Patient Identification at DUH “ALWAYS the Right Patient” We put the person who needs our care at the center of everything we do Requirements for Staff and Providers

 The National Patient Safety Goal to use 2 unique identifiers before providing care or treatment to patients has been in place over 10 years  Multiple events have occurred in in which patient ID was not carried out per DUH policy Patients registered to wrong MRNs Mislabeling of specimens Wrong procedures Wrong surgeries Why we need a heightened focus on patient ID processes Patient Safety is being compromised. Join the campaign to improve our performance!

Patient ID related occurrences over time

What Happens When The Patient’s ID Is Not Confirmed Appropriately ? A patient’s measurements that were put in the wrong patient’s chart resulted in that patient getting an incorrect surgery A patient got someone else’s radiation treatment 2 different patients had radiology procedures with contrast that were not intended for them A patient got the wrong blood product A patient got blood that wasn’t necessary because this patient was registered to the wrong MRN in someone else’s chart. This patient also got a wrong diagnosis. A patient got a lumbar puncture that wasn’t needed because the test results that were taken were for another patient

Remember to Use Name and Date of Birth to confirm patient ID Use active communication to ALWAYS ask the patient to state their name and date of birth. Do not say “Are you Mr. Smith”, or “Is your date of birth 4/18/55?” Confirm what the patient states against the ID Band The Updated Patient ID Policy at DUH This also means: Confirm the ID against a credible source document, such as consent, face sheet, requisition, Maestro Care chart. If your department does not use ID Bands, you must confirm the patient’s stated name and date of birth against source documents

 During initial screening and admission - registration, appointment scheduling, phone screening, pre-op  During patient transfer or transport - for diagnostic tests and procedures/transfer between care areas or any hand off of care  Giving or receiving results over the phone  Labeling items - specimens, forms placed in the medical record Where Must Correct Patient ID Confirmation Occur?  Choosing a patient name from a list of names - a computer screen or paper log  Verifying the correct medical record is being used if multiple patient charts are open when using MaestroCare  Admitting or discharging a patient to or from a monitor  Placing stock items, like medication, in a patient-specific drawer

The Main Reasons For Errors During Patient ID Failure to use the patient ID band  Failure to use active communication consistently as in “Please tell me your name and date of birth”  Failure to use stated name and DOB against a Source Document – Consent Form, Ticket to Ride, Requisition, Medical Record etc.  False Assumption that someone else on the team already verified patient ID Failure to look at the patient ID when registering or admitting  Not looking at the ID to verify the patient  Not completing all verifications  Defaulting to name only when it matched the last name

What if my patients get frustrated that we keep asking them their name and DOB? What would you say? a.Ignore their frustration and go about your work b.“I’m sorry it frustrating for you, but it is very important we make sure we are keeping your safe” c.Perform Patient ID only when you meet them for the first time d.This policy does not apply to non- clinical staff Try This... We should use “Words that Work” that assure them we are interested first in their safety, and want to be sure we are always doing the right thing to the right person. For instance, you might say “I’m sorry it’s frustrating for you, but it is very important we make sure we are keeping you safe by making sure we are doing the right thing to the right person every time! We appreciate your participation in this process!”

The Rationale... We should use “Words that Work” that assure them we are interested first in their safety, and want to be sure we are always doing the right thing to the right person. For instance, you might say “I’m sorry it’s frustrating for you, but it is very important we make sure we are keeping you safe by making sure we are doing the right thing to the right person every time! We appreciate your participation in this process!” And Yes, the policy applies to all staff members and providers. Any Duke employee may encounter patients and need to communicate with them or intervene with them in some way. When it is your responsibility to identify the right patient, this policy applies.

Remember, It Takes A Team To Be Consistent… As a team member committed to supporting the values and mission of DUH, you should coach you coworkers on the impact of an inconsistent process for identifying the patient AND in the expectations of the policy including:  Reminding each other when patient ID is required  Offering to perform the double check with your coworker  Talking with your manager can help if you have concerns.. What Does This Mean For Our Area? Situations for our unit when inconsistency in the patient ID process would effect patient safety include …

ALWAYS – Our patients depend on this!