Hospitals’ rapid response begins with the patient
Community Health’s in-house system lets families backstop care
Published in: IndyStar.com
Written by: Daniel Lee
9/21/2007 – Patients at Community Health Network can hit the nurse-call button for everything from requesting an extra blanket to vital medical help.
But now patients at Community’s five area hospitals have a potentially powerful new communications tool — the telephone, to call for a second opinion.
This month the Indianapolis hospital system launched its Call FIRST program, allowing patients and their family members access to a special in-hospital telephone number to call if they have serious questions or concerns about their condition or the care they are receiving.
A nursing supervisor or consult nurse will be at the bedside within 15 minutes to assess the patient and the care being provided, Community said.
“The whole initiative is to improve patient safety,” said Bill Corley, chief executive of Community Health Network. “Sometimes a patient or family members believe there is a more critical situation than the staff does.”
Corley said Call FIRST — for Family Initiated Rapid Screening Team — is designed to get the patient evaluated immediately by a nurse not already involved in that person’s care.
It could be a patient feeling that his doctors or nurses don’t understand his condition or are not listening to his concerns. Or it could be an instance of a patient’s vital signs looking OK, but the patient or family member sensing something still is not right.
“The family is often the first to spot changes in behavior,” Corley said.
Community’s initiative is one of several by hospitals of all sizes working to improve patient care and reduce the chance of medical errors. Many programs are designed to streamline communications.
Wishard Health Services recently started using a communication system called Veriphy that immediately sends an alert to a physician’s pager, fax or cell phone when the result of a radiology test ordered by that doctor is flagged as critical.
Hospitals also have created rapid-response teams to deal with changes in a patient’s condition, such as chest pain or just a sense that a patient is deteriorating, before it becomes a code-red emergency. Those programs, though, typically are triggered by a nurse.
With Call FIRST, Community Health Network becomes one of a small number of hospitals to install a rapid-response system that is activated by patients or their families.
“Whenever health-care providers can give patients and family members information and control about what makes them safe, it will go a long way toward preventing harm,” said Betsy Lee, director of the Indiana Patient Safety Center at the Indiana Hospital and Health Association, in an e-mail.
Some patients seem to be reassured by the new system.
Sharon Gainar, a patient at Community North who was recovering from major surgery, said she has received outstanding care during her almost-two-week stay. But she likes having the option of calling in a nurse supervisor for a fresh perspective should she have any concerns.
“It’s just one less thing I have to worry about,” said Gainar, who lives in Fishers.
Community emphasized that the Call FIRST program is for serious concerns, not for routine questions or complaints from patients and their families. One patient has placed a call since the program began Sept. 1, but hospital officials said that was for a nonlife-threatening situation that was resolved.
Rhea Oliver, a registered nurse and clinical director of the inpatient surgical unit at Community Hospital North, said each person admitted to the hospital system receives a brochure about the program.
In designing Call FIRST, Community looked to the pioneering “Condition H” program used by the University of Pittsburgh Medical Center for patients and their families to summon help.
Since being launched in spring 2005, the pilot program at UPMC’s Shadyside hospital has received about 78 calls for help, said Susan Christie Martin, a director at UPMC’s Center for Quality Improvement and Innovation.
Martin said the hospital system still is analyzing whether Condition H has improved patient safety, but she added that the program has indeed helped improve the care of some patients.
Both Community and UPMC said a major motivation for their patient-call systems was the tragic death in 2001 of 18-month-old Josie King at Johns Hopkins in Baltimore.
Josie, who had suffered burns when she climbed into a hot bath, was recovering well but ended up dying of severe dehydration and misused narcotics, according to her mother, Sorrel King.
King said she raised concerns about her daughter’s condition with caregivers but they reassured her that Josie’s vital signs were fine. King is now a patient advocate who runs the Josie King Foundation, josieking.org, which is focused on the prevention of medical errors.
A program like the ones at Community or UPMC could have made all of the difference for Josie, King said. “In my daughter’s case, if I had been able to do that, I truly believe with 100 percent of my heart that she would be alive.”
Call Star reporter Daniel Lee at (317) 444-6311.