MUSC intends to lead way in patient safety
by Cindy AbolePublic Relations
Efforts to make important improvements affecting patient safety are a priority within accredited hospitals throughout the United States.
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West's Delores Lands, from left, Rena Butler, and Constance Sindelar, R.N.,
are trained to always practice patient safety.
At MUSC, caregivers do their best to avoid medication mixups, improve patient identification and communications, prevent wrong-site surgery, train and educate staff using fusion pumps and equipment alarm systems—all identified as JCAHO's National Patient Safety Goals.
As of Jan. 1, MUSC and 17,000 other JCAHO accredited health care organizations were tasked to implement these goals.
In response, the MUSC Patient Safety Committee chaired by Rosemary Ellis is working with various representatives to assure implementation of the 11 specific recommendations contained in the National Patient Safety Goals.
Reports of safety concerns in health care literature date back to the
early 20th century.
However it was not until 1999 when The Institute of Medicine
published the report, “To Err is Human; Building a Safer Health System,”
that professional and policy-making organizations began to seriously analyze
the critical issue of health care and safety. This report highlights perhaps
the costliest aspect of medical error—the loss of trust in the health care
system. MUSC is doing its share to promote patient safety and improve effective
practices at the Medical Center through a number of initiatives.
“Patient safety—and excellence in patient care in general represent core values at MUSC,” said John E. Heffner, M.D., professor of medicine and medical director, MUSC Hospital Authority. “The Institute of Medicine sounded a national alarm about patients in its report, “To Error is Human.” Our medical center has embraced the national patient safety movement and has developed a team that will make evidence-based contributions to this field. There is no more important endeavor than maintaining the confidence and trust of our patients at MUSC.”
Last spring, MUSC, through the efforts of the Clinical Center for Effectiveness, established the Partnering for Patient Safety program. The program involve patients, physicians, nurses, caregivers, staff and other hospital leadership as partners in the delivery of health care.
Some of the hospital’s efforts are not recent. Several years ago, as a result of shrinking reimbursements and health care budgets, many organizations responded by reducing the number of registered nurses. Stuart Smith, vice president of operations, knew intuitively that “reducing the number of registered nurses was not the right thing to do.” Evidence is now suggesting that those facilities with a higher RN to patient ratio are organizations with better patient outcomes.
The 1999 Institute of Medicine report revealed that an estimated 44,000 to 98,000 deaths annually in the United States are the result of medical errors making them the eighth leading cause of death—higher than motor vehicle accidents (43,458), breast cancer (42,297) or AIDS (16,516).
These latest concerns coupled with other health care issues including the national nursing shortage have drastically increased nurse caseloads, possibly compromising patient care. In addition to not reducing our number of registered nurses, Marilyn Schaffner, R.N., administrator of clinical services has developed multiple programs to attract and retain nurses. These programs include such things as tuition reimbursement, to the development of closer relationship with the College of Nursing.
Other efforts to address patient safety include weekly senior leadership rounds. Participants include Heffner, Ellis, Paul Bush, Pharm.D., director of Pharmacy Services; and other medical center staff. The group talks to staff and tests their knowledge through questions and drills.
“We want to promote a culture of safety—integrating safety into our daily routine through education and weekly patient/staff safety rounds,” said Schaffner.
For now, Ellis is focused on training and working with groups including Graduate Medical Education, Risk Management and other university departments to unite in this effort. One unifying tool that is currently being implemented is the online occurrence reporting tool. After completion of the implementation, anyone will be able to report a concern or an incident. Rosemary Ellis, director of quality, said that “the key to a successful patient safety effort is reporting to make improvement and not to count or cast blame. This is a tool that will give us the ability to respond quickly to any trends we may detect.”
“The Medical University is committed to assuring the safest care possible for all of our patients,” said MUSC President Ray Greenberg, M.D., Ph.D . “Equally important, we want to play a leadership role as advocates for patient safety. These efforts can prevent injuries and save lives, placing them among the highest priorities for the Medical University.”
Research indicates that evidence-based practice and standardization of care leads to better patient outcomes. Heffner has led this effort by the development of the Clinician Order form site at http://www.musc.edu/cce/ORDFRMS/. Clinician response to this site has been very favorable and not only do the preprinted forms support evidence-based care but they also save time for the clinicians.
JCAHO’s 2003 National Patient Safety Goals
and Recommendations
1) Improve accuracy of patient identification
2) Improve effectiveness of communication among caregivers
3) Improve safety of using high-alert medications
4) Eliminate wrong-site, wrong-patient and wrong-procedure surgery
5) Improve safety of using infusions pumps
6) Improve effectiveness of clinical alarm systems
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