Critical Path Network

Pre-testing patient safety tool helps ensure success

Evaluation helped create clear copy for patients

The University of Washington Medical Center in Seattle is in no hurry to implement a tool an ad hoc committee created to teach patients their role in safety issues. It is running it through a series of pre-tests before implementing it housewide. Evaluation began with eight patient advisors who were sent the tool and then interviewed on the telephone. It was a good way to identify problems before the committee proceeded with more structured pre-testing of the tool, says Cezanne Garcia, MPH, CHES, manager of patient and family education services.

Five of the eight people said that they would feel uncomfortable asking their health care provider to wash his or her hands, so the instructions were changed to prompt the patient to ask everyone to wash their hands. The advisors also said they liked the sections of the tool that had bulleted information vs. the parts that had narrative instruction. As a result, the committee changed the tool providing bulleted lists in all sections.

On the advice of the reviewers, the title was changed as well. The original title was "Patient Safety: Be Our Partner." The new title is "Partner-ing with You to Make Health Care Safer." There was some confusion on the exact meaning of patient safety, and that prompted the change.

Once the tool was revamped, the second phase of the testing began. In that phase, 30 patients in the inpatient and outpatient oncology setting were given the tool along with an evaluation form and asked to provide feedback on whether they found the tool useful and easy to understand. In patient care rooms, the tool and evaluation form was left by the interviewer who returned in about 15 minutes to pick up the evaluation sheet. In the waiting room, the materials were distributed to several patients and then the interviewer simply waited until all had completed the task.

One patient who reviewed the tool wrote, "These are clearly the basics, but they give me a good solid foundation to know what I can do."

Once the tool is fine-tuned, it will be implemented in three inpatient cancer areas and an affiliate. "We are going to implement it systemwide for a particular patient group. One of the things we want to learn a little bit more about is how we can best prepare our staff who work in these areas for what may be a potentially stronger advocacy voice that patients or family members may present by use of this tool," says Garcia.

Oncology service was selected as the test site because the instructions are aligned with the current practices in this patient care area. Hand washing is a paramount issue with oncology patients as well as infection control, as is careful monitoring of medication.

Once it is clear how best to orient staff to the tool that will be given to patients at admission or in appointment packets, it will be launched housewide, says Garcia. This should take place in three to six months, she says.