 patient and family advisers convened to discuss high reliability, governance, and patient and family engagement.
Join CAPS November 7th for its Safety Across the Board Signature Learning Series with national leaders Dr. William Annable, Chief Quality Officer and Director University Hospitals of Cleveland; Catherine S. Koppelman, RN, MSN, NEA-BC, Chief Nursing & Patient Experience Officer, University Hospitals Case Medical Center and Chrissie Blackburn, Principal Advisor, Patient and Family Engagement, University Hospitals Case Medical Center.
During this learning event we will investigate ways to engage front line workers and patients in an effort to improve outcomes. Sign up below.
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“National Coalition to Promote Continuous Monitoring of Patients On Opioids”.
The meeting will occur on November 14 in Chicago, IL and the focus will be on presenting the business case for monitoring patients on opioids. CAPS Board President, Helen Haskell served on the planning committee and CAPS is excited to be listed as a co-convener of the event.
Friday, November 14, 2014, 8:30AM-4:30PM EST
Location: American Dental Association, Chicago, IL
Learn More about Cutting-Edge Patient Safety Practices and Policies Underway in America’s Hospitals
Patient safety advocates across the nation have been following and contributing to the Partnership for Patients Campaign, launched in April 2011 by the Centers for Medicare and Medicaid Services (CMS) for the U.S. Department of Health and Human Services. Organized through the work of 26 Hospital Engagement Networks (HENs), more than 3700 hospitals are pursuing the Partnership goals of 40% reduction in preventable patient harm and 20% reduction of 30-day hospital readmissions.
In 2013 six HENs began pursuing an expanded list of safety topics known as the 11 Leading Edge Advance Practice Topics (LEAPT). LEAPT programming was designed to enhance the overall progress of the Partnership for Patients’ goals.
The LEAPT topics include important patient safety challenges that have impacted many patients and families. The topics are:
Please join us for this event featuring great progress made to date and ways patients and caregivers can be involved in this national effort.
Patients and families want the security of knowing that hospitals and the people who work in them do everything possible to keep us safe. Preventing harm in health care is not easy, and hospitals need a dedicated plan to keep every patient safe from all harms that can be prevented. We want the assurance that our hospital of choice sees the big picture when it comes to patient safety, that it is not just working project-by-project on a few things, but also connecting the projects in an overall safety strategy Patient needs are not met by hospitals great at preventing falls or bed sores, but lagging in stopping sepsis or surgery on the wrong part of your body. We expect Safety Across the Board.
Consumers Advancing Patient Safety (CAPS) offers a collaborative learning network where patients, family members & friends, physicians & other health care workers, hospital executives, policymakers and community members work together. We should all be sharing our tools, resources and quantifiable results to keep everybody safe, and help every patient get the best outcome. CAPS is a partnership platform for all stakeholders with an interest in providing safe and reliable health care. No one person knows everything. We believe that people regardless of their roles can impact improvement, at the local level as well as for other patients nationally.
CAPS invites you to become part of our learning network and contribute to advancing Safety Across the Boardas the “new normal” for health care. Have you or a loved one experienced a preventable medical harm such as MRSA or pneumonia? Do you know how your hospital is measuring its performance on safety? Hospitals that practice Safety Across the Board are more likely to have systems in place to prevent harm, and the commitment to keep you fully informed if harm does happen. Preventable medical harm is a massive problem that leads to more than 400,000 deaths annually, and injures many more. It must come to an end. We encourage you to partner with CAPS to learn more, contribute more and advocate more for safer health systems. Click here to see how you can join our Safety Across the Board Learning Collaborative, become part of various other partnering national networks or use CAPS resources to stay informed about medical harm and the national movement to improve quality. Get INTO ACTION!