Caring For Our Patients

1. Caring For Our Patients Annual Safety Training 2012/2013 Part 3

3. Primary purpose of risk management is to ensure quality care at Affinity Medical Center • The definition of an unusual occurrence is defined as any occurrence or event involving a patient, employee, medical staff member, or visitor which is not consistent with the normal operating procedures of Affinity Medical Center or routine care, regardless of whether or not there was an apparent injury or other damage RISK MANAGEMENT

4. Examples of Unusual Occurrences -Falls -Patients leaving Against Medical Advice (AMA) -Unexpected Deaths -Medication Errors -Spills -Negative Outcomes from Treatments or Procedures RISK MANAGEMENT

5. All hospital employees have the responsibility to report unusual occurrences • Utilize the appropriate form and forward to Risk Management within 24 hours • If the occurrence involves a visitor or employee it is strongly recommended that they be evaluated by the Emergency Department RISK MANAGEMENT

6. 2012 National Patient Safety Goals • Improve the Accuracy of Patient Identification • Improve the Effectiveness of Communication Among Caregivers • Improve the Safety of Using Medications • Reduce the Risk of Health Care Associated Infections • The Organization Identifies Safety Risks Inherent in its Patient Population • Universal Protocol for Preventing Wrong Site, Wrong Procedure, and Wrong Person Surgery GOALS

7. Affinity is committed to the safety of its patients • Falls can account for a significant portion of injuries in hospitalized persons • Fall prevention and education is priority • All Leadership and Supervisors are responsible for supporting the fall reduction program FALL REDUCTION

8. Patients at risk for falls will have a yellow leaf placed on the frame of their door Yellow arm bands will denote the patient is at risk for fall. Yellow nonskid slippers will be placed on the patient ALERTS

9. A fall risk assessment will be completed on admission • Low risk patients will be assessed every 24 hours • Pts will be assessed with any change in environment, mental status, or mobility • High risk patients will be reassessed every shift Inpatient Units

10. Patients will also be assessed for fall risk and yellow arm band be placed on patient if at high risk for fall. Outpatient Areas

11. Affinity recognizes and respects the rights of each individual • Pt rights are provided to each person receiving services at Affinity • Pt rights are posted throughout the hospital Patient Rights

12. The right to participate in the development and implementation of his or her care • Or his or her representative (as allowed under State Law) has the right to make informed decisions regarding his or her care. The patient’s rights include being informed of his or her health status, being involved in care planning and treatment, and being able to request or refuse treatment. The right must not be constructed a s a mechanism to demand the provision of treatment or services deemed medically unnecessary to inappropriate. Patient Rights

13. The right to formulate advance directives and to have hospital staff and practitioners who provide care in the hospital comply with theses directives • The right to have a family member or representative of his or her own choice and his or her own physician promptly notified of his or her hospital admission. • The right to personal privacy • The right to receive care in a safe setting Patient Rights

14. The right to be free from all forms of abuse or harassment • He right to confidentiality of his or her own medical records • The right to access information contained in his or her own clinical record within a reasonable time frame. The hospital must not frustrate the legitimate efforts of individuals to gain access to their own medical records and must actively seek these requests as quickly as its record keeping system permits Patient Rights

15. The right to be free from restraints of any form that are not medically necessary or are used as a means of coercion, discipline, convenience, or retaliation by staff • The right to be fully informed of and to consent or refuse to participate in any unusual, experimental or research project without compromising his/her access to services • The right to know the professional status of any person providing his/her care or services Patient Rights

16. The right to know the reasons for his/her transfer wither within or outside of the hospital • The relationship of the hospital to other persons or organizations participating in the provision of his/her care • The right to access the cost, itemized when possible of services rendered within a reasonable period of time Patient Rights

17. The right to be informed of the source of the hospital’s reimbursement for his/her services, and of any limitations which may be placed upon his/her care • Informed of the right to have pain treated as effectively as possible Patient Rights

18. Process for patients and families to file a complaint: EVERYONE is an ADVOCATE for the Patient • Employee is to immediately try to solve the complaint • Notify department supervisor of the complaint • Utilize the chain of command to solve the problem • Pts can also call the Ohio Department of Health Complaint Line at 1-800-342-0553 Patient Grievance Process

19. Under Ohio Law the hospital must explain to every patient their right to state their wishes regarding medical care and provide information on Advance Directives • This can be canceled at any time or be changed Advance Directives are Living Wills or Durable Power of Attorney Advance Directives

20. Allows patient to put his/her medical care in writing • Living Will tells how a patient wants the use of life-support methods to lengthen or extend their life when in a coma or beyond medical help • Health care providers must follow what the patient states in the Living Will or in the Doctor’s order to resuscitate or do not resuscitate order Living Will

21. Allows a patient to choose someone to carry out their healthcare wishes • An adult friend or relative acts for the patient when they can not act for themselves Durable Power of Attorney

22. Affinity is committed to maintaining confidentiality • Confidential information will not be discussed outside of patient care areas such as in public areas, elevators, rest rooms, or the cafeteria or outside of the hospital • Employees have access to confidential information only to perform their job if the patient is under their direct care • Do not release or discuss patient information with others unless it is necessary to care for the patient, is required by law, or the patient has consented to such disclosure Patient Confidentiality

23. Affinity strives to be a restraint free facility • Sitters are utilized in place of restraints • Restraints will only be utilized to protect a patient from injury to him/herself or to others to prevent imminent and serious disruption of the therapeutic environment • Alternatives should be attempted prior to initiation • All patients have the right to considerate, respectful care, at all times with recognition of their personal safety • Restraint use will be discontinued at the earliest time possible if initiated Patient Restraints

24. Affinity strives to be a restraint free facility • Sitters are utilized in place of restraints • Restraints will only be utilized to protect a patient from injury to him/herself or to others to prevent imminent and serious disruption of the therapeutic environment • Alternatives should be attempted prior to initiation • All patients have the right to considerate, respectful care, at all times with recognition of their personal safety • Restraint use will be discontinued at the earliest time possible if initiated Patient Restraints

25. Types of Abuse and Neglect • Domestic Violence • Child Abuse/Neglect • Adult/Elder Abuse Neglect • Emotional Abuse Abuse and Neglect

26. Healthcare Workers Responsibility is to report suspected abuse and or neglect • Provide appropriate inquiries • Provides sensitive, non-judgemental support • Address patient safety • Document in medical record finding of abuse Reporting

27. Professionals required by law to report abuse: • Physicians, Nursing Personnel, Hospital or Medical Personnel, Social Work Personnel, School Teacher, School Administrator, Guidance Counselor, Child/Daycare Personnel, Law enforcement Personnel • These people can not be prosecuted or held personally liable, even if the subsequent investigation determines that the reported abuse did not occur Reporting

28. Case management maintains a log for ICU, CVSICU, Rehab, Med-Surg, and Med-Tele on suspected abuse cases • Senior Mental Health and Emergency Department maintains their log on suspected abuse cases • Case Management will then report the suspected abuse and or neglect to the appropriate authorities Abuse Reporting and Logs

29. Age Specific

30. We deal with people of different stages • It is important to be prepared to deal with them when you encounter them in a work setting • Provide a comfortable safe environment • Consider patients, visitors, volunteers, physicians, and fellow employees as customers and recognize what stage of development they are in and respond appropriately Age Specific

31. Watch for this in patients and employees we are a LATEX reduced facility and a LATEX free cart is located in Central Sterile Three types of reactions to latex Itchy, dry, irritated areas on the skin, usually on the hands Allergic-contact dermatitis which begins with a rash and may progress to oozing blisters (similar to poison ivy) Latex allergy is an immediate reaction that ranges from redness, hives or itching, to runny nose, itching eyes, scratchy throat, breathing difficulty, and possible collapse Latex Sensitivity

32. Chief Quality Office Pam Shanklin RN prepares the Quality Assessment and Performance Improvement Plan for Affinity Medical Center • Approved by the Board of Trustees and drives each department’s efforts in monitoring and maintaining quality care • Quality and Patient Satisfaction Data is also shared with government and other external regulatory bodies • This information is available to the public as a guide for customers when choosing their hospital Quality Management

33. Idea Cycle is a process that is utilized here at Affinity • I-A problem is Identified • D-The cause is Determined • E-Possible solutions are Explored • A-Solutions are Activated Quality Management

34. All employees are encouraged to communicate opportunities for improvement by utilizing the “Quality Improvement Opportunity/Problem Referral Form” • The form is available in the Quality Department or from your Director • All forms will be reviewed by QIC and utilizing a prioritizing method, may be assigned a team to research the opportunity or resolve the problem Quality Management

35. MISSION Affinity Medical Center is committed to partnering with our community, patients, physicians, and employees to provide high quality, personalized, compassionate health care; contributing to a healthier community by promoting healthful living; and providing educational opportunities for healthcare professionals Employee Behavior

36. VISION Affinity Medical Center will be the premier healthcare resource in western Stark County and surrounding areas We will achieve this by: Recruiting and retaining qualified, compassionate caring staff Ensuring access to communities we serve Advancing clinical capabilities with state-of-the –art technology and best practice standards of care while preserving the friendly community atmosphere Employee Behavior

37. Collaborating with other healthcare providers, payers, and customers to better serve our patients’ needs • Exercising prudent stewardship of our assets and resources Behaviors Accountability Compassion Excellence Integrity Teamwork Behaviors

38. Always strive to provide outstanding customer service • Goal to exceed our customer expectations • Provide them with utmost kindness, care, compassion, courtesy, empathy, and respect • Greet customers with in a warm manner with a friendly, open smile and direct eye contact • Golden Rule “Treat others as you would want to be treated” • Patients, Families, Physicians, Co-workers, are all customers Customer Service

39. Display professionalism with all encounters • Be kind in every situation • Greet everyone with a friendly hello • Maintain eye contact when speaking with others • Use please and thank you as appropriate • Listen without interrupting Customer Service

40. AIDET • Provide prompt service • Inform customers about delays • Thank customers for waiting and apologize for delays • Answer call lights as soon as possible • Let individuals know you are happy to help them • Before leaving the room ask “Is there anything else I can do for you?” Customer Service

41. Communication creates a lasting impression • Be professional and caring when answering the phone • Identify the hospital, department, and your name as you answer the call • Be ready to answer questions about specific services Telephone Courtesy

42. If you can’t help the caller, offer to connect them to someone who can • Continue to be friendly and polite throughout the conversation • Thank the person for their inquiry as you end the call • Take a moment to think: Was this call unusual in any way? Should I mention it to my supervisor? Do we need to keep track of this kind of call? Telephone Courtesy

43. “Doing the Right Thing” • We strive to provide service excellence • “Community Cares Service Excellence Standards of Performance Handbook” provides clear and specific behavioral expectations Code of Conduct

44. Use opening words to decrease anxiety • Perform scheduled tasks • Address the 4 “P’s”: Pain, Potty, Possessions, Positions • Assess additional comfort needs • Conduct an environmental assessment • Close conversation • Tell each patient when you will be back • Document round on chart Hourly Rounding

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