Roger Williams, have tightened
their performace system.
New patient-safety standards that went into effect July 1 require most hospitals to outline clearer guidelines for avoiding medical errors and telling patients when they’ve been harmed during treatment.
The new rules were created by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), the not-for-profit safety and quality watchdog for nearly 5,000 U.S. hospitals. The new standards will force hospitals to take a closer look at potential hazards in their patient-care systems.
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“Health-care executive, physician and nursing leaders must radically change their thinking about medical mistakes,” JCAHO President Dennis O’Leary, M.D., said in a written statement. “We need to create a culture of safety in hospitalsin which errors are openly discussed and studied so that solutions can be found and put in place.”
But officials at hospitals in Rhode Island say they’ve already taken steps to counter medical errors, so the JCAHO standards will only reinforce efforts that already are well under way.
“The standards really reflect what our hospitals have been doing the past few years because of the increased focus on error prevention and patient safety,” said Cathy Boni, Hospital Association of Rhode Island vice president for clinical affairs.
The medical-errors issue has been magnified since 1999 when the Institute of Medicine released a report showing that between 44,000 and 98,000 patients die at U.S. hospitals each year as a result of medical errors.
In the wake of those findings, local hospitals have been analyzing patient-care systems that are most vulnerable to human errors, such as the administration of medicines. The hope is that hospitals will be able to spot potential problems before a medical error occurs.
For example, Boni said many hospitals have been investing in new intravenous infusion pumps, which are used to monitor the flow of drugs or fluids through a patient’s IV line. The Chicago Tribune reported last year that dozens of patients have died since 1995 as a result of the incorrect use of infusion pumps, which can send a lethal overdose of drugs through an IV.
Boni said some local hospitals have been voluntarily upgrading to new infusion pumps that have automatic clamps to prevent the free flow of fluids when a pump is turned off.
Similar measures have been taken to prevent errors in the administration of chemotherapy and other medications that have been associated with a higher-than-normal frequency of errors.
Some local hospitals, for example, have installed automated drug-dispensing machines on nursing units to ensure that a patient gets the right dose of the right medication.
A machine made by San Diego-based Pyxis Corp. assigns bar codes to nurses, patients and medications, so nurses must enter the correct code before they can take and administer a drug.
While the new rules don’t specifically mandate that hospitals invest in specific technologies, JCAHO does suggest a list of vulnerable systems that hospitals should examine and possibly redesign to prevent medical errors.
The requirements also mandate that hospitals tell patients or their families they have been harmed during treatment. Again, local hospital officials downplayed the significance of that regulation because they say that process is already in place.
“Informing a patient (about an unanticipated treatment result) is something we would normally do anyway,” said Mary Ann Palazini, joint commission coordinator for Roger Williams Medical Center.
While the new JCAHO requirements might not result in huge operational changes at most hospitals, Boni said they should make hospital employees more aware of the issue.
“The biggest thing the standards will do is encourage more of a culture of safety,” Boni said. “It should make (hospital employees) more confident to say ‘this mistake almost happened,’ or ‘this mistake did happen.’ That way they can correct the process so that it doesn’t happen again.”
(Photo, Tom Croke)
