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Encourage staff to catch mistakes before they happen

Staff Development Weekly: Insight on Evidence-Based Practice in Education, January 12, 2007

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Ripon (WI) Medical Center uses a nonpunitive "Form of Good Catches" to encourage staff to report near-miss situations.

The form, developed by the hospital's director of quality services, helps encourage staff to report errors and near-misses. It was originally created because the hospital did not know how other hospitals catalogued errors. The form was made so that anyone in the hospital could use it.

For example, if the lab gets an order and notices that it had the wrong patient name on it, that a patient was not entered into the computer correctly, or that there was an error prior to a blood draw, the lab would fill out the form in that case.

• Once a form has been filled out, it is sent back to the director of quality services, who compiles the results every month.
• Next, the information goes to the hospital's safety committee, which reviews issues such as these every month.

The form is most often used in the ER, the medical surgical/intensive care unit, diagnostic imaging, and the lab.

To learn more, go to Briefings on Patient Safety (BOPS). For the cost of just three stories, you can get the entire January issue of BOPS. Click here to choose between the PDF and HTML versions for just $30. Subscribers to the online version of BOPS have free access to this article. Subscribers to the print newsletter can find this article in their January issue.

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