'Know Your Physician' program improves care, safety
Patients, family members, and even staff sometimes don't recognize physicians or remember who is caring for which patient, and that issue can compromise patient safety. For that reason, Natividad Medical Center in Salinas, CA, developed a program to help everyone get to know the doctors better.
"Know Your Physician" is a communication improvement program developed to ensure that every caregiver on the medical/surgical floor knows the roles and responsibilities of each attending physician and resident at all times as well as their patient assignments and call schedules. The new program includes well-defined physician roles and responsibilities, a master call schedule, and assignment tool.
In addition to hospitalists and other physicians, Natividad has family medicine residents. For that reason, there are a lot of doctors around every day, explains Quality Director Jane Finney, CLS, MBA, CPHQ. "We found that the nurses complained of never knowing who the doctor was for the patient," she says. "The first solution was to put a white board in the room with the name of the patient's doctor on it, but the nurses didn't know what doctor's name to write. On any given day, the patient might have the attending, a number of residents, plus the on-call team in the evening hours, so it was very confusing to track."
Some investigation revealed the way the hospital published its call schedule was "extremely antiquated," Finney explains. The schedule was being faxed from the telecommunications department to each nursing unit, where it sat on the fax machine or the desk of the unit clerk rather than being communicated throughout the unit.
Finney also determined that the computer record listed the name of the physician who admitted the patient but was not updated with the name of the doctor who took over after admission. "The result was that our nurses were wasting a lot of time running around asking who to call about a patient, and doctors were getting calls about patients that weren't theirs anymore," she says. "We also found that the lab was trying to call doctors with critical results and not getting through to the right doctor."
The solution was the "Know Your Physician" program, which has several components:
- The roles of attending physicians, hospitalists, and residents were more clearly defined so that nurses would better understand which one should be responsible for certain tasks and information.
- The call schedule was reformatted to make it more user-friendly, and it is now posted on the computer system that is available to all nurses. The nurses use a computer at the bedside to document, and the call schedule is available on that device.
- The resident teams are clearly stated on the call schedule to avoid confusion regarding which residents are involved in the patient's care.
- The hospital's main computer is updated regularly with the name of the patient's attending physician, which ensures the lab knows who to contact with critical results.
The program has produced good results, Finney says. Nurses now know who to contact, patient satisfaction scores have improved 9% on the Hospital Consumer Assessment of Healthcare Providers and Systems Survey, administered by the Agency for Healthcare Research and Quality. The lab also is better able to report results.
"We consider this an important patient safety initiative, because if a nurse needs to get in touch with a doctor to say the patient's status has changed, those can be critical minutes," Finney says. "Critical lab results also are a matter of time and accuracy, so getting to the right physician immediately can be crucial to patient safety."
•Jane Finney, CLS, MBA, CPHQ, Quality Director, Natividad Medical Center, Salinas, CA. Telephone: (831) 783-2502. Email: firstname.lastname@example.org.