Condition H Networking
Every now and then, I get emails from people who are in the middle of implementing Condition H, and would like to talk with other healthcare professionals who have participated in a Condition H implementation.
For example, here are some good questions we recently received from Wisconsin:
1) What barriers, if any, did you experience from physicians and staff when implementing Condition H? How did you overcome them?
2) How do the nurses and medical staff react when the family or patient calls Condition H? Were there any feelings of guilt (i.e., "I failed the patient") or resentment? What resources are available for staff to debrief after a Condition H call?
3) How many calls do you get from patients or families per month? How many have been appropriate vs. inappropriate?
4) How willing were the physicians to do this? If there were any negative attitudes, how were they overcome?
5) If you have both staff-activated rapid response teams and patient- and family-activated rapid response teams, are the teams the same or do you have unique teams for both?
Are there any Condition H veterans out there who would be open to talking to colleagues in the early stages of implementation?
If you are interested, I encourage you to post below or email me at awesol@josieking.org to volunteer.
I will also set up a discussion page on our forum "Connecting with Others". Click
here to enter the forum.
Labels: Condition H
UPMC Releases Good News on Condition H
Good news from Pittsburgh.
UPMC is reporting results from the first two years of its implementation of Condition H, the patient- and family-activated rapid response team program that is gaining good traction in patient safety circles throughout the country.
From September 2005 to August 2007, there were 42 calls to Condition H. All of the calls were instigated by breakdowns in communication between caregivers and the patient or the patient's family. As the patient safety movement continues to make great strides and develop new techniques to prevent medical errors, it's clear that basic communication skills remain key resources for both caregivers and patients.
These and other successes are discussed in detail in the May/June 2008 issue of the Journal of Healthcare Quality.
As a Condition H partner, we at the Josie King Foundation are so proud of their success and hope that their impressive results inspire even more hospitals to implement Condition H. As a healthcare consumer, I'm relieved to know that more and more fellow patients have access to these rapid response teams.
Condition H consistently ranks among the top of the inquiries that we receive. It's encouraging to hear from so many institutions in varying stages of implementing patient- and family-activated rapid response teams of their own. For those of you who are associated with hospitals that have active programs, consider sharing any successes or lessons from your experience that could help your patient safety colleagues.
If you are in the early stages of planning, or are just considering starting a similar program at your institution, you can find helpful information on our website. Background material on Condition H is available
here. This page also contains program support materials developed by
UPMC for their program, like educational brochures and evaluation tools. These materials are all available for download, for you to learn from, amend and use at your institution. Big thanks to our friends at
UPMC for sharing their good work with the community.
Please send us your questions and share your stories by leaving a comment below or emailing me at awesol@josieking.org.
Thanks, and more soon,
Andrea
Labels: Condition H
JKF Blog 2.0
Summer! It's time for baseball and barbecues and vacations, but here at the Josie King Foundation it's also time to refresh our blog. We want www.josieking.org to be a continually useful resource for you, filled with new, helpful information and various ways to connect to the patient safety community. To better serve your needs, we've decided to add a second blogger to the mix.Â
This is where I enter the picture.
My name is Andrea Wesol, and I've been working with Sorrel and Tony for almost four years now. It's been a true pleasure to help them grow the Foundation and expand the scope of the work done in Josie's name. It's also been rewarding to communicate with you- the patients, families and medical professionals who write to us. I am most often the first point of human contact that most people have with the Josie King Foundation, and it's a role that I enjoy tremendously. I'll still be the one responding to your inquiries and ideas about the DVD of Sorrel's speech, Care Journals, Condition H, etc., so keep those emails coming. I do look forward to having the new medium of the blog to interact with you and generate public discussions about the patient safety topics that make this work so interesting.
Fear not- Sorrel will still be contributing to the JKF Blog. For you sports fans out there, think of me as the play by play announcer, and Sorrel as providing color commentary.
You can expect to find more frequent blog posts, so please bookmark this site and come back regularly to check out or contribute to the conversations. I encourage you to leave comments and questions about the blog after each entry, and you can always email me on any patient safety topic at awesol@josieking.org.
More soon,
Andrea
Labels: Blog
With the Medical Students
A few nights ago I spent the evening with 27 Post-Baccalaureate students from Johns Hopkins University. I had been asked by the director to join the students for dinner and then speak to them for an hour or so. I was to be joined by Rick Kidwell, who had been the lead attorney at Hopkins when Josie died and was now at UPMC, University of Pittsburgh Medical Center.
The Hopkins Post-Baccalaureate program is a year long program that prepares students for medical school. Hundreds of students from all over the country apply to this program, with only 42 acceptances for 27 positions. These students have earned their undergraduate degrees with an average of a 3.7 or above. More impressive than their high academic standings are the things they have done after college on the humanitarian level. Each one had an amazing story to tell. Some had spent time teaching in impoverished areas overseas. One spent a year with Dr. Paul Farmer, who is known throughout the world for his work and dedication in the poor towns of Haiti. Another student worked with the world renowned Dr. Benjamin Carson, a Hopkins pediatric neurosurgeon. One student worked as a teacher in the Mississippi Delta and then went on to teach children with AIDS in Africa. These life experiences shaped their young minds and led them to discover what it was that they truly wanted to become. Doctors. It is this dedication to public service, this humility and this selflessness that set these students apart from all others and landed them in the prestigious Hopkins Post-Bac program.
I always find it invigorating to be with medical students. They are so young and eager with bright minds that can be shaped. I can see the future in their eyes, and as I sat at my computer the day before and read all that they had accomplished and all that they had contributed to society and at such a young age, I knew that it was going to be a memorable evening.
Rick and I sat on folding chairs on stage and began our presentation. I started by sharing Josie's story. I broke it down as if it were a case study and watched them as they began to put the pieces together, realizing that a little girl had died at one of the best hospitals in the world, not because of a misdiagnosis or a medication error. It was something far simpler: communicaton, or rather, a lack of communication. I continued to talk about the importance of disclosure, and what it means to a family to be told the truth, to have questions answered and to know that the problem will be fixed. Rick shared the hospital's side of the story. He talked about how doctors and nurses are affected by medical errors. He told the students that when they become doctors, and if they make a mistake always to tell the family. "Don't worry about a potential lawsuit," he said. "That is the job of the risk manager." The discussion led to error reporting systems, family involved root-cause analysis and more. They asked interesting questions, and they shared their thoughts.
Soon these students will be in medical school. They will be inundated with Biology, Chemistry, Physiology. The importance of communication might not be woven into their curriculum. This was my chance to sink a story into their hearts and hope that when they become doctors that they will remember how to listen and communicate. These students are going places. These are the ones who are going to win Nobel prizes and find cures for our diseases. They are going to save lives. I am sure of it. I was honored to be with them I wish them all luck, and I thank them for listening.
Labels: Medical Students
It All Comes Back to Communication
In the nearly five years that I have been participating in this patient safety movement, I have met thousands of wonderful healthcare providers. I have visited hospitals all over the country. I have sat and listened to dozens of patient safety conferences and grand rounds. I have learned big words like nosocomial infections.
Through it all I have told Josie's story and every step of the way I have tried my best to inspire caregivers to incorporate patient safety best practices into their everyday experience on the job. I have looked and listened, and have been amazed at all of the good I see, while also being confused as to why things can't happen faster and why 98,000 people still continue to die from medical errors every year.
The thing that really continues to amaze me is the communication issue. Josie died because people didn't listen. They didn't listen to me, and they didn't listen to each other. I can't tell you how many stories I have on my computer from families who have been affected by medical errors, and there always seems to be a common thread, "They didn't listen."
Correct me if I'm wrong. Doesn't the Joint Commission report that over 60% of all sentinel events are due to a breakdown in communication? I am not a doctor or a nurse. I am not at the bedside, and I am not an expert in the field of patient safety; however it seems to me that if people communicated better we'd all be safer. I believe in high tech solutions. It is where we are heading, but wouldn't we get more bang for our buck if we communicated better?
I was in Pennsylvania a few months ago at a wonderful hospital by the name Abington Memorial. I was presenting at their Grand Rounds. After the presentation, I was lucky enough to join them on their Patient Safety rounds. The team consisted of two nurses, a doctor, and a board member. I was struck by two things:
The first was the presence of the board member. There is a lot of talk these days about getting board members involved, especially when it comes to safety and quality. It was so great to see first hand a hospital that was doing just that.
The second thing that struck me- Every unit we went to, the patient safety officer would ask the nursing team on the floor a question:
"If you could have anything you wanted on your floor to keep patients safe what would it be?"
Each floor had variations on the same response:
"I wish we could get into the doctors' heads."
"I wish we were more like a team."
"I wish we communicated better."
That is what they wanted. They did not ask for fancy equipment or the latest in technology. They wanted to understand what the doctors were thinking. They wanted better communication between the nurses and the doctors. The thing that amazes me even more is that I hear this everywhere I go. Communication- and it is not just between the doctors and the nurses. It is between the patients, their families and those who are caring for them.
It seems so simple, but I am learning that changing behavior is not an easy thing to do. I don't know what it takes, maybe time, maybe another generation, hopefully not more deaths.
I will tell you one thing. The board member that day heard that message loud and clear and I bet she shared what she learned with her fellow board members, at least I hope she did.
Labels: Communication, Hospital Visit
Introducing the Care Journal
Have you ever been a patient or had a loved one who was a patient in a hospital? Did you feel overwhelmed and scared? Was a lot of information thrown at you? I am guessing that your answers to the above might be yes. I know that I felt that way when Josie was in the hospital. I was in a new environment and I was scared out of my mind.
One thing I did that really helped was to write. I kept a journal. I kept track of everything from my parking space number to the names of the nurses on duty. I documented the medications she received and I wrote down questions and concerns I had for the doctor. Writing gave me a sense of control in a situation in which I had none. It helped me stay organized and on top of what was going on each day.
In my conversations with other patients and families over the years I have learned that they too often found comfort in writing. I decided that the Josie King Foundation needed to offer a journal that would help patients and their families manage their hospital stays. Each page would represent a day of health care, whether the patient is in the hospital or after they have been discharged. We call it the
Care Journal.
It was time to take the Care Journal out for a spin in the healthcare industry. What I learned shocked me. I was having dinner with a wonderful group of nurses. I excitedly unveiled the Care Journal campaign and as I waited for them to tell me how great of an idea it was. All I saw were blank faces.
They told me what it felt like to them and their colleagues when they see a patient or family member writing. It makes them feel threatened. Healthcare providers think that patients are creating documentation so that they can later sue. However, they all agreed that when they or their loved one was in the hospital that, absolutely, the one thing they did was to write. I asked other healthcare providers if they felt threatened in the same way, and the majority of them did.
I had no idea that nurses and doctors felt this way. The last thing I wanted to do was to further alienate the nurses from the patients, but I felt so strongly that patients should have this tool. My nurse friends and I came up with the perfect solution. The Care Journal needed to come from the hospital. It needed to be a gift from the nurse to the patient or family member.
This made great sense. We could offer a handy tool AND we could help bridge the gap of mistrust between the healthcare provider and the patient. Now, instead of a nurse looking at a patient and feeling threatened that nurse can say, "Oh, I see you are writing in your Care Journal. That is great and don't forget to write down your questions for the doctor when he makes his rounds."
Right now, we're working on the final touches of the Care Journal. We expect to have them in one month.
If you work at a hospital interested in partnering with the Josie King Foundation to distribute Care Journals to your patients, I will send your hospital however many you would like. You can write up a personal note to your patients telling them that you encourage them to partner with you in their care and attach it to the inside of the Journal. All I ask is that your organization make a donation to JKF. Just contact me and we'll get you started.
If you are a patient, the Journals will be available from our website in a few weeks. All the money from the Care Journal project will go back into this patient safety movement, funding great new ideas to improve the culture of healthcare.
I hope you like this project. Please email me at
sking@josieking.org to learn how to partner with us, learn more about the Care Journal, or- very importantly- let me know your thoughts on the project.
Labels: Care Journal
Welcome to Our New Website
Thanks for visiting us at the Josie King Foundation's new and improved home on the web. I encourage you explore the various areas of the site, and also to send us your opinions on the site. As we worked to create this website, we were guided by the hundreds and hundreds of e-mails that I have received from patients, families, doctors, nurses, hospital administrators, medical students, and nursing students.
These e-mails came from all corners of the world and covered an enormous range of thought and emotion, but all had one thing in common- a passionate interest in and commitment to improving patient safety. These e-mails come from people like me who have been affected by medical errors in one form or another and are looking for ways to make their hospital safer.
This new website responds to your needs. It is a place that provides help and information. A place where people can learn from experts in the field. A place to find the latest and most helpful websites, books, and articles about issues related to patient safety.
The new website also fulfills a vital need of the Foundation- to share information about the successful patient safety programs that we have supported. Good things are happening in patient safety all over the country. We want to help spread the word so that these good things take root and replicate in new places where the need is dire.
We also wanted the site to be a place where people could connect with others. Why should the interesting, wonderful, and sometimes heartbreaking e-mails come just to my inbox? Wouldn't it be great to pass them along so that thousands of others can read, react and connect? Maybe by creating this online community, doctors, nurses, and families can come together and solve problems or help each other.
I think this website will achieve some of those goals. It will continue to evolve as we react to your ideas and the progress shaping patient safety as a field. We would really love your feedback- good or bad. It all helps.
Labels: Website
