| In 2005 the NHA Board identified the following as the designed future for healthcare in Nebraska: In 2010, the Nebraska Hospital Association is the influential voice in the state for health care. Nebraska is home to healthy communities where hospitals are known as leaders of quality initiatives. Health care sets the standard for service excellence and Nebraska’s hospitals foster innovation. Working from this set of shared values, health care has come to be the industry of choice in the state. Nebraskans are assured access to health care; there is full coverage and a fair payment system in place.
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To help Nebraska’s hospitals achieve the goal of being leaders in quality initiatives, we will be sharing with you some of the quality initiatives that are taking place right now in Nebraska. Each month we will bring you an innovative, reproducible model of a healthcare quality initiative.
This month we feature Nemaha County Hospital and their Safety
Team program.
Click here to view the Archives.
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Hospital of the month - Nemaha County Hospital, Auburn, NE
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Safety Brochure
Medication Reconciliation
Report
You Are Part of Our Safety Team!
 Like any healthcare provider that not only cares for, but cares about its patients, Nemaha County Hospital has always placed an emphasis on the importance of patient safety. In the area of medication safety, our approach is multi-faceted and includes the patient, technology and participation in national patient safety initiatives.
In 2000 Nemaha County Hospital purchased its first Pyxis system for unit dose dispensation and administration of medications to patients. Three years later, we began implementing our current information technology system which included bar-coding the patient’s wrist band to assure that the correct patient was receiving the correct medication in the correct dose. The medication verification system was activated to provide an audit trail of safety checks as well as a log of near misses and medication errors.
Nemaha County Hospital also made the commitment to participate in the Institute for Healthcare Improvement’s (IHI) 100,000 Lives Campaign. Although not all of the goals of the Campaign are pertinent to this Critical Access Hospital, preventing adverse drug events through a process of medication reconciliation was one that the hospital embraced. When a patient is admitted to Nemaha County hospital, all home medications are identified and the information entered into their electronic medical record. Local pharmacies are contacted and asked to fax the patient’s medication list to the hospital. This information is entered into the patient’s medical record. The physician must continue or discontinue each medication and provide the reason for its use. As medication is prescribed for the patient during their hospital stay, the information is appended to the patient’s Medication Reconciliation Report. At discharge, all medications are reviewed by the physician to confirm the dose, frequency, reason for the mediation and route of administration. At this review, each medication is again continued or discontinued by the physician and a copy of the report is printed for the patient’s use. The physician meets with the patient/family and reviews the list with them prior to discharge.
The patient is also a part of the safety team at Nemaha County Hospital. At admission, each patient is given a copy of the safety team brochure. The brochure explains some of Nemaha County’s efforts to improve patient safety and encourages patients and their families to speak up if they see something that seems unsafe. The brochure lists four simple steps patients and their families can take to help the staff at Nemaha County Hospital prevent medical errors –
- If something doesn’t seem right, speak up!
- Don’t let anyone give you a medication without first scanning your armband, the medication and speaking your full name or birth date.
- When a nurse gives you a medicine, ask what it is.
- Make sure caregivers wash their hands.
The medical staff and the Board of Directors are key to the success Nemaha County Hospital has experienced in providing safe, high quality health care. Patient safety is the first agenda item at every meeting of the governing board. Near misses are discussed so that they may learn from them in an effort to prevent the near miss from becoming an actual event in which the patient was affected. Over the years the hospital has seen an increase in the reporting of near misses but a decrease in actual errors that reached the patient. This is one measure that demonstrates a successful medication safety program is in place and working effectively.
Obviously, these initiatives are successful because of the active involvement and dedication of all the staff. In fact, the medical staff at Nemaha County Hospital is urging the hospital to take the next step in medication safety. The physicians already have access to the hospital’s electronic medical record and can view flow charts, lab and x-ray results, reports of the history and physical, consultation and surgery online. The physicians have asked to be able to place orders online. They plan to implement computerized provider order entry (CPOE) during the first quarter of 2007 says Marty Fattig, CEO at Nemaha County Hospital.
If you have any questions or would like your hospital's quality
initiatives to be featured on the NHA Web site, contact Monica Seeland, Vice
President, Quality Initiatives, (402) 742-8152 or mseeland@nhanet.org.
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