Patient Safety Goals

Abstract In this paper, the topics of meaningful use, the National Patient Safety Goals, mobile technologies, current technologies, and different ways to analyze healthcare data are talked about. Furthermore, the National Patient Safety Goals are broken down and a few are explained more in depth with regards to processes of analyzing and tracking data. The analyzing and tracking of data is necessary in order to ensure that healthcare professionals, healthcare organizations, and healthcare consumers are all a part of the course of treatment. It is also important to ensure the quality of healthcare is met on all sides of the field.

Healthcare Law and IT Tom Keefe, senior director of state government relations
for the Healthcare Information and Management Systems Society said that legislation in Massachusetts “will have a direct effect on mandating nationwide use of EHRs...healthcare today is an industry characterized by revolutionary technological advances” (Rhea, S. 2008). Technological advances have been utilized by the healthcare industry for years in one way or another. One of the most widely recognized technological advancement in healthcare is the Electronic Health Record (EHR). Simply put, HER’s are “digital versions of patients’ paper charts” (“Learn EHR Basics,” n.d.). Some of the information that can be contained in an EHR can include a patient’s medical history (including diagnoses, any test results, and medications), information from health clinics, pharmacies, emergency facilities and laboratories. The benefits of EHRs are to
“Improve quality and convenience of patient care, increase patient participation in their care, improve accuracy of diagnoses and health outcomes, improve care coordination, and increase practice efficiencies and cost savings” (“Benefits of Electronic Health Records [EHRs],” n.d.).

Healthcare professionals and hospitals who utilize EHRs, whether that is through implementation or upgrades, are eligible to receive incentives from the Centers for Medicare and Medicaid Services (CMS) (“EHR Incentives & Certification,” n.d.). This incentive is possible due to the American Recovery and Reinvestment Act of 2009.
In order to be eligible for any incentives, healthcare professionals and hospitals must meet the definition of meaningful use. Meaningful use is defined as “using certified electronic health record (EHR) technology” (“EHR Incentives & Certification,” n.d.) in order to “improve quality, safety, efficiency, and reduce health disparities, engage patients and family, improve care coordination and population and public health, and maintain privacy and security of patient health information” (“EHR Incentives & Certification,” n.d.). In other words, utilizing meaningful use would hopefully result in improved medical outcomes as a result of patients being more involved in their care and course of treatment and information being available to healthcare professionals where and when it is necessary.
Healthcare professionals and healthcare organizations must also meet the National Patient Safety Goals (NPSG). In 2003 the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) developed six NPSGs with a seventh added in 2004. NPSGs were created with the hopes of delivering safe patient care (Harris & Schmitt, 2004, pp. 88). The seven NPSGs are
“improve the accuracy of patient identification, improve the effectiveness of communication among caregivers, improve the safety of using high-alert medications, eliminate wrong-site, wrong-patient, wrong-procedure surgery, improve the safety of infusion pumps, improve the effectiveness of clinical alarm systems, and reduce the risk of healthcare-acquired infections” (Harris & Schmitt, 2004, pp.89).

Ultimately, the seven NPSG’s, if implemented and followed, would result in safe, consistent patient care. In order to make sure that the NPSGs are followed correctly, they should become a part of initial training upon employment in the healthcare industry. Also, there should be a refresher training each year where healthcare professionals get together and review the NPSGs as well as try to find new ways to track the data and achieve each of the goals. In order to ensure a healthcare organization is meeting the requirements of both meaningful use and NPSGs, the organization needs to collect patient data and analyze the collected data in order to break negative patterns. One process that can be utilized to collect patient data is an Electronic Medical Record (EMR). One of the biggest benefits an EMR provides to healthcare professionals is the ability to track, identify, monitor and improve a specific practice or healthcare organization (“What is an Electronic Medical Record (EMR),” n.d.). An EMR could track patient data over time, identify when a patient needs a screening or preventative visit, monitor where patients stand in regards to vaccines, and to ultimately improve the quality of care in a given practice (“What is an Electronic Medical Record (EMR),” n.d.). Implementing the use of EMRs into a healthcare practice would get the ball rolling where technology in the healthcare field is concerned. Starting off small is a good way to allow the healthcare professionals, as well as the patients, to form the necessary trust in further technological advancements. If an EMR is already in place in a medical practice, mobile healthcare is another process that healthcare professionals can use to collect and analyze data. Mobile healthcare is also a great tool for healthcare professionals who have a variety of patients over a large geographical area or who are always on the move between their practice and hospitals. Also known as m-health, mobile healthcare is the application of mobile information technologies in the field of healthcare (Siau & Shen, 2006, pp. 90). Siau and Shen state that “mobile technologies can be applied to healthcare in various ways such as voice communication, messaging, notification, asset tracking, and remote access” (Siau & Shen, 2006, pp. 90). Mobile technologies can reduce administrative costs, improve the response of healthcare professionals, as well as motivate healthcare consumers to become more involved in their treatment course (Siau & Shen, 2006, pp. 90). Current technologies in existence make m-health possible. Three examples of these current technologies are Wireless Application Protocol (WAP), Global Positioning System (GPS), and Global System for Mobile Communication (GSM). Mobile technologies allow flexibility between healthcare providers and healthcare consumers. Patients and doctors, as well as administration professionals, benefit from mobile technologies. In the future, mobile technologies in healthcare organizations could save lives. Mobile technologies, including EMRs and EHRs, allow providers to collect patient data (including past patient history, demographic information, family history, allergies, test results, and lab results for example), track inventory, exchange data and communicate. Healthcare professionals can access a patient’s data and communicate with other healthcare organizations, pharmacies, healthcare professionals, and even the patient themselves. With the advancement of this technology, patient centered healthcare takes on a whole new meaning. The patients can have access to their files, be able to communicate with their healthcare professionals directly, and have access to online information about their diagnoses, medications, and course of treatment. As is always the case, the privacy and security of confidential information are a major concern and that concern heightens when thinking of mobile technologies. Without privacy and security, users of m-health would not be able to form the trust that is necessary when using mobile technologies. HIPPA Privacy and Security Rules “have detailed requirements regarding both privacy and security…the HIPPA Privacy Rules covers protected health information in any medium…the HIPPA Security Rules covers electronic protected health information” (“Privacy and Security,” n.d.).
Studies regarding privacy and security have been, and will continue to be, conducted. Plans regarding privacy and security have been created and implemented in order to help ensure the privacy and security of confidential information. With the topic of privacy and security met, we can now return to the National Patient Safety Goals and how they should be implemented, applied to the practice of healthcare, and tracked by healthcare professionals. National Patient Safety Goals should be utilized and met in every type of healthcare organization setting. Some examples of such a setting are hospitals, clinics, schools and universities, nursing homes, and mental health facilities. Every healthcare consumer deserves the very best care possible. The Joint Commission on Accreditation of Healthcare Organizations recognized that, and as mentioned earlier, created the seven National Patient Safety Goals. Take the mental health facility in the form of a group home for example.
Many of the consumers’ needs are met daily by direct care professionals. There is an in-house nursing department that takes care of medical needs that arise during the course of the day. The nursing department also handles scheduling many doctors’ appointments for the consumers’, helping to ensure their health. Aforementioned, there are seven National Patient Safety Goals, however, only a few will be focused on for the sake of tracking and analyzing data in certain types of care that would benefit a consumer in a group home setting. In terms of long term care, the National Patient Safety Goals that are focused on are making sure residents are correctly identified, make sure medications are used safely, preventing infection, preventing residents from falls, and preventing bed sores (The Joint Commission Accreditation, 2013). In order to ensure that medications are safely used, a group home could put together a medical administration record (MAR) in which each resident residing in the group home would have their own sheets with each medication they take listed. On these sheets, staff is responsible for initialing each medication they provide to a resident. In order to meet state requirements, the staff also initial and sign the back of the medication sheets and at the end of each month, the MAR is sent to the nursing department to be reviewed before being returned to the group home to be filed.
In addition to the MARs, another way to track when medications are not used safely is through incident reports, which are entered into a system that is run by the state. Both of these methods are great ways to make sure each resident is getting the correct medication at the right time on the right date and by the correct route. In a home care setting, the National Patient Safety Goals that are strived to be met are identifying patients correctly, safely using medicines, preventing infections, preventing falls, and identifying patient safety risks (The Joint Commission Accreditation, 2013).
In order to help protect residents from falls, it is important to know each resident and what they are capable of, especially when it comes to ambulating. For example, if a resident who lives in a group home has an unsteady gait, they should be monitored when on or around stairs. They should also not be left alone for too long. Ways to track this are by creating and implementing behavior plans as well as social and environmental plans. Their behavior throughout the day should be watched and documented. Any incidents of falls or injuries should be written on an incident report and reported to the proper people/organizations, given the category of the
incident. In a behavioral health care setting, the National Patient Safety Goals that are focused on are correctly identifying residents, safely using medications, preventing infection, and identifying client safety risks (The Joint Commission Accreditation, 2013). Identifying clients correctly is one of the most important and widely used National Patient Safety Goal. It is something that you see happening in every healthcare organization that directly deals with patients. Normally, healthcare providers use two different forms of information to make sure they are working with the right consumer. Some examples of ways consumers can be identified are by name, birth date, patient number, primary care doctor, etc. As a healthcare professional, it is important that they make sure they are working with the right patients, so that there are no mistakes during the course of treatment. While this is not the easiest data to analyze or track, there are a few different ways it can be done. For example, if a resident goes to see their primary care physician, their picture could be taken at the office as a way of identifying the right resident. Facilities could also create and utilize a cover sheet with all the residents pertinent information including, but not limited to, their name, address, social security number, health insurance information, emergency contact, and diagnoses. It is imperative that as much data as possible be tracked. The more data that is collected and tracked, the better the analysis will be. When working with residents in the mental health field, many families are not involved and it is the job of the direct care professionals to advocate for the health and well-being of the residents they work with. Tracking this data can be done in the forms of behavior plans, behavior logs, social and environmental plans, incident reports, family history as well as past medical history and medications, both past and current, just to name a few. In order to ensure that all data is tracked properly, it is important to have a common template that is used agency wide. This will cut down on confusion. In the future, it is my hope that group homes will incorporate some sort of technology in order to better track and analyzing data on residents. If there was a common technology used agency wide, it would cut down on how much paper is used as well as constantly repeating information on many different forms. Also, it would be a great way for anyone involved with the care of a resident to quickly have access to the information they need. If this technology was linked up with the primary care physicians that serve this population, there would not be a need to carry around big files for each resident and there would be better communication between residents, staff and physicians, which would make for a more productive and higher quality visit and course of treatment.

References
Benefits of electronic health records (ehrs). (n.d.). Retrieved from http://www.healthit.gov/providers-professionals/benefits-electronic-health-records-ehrs Benefits of ehrs: What is an electronic medical record (emr)?. (n.d.). Retrieved from http://www.healthit.gov/providers-professionals/electronic-medical-records-emr EHR incentives and certification. (n.d.). Retrieved from http://www.healthit.gov/providers- professionals/ehr-incentives-certification
Harris, J., & Schmitt, L. (2004). National patient safety goals guide safe care. Journal of Nursing Care Quality, 19(2), 88-91.
The Joint Commission Accreditation. (2013). Behavioral health care: National patient safety goals. Retrieved from http://www.jointcommission.org/assets/1/6/2013_BHC_NPSG_final_10-23.pdf The Joint Commission Accreditation. (2013). Home care: National patient safety goals. Retrieved from http://www.jointcommission.org/assets/1/6/2013_OME_NPSG_final_10
23.pdf
The Joint Commission Accreditation. (2013). Long term care: National patient safety goals. Retrieved from http://www.jointcommission.org/assets/1/5/2013_LTC_NPSG_final_10
23.pdf
Learn ehr basics. (n.d.). Retrieved from http://www.healthit.gov/providers-professionals/learn- ehr-basics
Privacy and security. (n.d.). Retrieved from http://www.healthit.gov/providers-professionals/ehr privacy-security Rhea, S. (2008). Massachusetts mandate: law requires some IT, regulates consulting deals.
Modern Healthcare, 38(33), 12-13.
Siau, K., & Shen, Z. (2006). Mobile healthcare informatics. Medical Informatics and the Internet in Medicine, 31(2), 89-99.