Engage family members in crucial conversations
Anyone facing a hospital stay probably has heard the advice: Take someone with you to lend support, ask questions, and serve as a care partner and advocate.
But is the clinical team including this person in crucial conversations? It is important to include the patient’s family member or other advocate because that person can help solidify the doctor’s relationship with the patient, says Leilani Kicklighter, RN, ARM, MBA, CPHRM, LHRM, a patient safety and risk management consultant with The Kicklighter Group in Tamarac, FL, and a past president of the American Society for Healthcare Risk Management (ASHRM).
"If it comes to the point that they’re considering legal action, they may not take that step if they feel like they have a good relationship with the doctor and they know that he or she really had the best interests of the patient at heart," she says. "Being inclusive with these conversations is a way to get that bond. If you’re talking only with the patient, even if you do it well, later on they might have family members who see the doctor in a different light."
Risk managers should counsel physicians to include family members in crucial conversations, with the patient’s permission, suggests Karen Curtiss, president of PartnerHealth, a company in Illinois that promotes patient safety.
Curtiss became concerned about family involvement in patient care when a series of medical errors occurred in her family. After a successful lung transplant at a top academic medical center, her father died from complications resulting from a fall that went untreated for 57 hours, which led to pneumonia, blood clots, a pulmonary embolism, and two infections. Her husband spent 18 months recovering from sepsis and an infection, stemming from improper surgery preparation and care afterward. And her young son would have undergone an unnecessary operation had she not questioned a doctor and sought a second opinion.
Determined to help other families avoid similar fates, Curtiss, a consultant with more than 25 years of market research experience, started digging for answers. Curtiss compiled her research into "Safe & Sound in the Hospital," a new handbook designed to educate patients and their families about how to prepare for a hospitalization, stay on top of the many issues that can arise during a hospitalization, and help prevent another hospital stay. The book provides practical tips, creative tools, and quick checklists that care partners can use to help prevent common hospital hazards and promote a safe recovery.
Curtiss suggests that risk managers train clinicians to pass these tips to family members:
• Keep your loved one safe from infection.
Make sure everyone, especially doctors and nurses, washes his or her hands before touching your loved one. Make colorful tent card signs for your loved one’s room with messages such as "Thank you for washing your hands!" or "For my safety, please wash your hands."
Clean TV remotes, door knobs, telephones, bed rails, call buttons, faucets, toilet flush levers, and personal items with alcohol wipes and bleach wipes to help prevent infection. Repeat cleaning after every touch or brush with clothing.
• Speak up and ask questions. Get to know everyone who takes care of your loved one. Ask questions in a friendly, respectful way. Don’t be afraid to admit if you don’t understand their answers and need a "plain English" translation.
• Find out how to call for a Rapid Response Team if you feel like your loved one is going downhill and no one seems to be taking action. Trust your gut; you know your loved one best.
• Ask the nurse to pause and double-check each medication just before it’s given. Verify the prescription, the dose, and intended patient. NEVER interrupt a nurse in the middle of administering a drug unless you sense a mistake.
• Understand that virtually every patient is at risk to take a fall. Look for items in the room that might cause a trip, and bring non-skid socks or slippers for your loved one to wear. Ask the nurses about a cane for your loved one to use. Make sure someone is available to help your loved one to the bathroom and back.
"In my experience, everyone in hospitals is well-intentioned. We just need more eyes and ears on patients, and who could be more patient-centered care partners than families?" Curtiss says. "It’s so important for families to be engaged and vigilant and to have their eyes wide open when someone they love is in the hospital."