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Tuesday, Aug 9, 2022
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Tighter Standards Loom for Hospitals on Patient Saftey

Patient safety goal standards will tighten for hospitals at the start of the new year, according to rules set forth by the Joint Commission on Accreditation of Healthcare Organizations. Hospitals will have to improve communication between staff members, physicians and others in order to make sure patients are given the proper care as different nurse and doctors come on duty. The idea, said Darlene Christiansen, the incoming executive director of standards for hospitals and critical access hospitals for the organization, is to make sure that hospitals’ medical staff members get the chance to talk with each other. “We want to implement a standardized approach to handing off communications from shift to shift,” said Christiansen. “There needs to be an opportunity for people coming on to ask questions related to care and actually have the opportunity to have dialogue back and forth.” Dr. Bernard Klein, Chief Medical Officer for Providence Health Systems Valley Service Area, said the requirement is crucial as medical professionals continuously have more information to track. “The reason it’s so important is that, as you can imagine, patients coming into the hospital are much more complex. When you hand off a patient, that’s a chance to drop a ball and we want to make sure we have a good transition process,” said Klein “If a patient is on medication that’s important. If there are pending lab results we need to be waiting for that. If the patient has a ‘do not resuscitate’ it’s really important for everybody to know that.” List of medications Christiansen said that hospitals are having the hardest time with a new requirement that hospital staff members obtain and document a complete list of a patient’s current medications, in order to avoid dangerous interactions and side effects. “The public is very well-educated, they get onto the Internet and read about their diagnoses and they begin to self-medicate. It’s not unusual for them to order medications over a Web site. So it’s important that a health care organization speak with a patient, not only about prescriptions, but over the counter medications or herbal medications,” said Christiansen. The problem, however, is that patients come in a non-responsive state and can’t say what medications they take. “Patients often don’t know what medications they’re taking when they come through the door,” said Klein. “If this results in more patients getting educated, that’s a good thing.” The public, he said, not only needs to start thinking more about their prescriptions, they also need to start remembering to mention over the counter and herbal medications because of the side effects those treatments can have. Klein said he has treated patients who have exacerbated heart conditions taking herbal remedies. New system The problem that doctors and other staff members have is that any new system requires more work. Every time a medication is added to a patient’s regimen, someone needs to print a new list and hand it over to another department. Klein said that Providence has developed its own system that is easy to use and plans to launch it shortly. Hospitals will also have to begin labeling every medication before giving it to a patient, a system that helps prevent mistakes in treatment, especially when a nurse or doctor is dealing with more than one syringe. Christiansen said that a system of barcoding medication to ensure patients are receiving proper treatment can help reduce mistakes as well. While working on plans to implement this year’s requirements, Klein is also looking ahead to the rules that the JCAHO will likely require in 2007 such as a rule that hospitals establish specialized teams to treat patients. Providence he said, has taken the step of establishing rapid response teams to arrive within five minutes if a patient’s vital signs are fluctuating, and to assess, stabilize and communicate the information to doctors. “It’s a simple idea, but the idea behind it is great,” said Klein. “Why wait until a patient codes, what wait until a patient crashes to respond?”

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