The following is an excerpt from a recent TJC article, written by Kathy Tolomeo on July 26, 2017. (Article link no longer available.)

Ambulatory health care facilities face many challenges in ensuring the quality and safety of care of their patients. One TJC Environment of Care standard that has been particularly challenging for ambulatory care organizations is EC.02.06.01, which requires establishing and maintaining a safe, functional patient care environment. 

Given how crucial this environment of care standard is, it’s important for ambulatory care organizations to evaluate common issues that can:

• prevent them from meeting their requirements
• trigger noncompliant findings
• compromise patient or staff safety in the physical environment

Unfortunately, ambulatory centers that qualify as “ambulatory health care occupancies” very often do not have staff dedicated specifically to maintaining a safe environment, which makes it harder for these health care organizations to stay on top of potential issues.

Many organizations make the mistake of using the EPs in EC.02.06.01 as a checklist, which means they may often cross off items too quickly.

The following measures can help your ambulatory care organization create a safer environment:

1. Conduct risk assessments.
2. Improve rounding and environmental tours.
3. Refer to important codes and guidelines.
4. Take advantage of Joint Commission’s EC tools.
5. Remember TJCs intent. They aim to prevent deficiencies that compromise patient and staff safety in your ambulatory organization’s physical environment.
   
   

Interested in a real world example?  Montefiore Health System's Environmental Health & Safety department has improved safety and reduced fines with Readiness Rounds' performance improvement solution.  Download the free white paper here.

Value-Based Purchasing is Here to Stay

The following is an excerpt from a recent article in Health Leaders Media written by Rose Higgins on July 24, 2017.

By the year 2020, value-based care could be the dominant payment model for healthcare organizations. Healthcare provider organizations will have to deal with new realities – by implementing new strategies.

Those realities are:

1. Healthcare networks will need to focus on efficient care delivery.
2. Healthcare delivery systems will increasingly compete on quality and cost.
3. Care delivery is best developed and delivered by teams with a focus on care coordination.
4. Value based care is here to stay.
   
   

Higgins lists the following strategies for success:

1. Understand the data that your organization collects.
2. Prepare to rely more heavily on layering data (clinical, financial, behavioral, etc.).
3. Use predictive and prescriptive analytics to transform data into impactful intelligence.
4. Drive quality improvements. 
5. Manage population and financial risk.
6. Optimize provider networks.
   
   

The adoption of value-based payments is happening now and accelerating rapidly. It is our observation that payers, providers and consumers are transitioning to these models, but each at varying speeds. Regardless of their location on this path, healthcare organizations need to focus on using data and analytics as a tool that will guide them in meeting their quality-based goals.

Security Strategies Must Include Protecting Patients and Their Data

Still doing your Fire Drills on paper?

When overseeing and conducting your hospital's fire drills, have you ever thought, “There has got to be a tool for this?”

While pagers may still (somehow) be a relevant tool while working in a hospital, there are hi-tech solutions that utilize the marvel of current mobile technology, with hospital Facility, Safety, and Emergency managers in mind.

Over the last few years, multiple companies have developed programs that allow you to use your mobile device (iPad, iPhone, Android tablet, etc.) to conduct Environment of Care rounds, ILSM monitoring or, in this case, schedule, to streamline and automate the documentation of all your required fire drills.

The 6 musts of digital fire drill checklists:

• Must be usable on multiple mobile formats: iPad, iPhone, Android phone or tablet, workstation, workstation on wheels and even in hard copy form, if supplying mobile devices looks to be an additional challenge for the organization.
• It must be easily navigable and provide an intuitive user experience.  This is critical for easy use within the organization.
• The content must be customizable. All hospitals are presented with their own challenges and needs.
• It must include a closed-loop type follow-up system to automatically notify department managers or other Healthcare employees of potential issues.
• Fire drill checklists must have the potential to be both scheduled and deployed on-the-fly.
• It must include data aggregation for use in understanding the areas most in need of improvement, the application of which may be used for Performance Improvement, and not just documentation.

Readiness Rounds has created a checklist that encompasses all of the features above.

If the Fire Drill Checklist caught your eye, there’s a good chance you will be interested in our rounding solutions for Environment of Care, ILSM, PCRA or ICRA.

As much as patients and their families expect to be treated in a safe and compassionate manner by skilled individuals, it should be a given that patients and family members expect to be treated in a safe environment, conducive to their care and treatment. 

Proactive rounding is the key to promoting patient safety from an environmental standpoint and requires active attention to the daily circumstances that increase risks to both patients and staff. (2)

Use proactive rounding for best practice:

1. Make environmental rounds to identify opportunities to improve Patient Safety.

These types of rounds are commonly referred to as Environment of Care Rounds, Physical Environment Rounds, Safety Rounds, Continual Readiness.

2. Represent a multi-discipline Patient Safety team.

Include members such as: Safety Officer, Engineering (Facilities), Infection Prevention, Environmental Services (Housekeeping), Security, Emergency Management, and Privacy Officer.  Each member needs to have a defined checklist of questions related to their expertise and skill set for the rounds, preferably an electronic checklist that can be completed on a tablet during rounds.

3. Tour every Department of the hospital, preferably unannounced to the Department staff.

Utilize the following approaches: Observe practices, such as handwashing; interview staff with knowledge-based questions; inspect mechanical devices and equipment; observe the environment, looking for obstructions and hazards.

4. Tour as a team on a set/routine schedule.

Hospitals that use a schedule are most successful at conducting and sustaining these Patient Safety rounds. Set a weekly schedule, for example "Every Tuesday at 10 am." Unavailable team members need to provide a substitute.

5. Engage the department staff and debrief with department management at the end of each round.

6. Don’t interrupt patient care, but also don’t shy away from sharing with patients why you are conducting rounds.

Results: As a result of these rounds you should be able to identify the systematic issues that affect patient safety in your facility. What items from the checklists consistently fail and potentially cause an unsafe environment? Is the data from your rounds quantifiable, and what corrective actions have been taken? 

Lastly, consider this question often:

If you are not going to use the data from these rounds for Performance Improvement of Patient Safety, why are you doing them?

Sources:

(1) Joseph, Anjali, PhD, and Eileen B. Malone, RN, MSN, MS. "The Environment: An Often Unconsidered Patient Safety Tool." Web M&M. N.p., n.d. Web. 18 Aug. 2015. <https://www.ahrq.gov/cpi/about/otherwebsites/webmm.ahrq.gov/index.html>

(2) Susan E Mazer, MA. “Ways to Improve Patient Safety: How the Environment Plays a Critical Role.” Healing Health. <healinghealth.com>.