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Clarifying processes for patient identifiers

Accreditation Connection, February 27, 2009

Q. Our cardiopulmonary staff members have a short period of time to perform EKGs on patients coming into the emergency department with chest pain. This time frame has been established so that we can provide our patients with the best quality of care possible and also to meet core measure requirements.

The patient may not be wearing an identification (ID) bracelet before the cardiopulmonary staff member arrives to complete the EKG.

What process do you suggest for identifying the patient? The patient may or may not be responsive and have a family member or caregiver with him or her at the time.

A. The best place to start is to remember why this National Patient Safety Goal (NPSG) was created. Misidentification of patients was a problem in healthcare with sometimes disastrous outcomes due to delivery of the service to the wrong patient or omission of the service to the intended patient.

In a busy ED, it is quite likely that two middle-aged patients may be there with a presumed myocardial infarction, or two cases of any other diagnosis. We know that we must avoid using a technique that relies on a room assignment or physical description, such as “50-year-old male in the hallway bed.”

The Joint Commission (formerly JCAHO) has not posted on its Web site FAQs for 2009 that would provide clear guidance on this subject. There was one FAQ in 2008 that dealt with unidentified patients known as John Does, but that is somewhat different from your question.

Access the full story in the February issue of Briefings on The Joint Commission. Access is free for BOJ subscribers; nonsubscribers can purchase a copy of the story for $10 by clicking here.

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