Chief Residents’/Fellows’ Meeting on Patient Safety JCI Preparation of Trainees 9 June 2015

Scenario on Sept 14-18,2015 Every morning, the chief resident submits to the executive office the list of inpatients for the day. This list is given to the JCI surveyors who will conduct patient tracers. During the patient tracers ( ER, Nursing Unit, Radiology, ICU, OR,RR, etc ), the health care providers will be interviewed on how they rendered care to the patient. Sample questions: How do you ensure correct patient identity? How do you assess patients? Show me your documentation of your assessment? When was this written?What is your hospital policy on patient assessment?

Scenario on Sept Sample questions: What is the policy and process of transferring patients to the ICU? What are the criteria for admission to the ICU? Who secures the informed consent for surgical procedures? How is the informed consent obtained? Where is it documented? What is the process for discharge of patients? Show me the discharge instructions ? Where is the documentation of patient education ? Who educates the patients re: home medications?

Sample patients for tracer. Psychiatric patient Pediatric and/or neonatal patient Maternity patient Patient receiving imaging services Patient receiving rehabilitation services Patients who cross programs Patients received from another hospital, long term care, Patient transferred from another hospital Patients who underwent neurosurgery High risk pregnant patients

Staff Qualification and Education Interview Selected 201 files of medical staff and trainees Check if licenses are updated Check if there are CME certificates ( ) Credentials: Diploma, Diplomate certificates Proof of Patient Safety Training ( 2015) Evaluation of Trainees by the departments

Open and Closed Chart Reviews Review of inpatient charts for completion: ( Open chart review) Patient Databases if all sections are filled up and signed Progress notes and Care plans using measurable goals Legible handwriting Printed name and signatures Informed consent Patient Education documentation Request forms for imaging procedures/ blood transfusion If medications are written properly If there are telephone orders Operative Technique/Operative Records etc

How do you prepare as PS champs? How do you prepare your trainees ? Complete the Patient Safety training curriculum Study JCI guides/cheat cards Know the hospital policies/ department policies/unit policies( ICU, ER, Radiology, Laboratory etc) Practice PATIENT SAFETY THINKING all the time Endorse patients ( hand-offs) Document assessment, reassessment and care plans using measurable goals Documentation including printed name and signature Supervise the medical students and junior residents /fellows Know your patients Complete your medical records including Discharge summaries on time Submit your CME certificates and all MTO requirements/ update licenses /BLS/ACLS

Scenario 3-5 years from now You are Diplomates of your specialty practicing in the TMC network ( hospitals and clinics). You carry the TMC Brand of care wherever you go. You practice patient safety thinking and behavior in all your health care activities You assess your patients promptly and thoroughly You document all your assessment findings You document your care plans and explain to the patient and family You hold team and family meetings if necessary You always use patient identifiers provide your patients with complete discharge instructions including discharge summary You sign all your orders and write legibly on the chart You COMMUNICATE with patients and INVOLVE them in their care You are champions /role models of Patient Partnership