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IHC Work Plan Description — Patient Safety (pg. 2)
Culture of Safety
Transforming an organization's culture is critical to improving patient safety. The environment should be conducive to discussing unintended consequences of care in a constructive manner. All are served better when providers are focused on learning from past mistakes rather than "pointing fingers" when something goes wrong. Components of a safe culture include:
- Patient Safety Dialogues
- Blameless Reporting
- Engaged Leadership
Many organizations are currently working on internal processes for improving the Culture of Safety. IHC is tackling this problem through production of a Culture of Safety Toolkit. This resource contains tools for improvement, the experiences of others, and practical approaches to improve the culture of safety.
The project team includes physicians, nurses, and Iowa experts in patient safety from IHC as well as representatives from the Iowa Foundation for Medical Care and the Iowa Department of Public Health. The team identifies areas for improvement and works to disseminate best practices, resources, and success stories. The toolkit for Safe Culture includes tools for improvement, Iowa success stories, mentor facilities, and a resource list for more information.
Health Literacy Initiative
Health literacy is the degree to which individuals can obtain, process, and understand the basic health information and services they need to make appropriate health decisions. If patients have difficulty grasping the information they need to better nurture their health, it is a provider's responsibility to make that information more easily understood.
Many adults have difficulty understanding information offered by healthcare providers. Healthcare information, encompassing everything from prescription drug instructions to insurance forms, contains complex, jargon-heavy text. Even individuals with high literacy rates may have trouble understanding and using health information.
IHC is tackling this problem in part through production of a Health Literacy Toolkit. The project team includes representatives from the Iowa Health System, the Iowa Department of Public Health, and other healthcare providers. This resource offers more information on the issue as well as practical solutions.
Medication Reconciliation
Studies have found that as many as 46% of admissions will have at least 1 omitted medication from a patient's regular routing. Any instance of a patient transition opens up the opportunity for missed or incorrect information. This can occur at:
- Admission
- Discharge to home
- Transfer between units
- A visit to a different doctor
An accurate and up-to-date medication list for all patients is important to reduce medication errors. Recognizing this, IHC produced a Medication Reconciliation Toolkit for healthcare providers in the state. A project team was assembled including physicians, nurses, hospital pharmacists, hospital management, and other healthcare providers. The team focused on improvement in reconciliation at admission, time of discharge, and in the community.
This resource offers more information on the issue as well as practical solutions. Protocol examples are posted for healthcare providers attempting to improve medication reconciliation in their respective facilities. These forms contain all of the data elements needed to successfully manage patient medications upon admission and after discharge from the hospital.
Patients are a vital member of the healthcare team and play an important role in their own safety. The coordination of medical information as a patient goes to different facilities and physicians can help eliminate medical errors. IHC, in collaboration with several providers across Iowa, worked to develop a tool that facilitates personal medical record keeping.
This tool, called a Med Card, helps patients maintain current lists of medications, their doses, allergies, and other pertinent medical information. An informational brochure and a wallet-sized version of this personal medication card have been developed to improve Medication Reconciliation across the inpatient and outpatient continuum. Together IHC is working to spread this model across Iowa. The Iowa Healthcare Collaborative has received a grant from the Regency Foundation to aid in the production and distribution of medication cards across Iowa.
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