Harm prevention strategies
- Patient-centered care: Include the patient as a partner with the unit team, review daily plan of care and involve patient in goal setting, educate on medications and treatments and encourage involvement in care handoffs and daily rounding.
- Safety unit champion: Develop unit-based subject matter experts and “go-to” staff who provide peer-to-peer support for additional information, techniques and problem-solving for the patient and care team. A valuable form of “real-time” staff development.
- Purposeful (5Ps) hourly rounding: Address pain, personal needs, position, possession and peaceful environment.
- Standardized handoffs: Shift-to-shift, unit-to-unit, ensuring current status of therapy and applicable safety protocols are addressed using a checklist.
- Safety huddles: A brief meeting at the start of each day or shift on the unit to discuss any patient safety issues during the past shift or 24 hours, any anticipated issues and what the unit can do today to keep patients safe.
- TeamSTEPPS®: A set of tools to improve communication and teamwork, and optimize information to achieve the best clinical outcomes. Pick key tools for your organization to routinely use.
- Formal feedback: From leadership on quality and safety issues, patterns and trends, improvement activity and data analytics.
Awareness and engagement
- Frontline staff engagement: Ongoing sharing of information, data and quality improvement stories to create a continuous learning unit environment.
- Multidisciplinary rounds: Teams work together in real time to address condition, concerns and set daily goals with the patient/care partner.
- Leadership safety rounding: An opportunity for leaders to talk with frontline staff about safety issues in the organization and their support for staff-reported errors/near misses, new ideas/innovation, removal of barriers, understanding the patient experience and supporting safety protocols. This is an ideal time for feedback, recognition and thanks.
- Use bedside white board: A mechanism to keep everyone involved in the patient’s care on the same page. Update during shift report or multidisciplinary rounds, include bedside staff and care partner names, and visual cues regarding prevention strategies, e.g., mobility instructions, diet, targeted discharge.
- Administer Culture of Safety Survey: Understand the unit culture and identify goals for improvement based on team feedback.
- Involve patient and care partner in care delivery, including decision-making, customized care planning, emotional support, care coordination and a smooth transition to post-hospital care services.
- Educate using teach-back for understanding and a demonstration of independent management by the patient and care partner.