Bridge to bet­ter care

Ses­sions fo­cus on part­ner­ships with pa­tients, fam­i­lies

Modern Healthcare - - THE WEEK IN HEALTHCARE - Mau­reen Mckin­ney

Pa­tients and their fam­i­lies are an of­ten-un­tapped re­source of crit­i­cal in­for­ma­tion that can en­hance care, ease di­ag­no­sis and help to avoid a host of ad­verse events. That was a re­cur­ring theme at the re­cent 14th an­nual Pa­tient Safety Congress held by the Na­tional Pa­tient Safety Foun­da­tion from May 23-25 and drew about 1,200 at­ten­dees to a sprawl­ing con­ven­tion cen­ter just out­side Washington.

The first of­fi­cial day of the con­fer­ence kicked off with a ple­nary ses­sion in the form of a mini-play, in which a wor­ried mother tried in vain to con­vey the se­ri­ous­ness of her young son’s con­di­tion to a busy and dis­tracted emer­gency room physi­cian. The boy, ac­cord­ing to the sce­nario, had a se­ri­ous in­fec­tion that went un­de­tected and he ended up in the in­ten­sive-care unit.

“Pa­tient and fam­ily en­gage­ment has al­ways been a pri­or­ity of ours,” Diane Pi­nakiewicz, the NPSF’S pres­i­dent, said dur­ing an in­ter­view. “But it has higher vis­i­bil­ity now be­cause it’s fi­nally get­ting some sig­nif­i­cant lift in the field.”

Su­san Edg­man-le­vi­tan, ex­ec­u­tive di­rec­tor of the John D. Stoeckle Cen­ter for Pri­mary Care In­no­va­tion at 907-bed Mas­sachusetts Gen­eral Hospi­tal, Bos­ton, led a ses­sion later that morn­ing on the press­ing need to part­ner more ef­fec­tively with pa­tients.

Pa­tients and their fam­i­lies need ev­i­dence­based in­for­ma­tion and coach­ing to be­come more con­fi­dent, she said, but con­versely, clin­i­cians also need to be trained to be more re­cep­tive. She cited a long list of op­por­tu­ni­ties to en­gage fam­i­lies.

For in­stance, in ICUS, where open visi­ta­tion poli­cies are just be­gin­ning to be­come the norm, fam­ily mem­bers of pa­tients with ven­ti­la­tor-as­so­ci­ated pneu­mo­nia can no­tify staff when the hospi­tal bed is not re­clined at the cor­rect an­gle, an ev­i­dence-based prac­tice that pre­vents fur­ther com­pli­ca­tions, she said.

Edg­man-le­vi­tan ad­vised the use of dis­charge quizzes to test pa­tients’ and care­givers’ knowl­edge of treat­ment plans and med­i­ca­tions. “Most pa­tients feel at dis­charge like they’re about to be thrown off a cliff,” she told the au­di­ence. She also rec­om­mended us­ing videos that ex­plain pro­ce­dures in de­tail, tools such as ques­tion lists that help pa­tients make the most out of am­bu­la­tory vis­its, and the shar­ing of spe­cific clin­i­cal path­ways, com­plete with glos­saries of clin­i­cal terms.

“When we in­volve pa­tients and their fam­i­lies, we won­der af­ter­ward how we ever did it with­out them,” Edg­man-le­vi­tan said.

Char­lene Pen­ning­ton, co­or­di­na­tor of qual­ity, risk and reg­u­la­tory com­pli­ance at 187-bed Re­ston (Va.) Hospi­tal Cen­ter, said she came to the con­fer­ence to learn more about ways to tackle her hospi­tal’s top qual­ity and safety pri­or­i­ties, which in­clude cen­tral line-as­so­ci­ated blood­stream in­fec­tions, falls and dis­charge pro­cesses.

Stephen Pow­ell, pres­i­dent and CEO of Health­care Team Train­ing, a com­pany based in Fayetteville, Ga., called the con­fer­ence “a great place to find the pulse of the in­dus­try each year.”

“I come to see what’s work­ing for peo­ple, not just in the­ory, but at the point of care,” he said. “I’m look­ing for so­lu­tions that are spread­able, sus­tain­able and scal­able.”

A num­ber of at­ten­dees men­tioned the im­por­tance of the Part­ner­ship for Pa­tients, HHS’ $1 bil­lion pa­tient-safety ini­tia­tive first an­nounced in April 2011.

“It’s try­ing to spread the suc­cess of the best, those early pioneers who have made it work, but it is a painstak­ing process,” Pow­ell said of the fed­eral gov­ern­ment’s pro­gram.

Mary Beth Navarra-sirio, vice pres­i­dent and pa­tient-safety of­fi­cer for Mckes­son Corp., and a co-chair of next year’s con­fer­ence, said the col­lab­o­ra­tive struc­ture of the Part­ner­ship for Pa­tients of­fers op­por­tu­ni­ties for syn­ergy with NPSF and other or­ga­ni­za­tions.

Pi­nakiewicz also gave an up­date on the re­cently launched cre­den­tial­ing pro­gram for Cer­ti­fied Pro­fes­sion­als in Pa­tient Safety, which mea­sures safety-re­lated knowl­edge and com­pe­tency in six ar­eas: cul­ture, risk iden­ti­fi­ca­tion and anal­y­sis, data man­age­ment sys­tem de­sign, lead­er­ship, ex­ter­nal in­flu­ences and mit­i­gat­ing risk.

Since the test be­came avail­able March 5, 280 50-ques­tion prac­tice ex­ams and 116 full ex­ams have been pur­chased, she said. So far, 82 pro­fes­sion­als—in­clud­ing physi­cians, phar­ma­cists and nurses—have been cre­den­tialed, Pi­nakiewicz said.

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