While improving a hospital's overall quality and safety requires multiple strategies, solutions to specific quality and safety problems do not have to be complex. Maureen Winchell, quality consultant for Community Hospital Corp., shares four examples of simple changes that made a big impact on safety in different hospitals.
1. Assigning someone to check catheters. To improve the rate of appropriate urinary catheter removal, one hospital assigned a nurse to be responsible for checking that catheters were removed on time. Establishing accountability for catheter protocols significantly improved the removal rate. "When it's everybody's job, it's nobody's job," Ms. Winchell says. "Having a dedicated individual for [that task] increased awareness and compliance with catheter removal."
2. Taping an "off limits" zone. Healthcare facilities need to have easy access to a fire extinguisher in case of a fire, which means nothing should be stored in front of it. However, at one hospital, people frequently unintentionally blocked the extinguisher with wheelchairs, even after multiple verbal reminders on separate occasions. The hospital outlined an area on the floor in front of the extinguisher with red tape to visually and consistently communicate that nothing should go there. This simple strategy was effective in keeping that area free of objects, according to Ms. Winchell.
3. Identifying high-risk patients with a door sign. Several years ago, one hospital denoted patients at high risk for falls with a lamp sign on the door that called staff's attention to the patient. The sign raised awareness among staff of patients' risk, which helped reduce the fall rate.
4. Providing a scale. An important post-discharge instruction for heart failure patients is to weigh themselves daily, as sudden weight gain is a risk factor for readmission. To ensure each patient could follow this instruction, some hospitals have established programs where people and organizations can donate funds for the hospital to purchase medically approved scales for in-home use, which are provided to patients who do not have one, according to Ms. Winchell. Simply providing this tool makes it easier for patients to comply with the daily weight instruction, which may reduce avoidable readmissions.
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