Improving the Culture of Safety | Reducing Infections | Improving Medication-Use Safety
In 1999, the Institute of Medicine (IOM) published its study To Err is Human, catalyzing the health care industry to make patient safety a priority. The National Quality Forum (NQF) developed a list of 30 "Safe Practices for Better Healthcare" and JCAHO developed its National Patient Safety Goals, which are updated annually. NorthShore University HealthSystem (NorthShore) has implemented the 30 practices and the National Patient Safety Goals using a combination of the latest technology, education and changing our practices.
Central to our response is the Epic electronic health record system implemented throughout NorthShore. We use it to improve communications, alert doctors, nurses and others to potential problems, and monitor care in ways that are not possible with a paper record.
As a patient, a caregiver, or someone otherwise involved in supporting someone with an illness, you have an important role keeping patients safe. It is not just the responsibility of your physician, the care team and the hospital. To learn more about what you can do, read our Culture of Safety brochure.
Improving the Culture of Safety
NorthShore University HealthSystem (NorthShore) has instituted a culture of safety throughout the enterprise. We have a "blame free" philosophy that assumes that errors are the result of systems that can be improved. Employees are encouraged to report patient safety problems without fear of punishment. To facilitate this, we implemented an electronic reporting system that is used by medical staff, nursing and other clinical staff, and other employees. If issues are identified by patients or visitors, these too are entered into the system for review and appropriate action.
NorthShore participates in a 114 hospital Patient Safety Consortium organized by Stanford University's Center for Health Policy. Employees and medical staff are surveyed to measure our "Climate of Safety". Our results are benchmarked against other hospitals, providing indicators of change over time and improvement opportunities.
NorthShore is a leader in using technology to reduce the incidence of nosocomial (acquired in the hospital) infections. We want to avoid nosocomial infections as these can cause complications that may keep patients in the hospital, require additional tests and medical care, and in some cases cause disability or death. Infections are becoming harder to treat as many antobiotic resistant strains of bacteria are developing.
Our Department of Pathology and Laboratory Medicine uses sophisticated computer technology called data mining to predict outbreaks before they occur. This permits us to take the necessary actions to minimize the effect.
Another use of state of the art technology to reduce infections is the screening of all patients upon admission or pre-operatively for staphylococcus aureus (S. aureus), a common and potentially fatal organism. A pilot program established in the NorthShore Orthopaedic Institute screened patients pre-operatively. Patients testing positive are treated with a topical ointment. Post-operative infections were reduced from four percent to one percent, saving patients from potentially serious infections.
Improving Medication-Use Safety
The Epic electronic health record used throughout NorthShore has significantly improved medication safety for our patients. NorthShore has experienced a 100% elimination of all transcription-related medication errors; a 70% decrease in delayed administration of medications to patients; a 20% decrease in omitted medication administration; and a 50% reduction for time from order to administration of first-dose antibiotics.