Nursing

Here's how to address the 2001 patient safety standards

Nurse Leader Weekly, August 22, 2003

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With all the excitement over the new National Patient Safety Goals, you may have forgotten about the Joint Commission on Accreditation of Healthcare Organizations' (JCAHO) other patient safety requirements: The 2001 patient safety standards.

July marked their two-year anniversary. In honor of this occasion, we asked 135 readers just how difficult it has been to comply with each of the standards, which appear throughout the Comprehensive Accreditation Manual for Hospitals, but mainly in the leadership and performance improvement chapters.

Read on for strategies to deal with the standards most commonly cited as "moderately difficult," "difficult," or "extremely difficult."

The gaping maw of resources Judging from the number of respondents challenged by implementing leadership standards LD.4.4, LD.4.4.1, LD.4.4.2, and LD.4.4.3, it's not easy to get what you need in a hospital.

These standards call for leaders to allocate adequate resources for measuring, assessing, and improving the hospital's performance and patient safety-including personnel, time, information systems and data management processes, and staff training.

"Hospitals are bare bones, and we don't have the human resources to go around," says Marie Ann Thompson, RN, vice president of patient delivery systems at Pottstown (PA) Memorial Medical Center.

Thompson understands the logic of the patient safety standards, "but I really don't feel the people who did this realize the . . . burden they've put on hospitals." Even implementing best practices, such as the National Patient Safety Goals, can be difficult without adequate staff or time, she added.

"We're living in reality, and reality is we only have 'x' number of resources," says Glenn Krasker, president of Wilmington, DE-based Critical Management Solutions, a consulting firm specializing in medical error risk reduction.

But all is not lost. Concerned staff members may be able to carve out a bigger piece of the pie for their patient safety department by educating leaders. Krasker suggests that the following strategies might help drive home your points about protecting patients:

  • Gather your ammunition, including information such as
    • 1) medical error horror stories publicized in the media, such as the case of Jesica Santilan, the 17yearold who received a heart-lung transplant of the wrong blood type
    • 2) data on nationwide medical errors
    • 3) data on nationwide malpractice suits
    • 4) near-miss data from your own organization
  • Tell a turnaround story. Ask your colleagues whether they know of a hospital that's committed to patient safety, and try to find out how that organization achieved success.
  • Have your people talk to my people. Find a colleague whose leaders are committed to patient safety and ask whether the executives would be willing to share their thoughts with your executives.

But don't be surprised if you still don't manage to snag all of the time and staff you need. Hospital executives simply have a different view than patient safety officers or risk managers when it comes to allocating resources. "You're never going to have 100% congruence between those perspectives," says Krasker.

Adapted from: Briefings on Patient Safety, www.hcmarketplace.com/prod.cfm?id=234&S=ENMW.



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