As you are all interested in patient safety/QI, I wanted to run an idea by this very talented group and see if you had any thoughts/improvements/additional ideas.
Background: At the Washington DC VAMC there is minimal communication between the house staff and nursing staff, often the two groups don’t interact all day. One of the biggest hurdles that residents feel they must overcome is being able identify which nurse is caring for their patients and how to get a hold of them. The current work environment yields fractionated and adversarial relationships with the patient’s medical team, hindering a patient centered approach to treatment.
Aim: To improve communication between nursing staff and house staff with regards to patient care
Intervention: On day one of the rotation, all house staff will be taken to each medicine ward floor and introduced to the nursing staff. Each team room… Continue reading
Unfortunately, there were countless errors from before the start of Lewis’ surgery all the way through the handling of his death. The one systematic error I will comment on is physician-patient communication. Every patient undergoing a procedure needs to sign an INFORMED consent, which includes understanding the risks, benefits and alternatives to the treatment being offered. The situation continued to tailspin into a downward spiral as family was unaware of the expectations post op. There were multiple efforts made by the patient’s mother and nursing staff to notify the physicians that something was wrong. The physicians ignored the most valuable resource available to them, Lewis’ mother, who knows him better than anybody else. Her concerns were repeatedly disregarded or ignored because the doctor did not want to believe something was wrong.
Dr Levy eloquently stated, ” if you can’t see your mother/sister/daughter/son in your patient,… Continue reading