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Making a Difference in Health Care

Making a Difference in Health Care. The Librarian as Advocate http://nnlm.gov/training/patientsafety/global.html . How is Your Library Involved in Patient Safety (or how will it be)?. Librarian: Patient Safety Advocate. Supporting Research Supporting Recognition

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Making a Difference in Health Care

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  1. Making a Difference in Health Care The Librarian as Advocate http://nnlm.gov/training/patientsafety/global.html

  2. How is Your Library Involved in Patient Safety(or how will it be)?

  3. Librarian: Patient Safety Advocate • Supporting Research • Supporting Recognition • Supporting Patient Involvement • Education • Resources • Library Services

  4. SupportingResearch

  5. Research: Funding • Patient Safety Grants • USA: Agency for Healthcare Research and Quality (AHRQ), National Institutes of Health, National Institute of Nursing Research, National Science Foundation, Grants.gov • International: WHO Patient Safety Research Small Grants, The Commonwealth Fund • Non-Profit/Private foundations: National Patient Safety Foundation, Robert Wood Johnson Foundation

  6. Research: Resources • Health Services Research Projectsin Progress • NLM HSRProj: http://www.nlm.nih.gov/hsrproj/ • Informational databases • Public: Joint Commission Sentinel Events, HHS Hospital Compare • Member: Quantros/MedMarx, MedSun • Private: HealthGrades • Article sources • PubMed.gov and PubMedCentral.gov

  7. SupportingRecognition

  8. Recognition: Accreditation • Hospitals and health centers • The Joint Commission and the Joint Commission International • Patient Safety Goals • Sentinel Events • Health care • International Accreditation Service (IAS)

  9. Recognition: Certification • Health professionals - recertificationrequirements may include patient safety topics • Students and residents - required to take patient safety courses • New York Medical College • Officers • International Association for Healthcare Security and Safety (IAHSS) • American Society of Medication Safety Officers (ASMSO)

  10. Recognition: Awards (USA) • Malcolm Baldrige National Quality Program, National Institute of Standards and Technology (NIST) • John M. Eisenberg Award for Patient Safety and Quality, The Joint Commission • Magnet Recognition Program, American Nurses Credentialing Center (ANCC) • America Hospital Association-McKesson Quest for Quality Prize, Health Research and Educational Trust • Cheers Award, Institute for Safe Medication Practices (ISMP) • Marvin Shepherd Patient Safety Award, Healthcare Technology Foundation

  11. Supporting PatientInvolvement

  12. Patient Involvement: Areas • Patient education • Health literacy • Partnering with education committees and organizational agencies • Patient advocacy • Providing resources

  13. Patient Advocacy: Personal • Individual Advocacy – In doctor and hospital visits • Share information • Create a Personal Health Record or keep lists of health problems, previous operations, etc. • List or bring all medications, supplements, and vitamins • Get information • Ask questions about treatments, medications, etc. • Research illnesses and treatments • Bring an Advocate • Know what to do before leaving • Ask about medications and future appointments

  14. Patient Advocacy: Advocate • Patient Advocate – For friends and family • Willingness to go with the patient to appointments, be with them in the hospital and clinics • Listening and taking notes • Speak up when necessary to clarify an issue and to ask a question • Question when something does not seem right in the hospital, nursing homes, clinics, etc.

  15. Patient Advocacy: Representative • Patient Representative – In health care organizations • Work to improve safety at the organization and individual unit level • Serve on committees and boards • Assist on rounds (still rare) • Support staff and families

  16. Patient Advocacy: Activist • Patient Participant/Activist • Participate on state and regional coalitions and organizations • Serve nationally and/or internationally • Advocate for public reporting and accountability of hospital and health system performance • Volunteer, make donations, work with fund-raising • Be aware of regional and national legislation, contact legislators Gibson, Rosemary. Role of the patient in improving patient safety. WebM&M. 2007(Mar): Perspectives on Safety. http://webmm.ahrq.gov/perspective.aspx?perspectiveID=38

  17. Patients: Online Resources I • Online Information • Getting Safer Care (AHRQ) http://www.ahrq.gov/consumer/safety.html • Treatments and Medications (AHRQ) http://www.ahrq.gov/patients-consumers/diagnosis-treatment/treatments/index.html • Speak Up Initiatives (The Joint Commission) http://www.jointcommission.org/speakup.aspx • MedlinePlus.gov (NLM) – includes health information in multiple languages http://www.medlineplus.gov/patientsafety/

  18. Patients: Additional Resources II • Online Information • Treatments and Medications (AHRQ) http://www.ahrq.gov/patients-consumers/diagnosis-treatment/treatments/index.html • Personal Health Records(NLM) http://www.nlm.nih.gov/medlineplus/personalhealthrecords.html • Drugs: Information for Consumers (FDA) http://www.fda.gov/Drugs/ResourcesForYou/ • Anesthesia Patient Safety (AANA) http://www.anesthesiapatientsafety.com/

  19. Patients: Medical Errors • Support • USA: Medically Induced Trauma Support Services (MITSS), PULSE (Persons United Limiting Substandards and Errors in Healthcare), • Advocacy • USA: Voice4Patients, Consumers Advancing Patient Safety (CAPS), Josie King Foundation • International: WHO Patients for Patient Safety (PFPS), Iatrogenic Europe Unite (IEU) – Alliance, International Alliance of Patients’ Organizations (IAPO)

  20. Education

  21. Education: Topics • Health literacy • Easy to read, Language appropriate • Consumer resources and advocacy • Legislation • Accreditation / Certification requirements • Evidence based medicine / Research based practice • Quality indicators / Risk management • Current research

  22. Education: Opportunities • Alert services • Institute of Safe Medication Practices (ISMP), PubMed My NCBI, National Institutes of Health (NIH), WHO • Email Discussion Groups • National Patient Safety Foundation Patientsafety-L • American Society of Medication Safety Officers (ASMSO) • Conferences/Seminars/Workshops • International Forum on Quality and Safety in Healthcare (IHI/BMJ), The International Society for Quality in Health Care (ISQua), National Patient Safety Foundation (NPSF) • Medical associations, Library associations

  23. Education: Opportunities Online I • Books, Journals, Newsletters • Quality Chasm series - http://www.nap.edu/ • Patient Safety and Quality Healthcare- http://www.psqh.com/ • Podcasts and Videos • Healthcare 411 - http://healthcare411.ahrq.gov/ • Curriculum Resources • WHO Patient Safety Curriculum Guide: Multi-professional Edition http://www.who.int/patientsafety/education/curriculum/en/ • Patient Safety Resource Seminar: Librarians on the Front Lines - http://nnlm.gov/training/patientsafety/

  24. Education: Degrees • Graduate Certificate • Graduate Certificate in Patient Safety, University of Wisconsin-Madison, Madison, WI, USA • Masters Degree • Master of Science: Quality and Safety in Healthcare (MSc), Imperial College, London, UK • Master of Science in Patient Safety Leadership, University of Illinois, Chicago, IL, USA • Fellowship Programs • ISMP Safe Medication Management Fellowship, ISMP • Scottish Patient Safety Fellowship Programme, NHS Scotland

  25. Resources

  26. Resources: Examining Events I • Root Cause Analysis (RCA) • Examining events • Incident Decision Tree • Examining events • Failure Modes and Effects Analysis (FMEA) • Examining processes • Probabilistic Risk Analysis (PRA) • Examining processes starting with outcomes • Six Sigma • Measurement studies

  27. Resources: Communication • Human Factors Engineering • Human abilities/characteristics affecting design/operation • Crew Resource Management (CRM) • Communication, team working • Situation-Background-Assessment-Recommendation (SBAR) • Communication, team working • Patient/Problem, Assessment/Actions, Continuing/Changes, Evaluation (PACE) • Communication

  28. Resources: Online Studies • Agency for Healthcare Research and Quality's (AHRQ) • Comprehensive Unit-Based Safety Program (CUSP), 2003 • Healthcare Cost and Utilization Project (HCUP), 1988 • Quality Indicators Toolkit for Hospitals, 2011 • Canadian Patient Safety Institute (CPSI) • Canadian Incident Analysis Framework, 2012 • Institute for Healthcare Improvement (IHI) • Global Trigger Tool, 2012 • World Health Organization (WHO) • Methodological guide for data-poor hospitals, 2010

  29. Resources: Legislation • Library of Congress legislative informationhttp://thomas.loc.gov/ and http://beta.congress.gov/ • National Academy for State Health PolicyPatient Safety Toolbox http://www.nashp.org/pst-nashp • National Conference of State Legislatures http://www.ncsl.org/ • USA.gov – links to state legislatures • National legislatures

  30. Resources: National Library of Medicine • Research and evidenced-based medicine • PubMed - pubmed.gov Article citation database, search for events and/or processes Track events/processes/topic with My NCBI • PubMed Clinical Queries Identify related reviews • ClinicalTrials.gov - clinicaltrials.gov Current and previous national and international studies • NIH Clinical Alerts and Advisories http://www.nlm.nih.gov/databases/alerts

  31. Resources: NLM • Drugs, chemicals and radiation accidents • Hazardous Substance Data Bank (HSDB) http://toxnet.nlm.nih.gov - research toxicology issues • Radiation Emergency Medical Management (REMM) - http://remm.nlm.gov - focus on radiation events • Chemical Hazards Emergency Medical Management (CHEMM) - http://chemm.nlm.nih.gov/ • Drug Information Portal- http:druginfo.nlm.nih.gov - Search across NLM, NIH and FDA databases • LactMed- http://toxnet.nlm.nih.gov/lactmed Drugs affecting lactating mothers and breastfed infants

  32. Resources: Searching PubMed • PubMed Search Strategies • USE DETAILS to clean up a search E.g. searching for patient safetygives the result: "patient safety"[MeSH Terms] OR ("patient"[All Fields] AND "safety"[All Fields]) OR "patient safety"[All Fields]) • Use Topic-Specific Queries (linked from PubMed homepage) • Electronic Health Records • Health Disparities • Health Literacy

  33. Resources: PubMed MeSH I • MeSH Terms related to patient safety issues • Disease Transmission, Professional-to-Patient • Drug Administration Routes • Hospitalization(includes Length of Stay, Patient Admission, Patient Discharge, and Patient Transfer) • Investigative Techniques (includes Equipment Safety) • Medical Errors (includes Diagnostic Errors, Medication Errors and Observer Variation) • Patient Participation • Patient Safety (or the broader term Safety) • Note: Term added to MeSH in 2012

  34. Resources: NLM for Patients I • For Patients and Families • MedlinePlus– http://medlineplus.gov general searches, patient safety page • Genetics Home Reference – http://ghr.nlm.nih.gov study genetic conditions and the responsible genes • Household Products Database– http://hpd.nlm.nih.gov health and safety information • Dietary Supplements Labels Database –http://dietarysupplements.nlm.nih.gov • NIH Senior Health – http://nihseniorhealth.gov information for seniors and their care givers

  35. The Library

  36. Advocacy: Start Where You Are • With Literature Searches • Stat for Emergency Room • Nursing Education Department • Monthly Infection Control Reports • Drug Use and Clinical Adverse Events • Patient/Family Questions • Specifics Adverse Events, FMEAs, RCAs • Research Studies

  37. Advocacy in Service • Creating and Sharing Information • Through Alert Services • Literature, Tables of Contents • Recalls, Clinical alerts, Drug updates, Diseases and treatments • Supporting Institutional Resources and Needs • Balanced Score Card, Indicators, Legislation • Policies, Procedures, Employee Handbooks • Electronic Health Records (MedlinePlus Connect)

  38. Advocacy in Service (pt. 2) • Creating and Sharing Information • For Patient Education • Brochures, Flyers, Surveys • Supporting nurses and patient educators • In Telling Stories • Of library involvement, institutional successes, individual joys or concerns • In Newsletters, on Blogs, with Articles, through the Intra- or Internet

  39. Advocacy in Service (pt. 3) Providing support for those experiencing medical error • Patients and families • P.U.L.S.E. http://www.pulseamerica.org/ • Consumers Advancing Patient Safety (CAPS) http://www.patientsafety.org/ • Medical professionals • Medically Induced Trauma Support Services (MITSS) http://www.mitss.org/ • Sorry Works! Coalition http://sorryworks.net/

  40. Advocacy in Education • In Training & Education • Student Curriculum development • Assistance with CME/CNE/CE requirements • Including patient safety when focusing on computer skills, EMB, searching, etc. • During orientation classes and introductions • On-line tutorials and resources preparation • In reference services, e.g. with patients and families, health professionals • Related to electronic health and medical records

  41. Advocacy Beyond the Library • Discover • Which institutional committees/groups/agencies focus/involve/include patient safety in their mandate • Who the institutional patient safety leaders are • Institutional patient safety policies, guidelines, and definitions • Participate • On Patient Safety committees, teams and boards • Attending related Morbidity and mortality meetings, patient safety councils, and quality committees • On Rounds and providing event study support

  42. Advocacy Beyond the Library (pt 2) • Connect with and educate • Safety Officers, Advocates and Directors • Executives: CEO, CNO, CME and others • Institutional leaders: Directors, Lawyers, Liaisons • Assist and support • Health Fairs • At community affairs department projects • Partner with other libraries • Serve as Community Liaison to professional advisory committees

  43. Advocating Patient Safety In Summary: All of the roles of the library ultimately support Patient Safety • Michelle Eberle, 2007 • http://nnlm.gov/training/patientsafety/global.html

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