News
March/April 2013
News
EMPSF Launches Nationwide Campaign for a ‘Safer Sign Out’ for Physicians
In the words of the late, great teacher in emergency medicine, Chaz Schoenfeld, “Sign out is the most dangerous procedure in the emergency department.”
In its National Patient Safety Goals for 2007, The Joint Commission called for the standardization of hand-off procedures. Until now, few models existed to help standardize physician practice in this area.
Safer Sign Out™ is a new tool that provides a structured, practical, efficient, and broadly accepted methodology for standardizing physician hand-offs in the high-risk field of emergency medicine. The key components of the tool were developed on a risk-based approach to focus on specific areas of vulnerability within the sign-out process. The design of Safer Sign Out was developed with established evidence, expert consensus, and clinician feedback.
The physicians of the Emergency Medicine Associates Safety Leadership Group located in Germantown, Maryland, initially developed the process. It has been implemented in 12 emergency departments in Maryland; Washington, DC; Virginia; and West Virginia with the intention to improve communication, teamwork, safety, as well as patient and clinician satisfaction. It has now gained national attention and has been featured on the website of the American College of Emergency Physician’s Section on Quality Improvement and was presented at the Maryland Patient Safety Conference in Baltimore on April 5th.
The Emergency Medicine Patient Safety Foundation (EMPSF) is serving as the distribution source to promote and provide access to the Safer Sign Out Toolkit. EMPSF is teaming up with leaders such as Robert Imoff and Bonnie Depietro of the Maryland Patient Safety Center and other groups to further study, refine, and share the Safer Sign Out process on a networked regional and national basis. A “Partnership for Patient Safety” campaign, led by EMPSF, is underway to bring leaders, organizations, and key stakeholders together to address additional critical safety issues in emergency care and develop tools and resources like Safer Sign Out to help reduce safety risks.
In April, EMPSF launched Safer Sign Out as a resource (available at www.empsf.org) that includes information, education, a process improvement tool, and resources for successfully implementing and maintaining a safer sign-out process for emergency physicians. On-site assistance to organizations will also be available to provide education and implementation training. We believe that now is the time to adopt a higher standard for physician communications in the hand-off of patients and want to help our nations’ nearly 5,000 hospitals get there by offering Safer Sign Out as a resource.
The Safer Sign Out design may have potential for application in other clinical settings such as post-anesthesia recovery units, ICUs, and medical floors. In addition, potential use with nursing and allied health professionals warrants further examination.
For more information on EMPSF and Safer Sign Out, please visit www.empsf.org or contact Dianne Vass, executive director, at dvass@empsf.org or 888-294-4624.
Drew Fuller is a board-certified emergency physician and a patient safety specialist with more than 25 years of healthcare experience in allied health, internal medicine, and emergency medicine. He is the strategic coordinator for patient safety for Emergency Medicine Associates (EMA), which serves 12 hospitals in the mid-Atlantic region. He is a Fellow of the American College of Emergency Physicians (ACEP), is a past chairman of the Section on Quality Improvement and Patient Safety (QIPS) and recently joined the Board of Directors of the Emergency Medicine Patient Safety Foundation. Fuller can be reached at drewfuller@mac.com.
Gustav O. Lienhard Award
Institute of Medicine will accept applications through May 6.
The Gustav O. Lienhard Award, established in 1986, is presented annually by the Institute of Medicine (IOM) in honor of Lienhard, who was chairman of the Robert Wood Johnson Foundation’s Board of Trustees from 1971 to 1986. The award—a medal and $40,000—recognizes individuals for outstanding achievement in improving healthcare services in the United States. Support for the award is provided by the Robert Wood Johnson Foundation (RWJF). Each year, a selection committee appointed by the IOM reviews nominations based on selection criteria that reflect the ideals and work of Lienhard and the RWJF.
Past recipients of the annual award include Don Berwick, MD (2012) “for his work to catalyze a national movement to improve healthcare quality and safety,” and John Wennberg, MD (2008), “for his leading role in reshaping the U.S. healthcare system to focus on objective evidence and outcomes rather than physician preference as the basis for treatment decisions, and for his efforts to empower patients with greater input on decisions about their own care.”
The IOM will accept nominations online for the 2013 Lienhard Award through May 6, 2013. The award will be presented at the IOM’s Annual Meeting in Washington, D.C., on October 21, 2013. For more information, visit http://www.iom.edu/Activities/Quality/Lienhard.aspx.
Lucian Leape Institute Report Urges Emphasis on Joy, Meaning, and Workforce Safety in Healthcare
The Lucian Leape Institute at the National Patient Safety Foundation released a report in March focusing on the health and safety of the healthcare workforce and calling upon healthcare organizations to initiate broad organizational changes to reduce physical and psychological harm to healthcare workers. Through the Eyes of the Workforce: Creating Joy, Meaning, and Safer Health Care contends that patient safety is inextricably linked to healthcare workers’ safety and well-being because caregivers who suffer disrespect, humiliation, or physical harm are more likely to make errors or fail to follow safety practices.
The report is the result of two Institute Roundtables on the topic. It represents the experiences and opinions of frontline practitioners, leaders of healthcare organizations, scholars, and representatives of government agencies and professional societies.
“The basic precondition of a safe workplace is protection of the physical and psychological safety of the workforce,” said Paul O’Neill, former U.S. treasury secretary and chairman and CEO of Alcoa. “Most healthcare organizations have done little to support the common contention that ‘people are our most important asset.’”
O’Neill and fellow Leape Institute member Julianne Morath, RN, MS, chief quality and safety officer at Vanderbilt University Medical Center, led the roundtables on this topic and were instrumental in writing the report.
“The healthcare workforce is made up of caring, well-intentioned individuals, but unfortunately, many are subjected to bullying, harassment, disrespect, and even physical assault,” said Morath. “Healthcare workers suffer more injury—and disrespect—than workers of other industries.”
The report details vulnerabilities in the system and the costs of inaction:
- Emotional abuse, bullying, and even physical threats are often accepted as “normal” conditions of the healthcare workplace.
- Production and cost pressures in healthcare have reduced intimate, personal caregiving to a series of demanding tasks performed under severe time constraints, detracting from what should be joyful and meaningful work.
- More full-time employee workdays are lost in healthcare each year (due to illness or injury) than in industries such as mining, machinery manufacturing, and construction.
Examples of workers’ experiences punctuate the report and bring the issue to life. The report concludes with examples of what a healthy and safe workplace looks like and recommends strategies to improve the environment.
“We are grateful to our roundtable experts who contributed to this report,” said Lucian Leape, MD, chairman of the Institute and a founder of the patient safety movement. “We believe it is essential for healthcare leaders to address these issues to move the patient safety efforts forward.”
This is the third in a series of reports on issues that the Leape Institute has identified as top priorities in ongoing efforts to improve patient safety. The first, Unmet Needs: Teaching Physicians to Provide Safe Patient Care (2010) addressed dysfunction in medical education. Last fall, the Institute published Order from Chaos: Accelerating Care Integration, which looked at the problems caused by fragmented care and possible solutions. Subsequent Institute initiatives will address the promotion of active consumer engagement in patient care and provision of fully transparent care.
To learn more and download the report, visit http://www.npsf.org/about-us/lucian-leape-institute-at-npsf/.
The Lucian Leape Institute at the National Patient Safety Foundation gratefully acknowledges SEIU Healthcare for its generous support of the LLI Expert Roundtable on Joy, Meaning, and Workforce Safety.