Transcript Otsego Memorial Hospital Association Corporate Overview

At our best when
it matters most.
To provide exceptional
healthcare that meets the
needs of our patients and the
communities we serve.
Our service area includes:
Gaylord, Elmira, Wolverine, Vanderbilt,
Johannesburg, Atlanta, Lewiston, Indian
River, Frederic and Waters
To be the center of northern
Michigan’s patient focused
alliance dedicated to
healthcare excellence.
• Established 1951
• Private, Non-Profit Corporation
• Governed by 10 Member
Board of Directors
• Accredited
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Otsego Memorial Hospital
OMH Foundation
McReynolds Hall
OMH Medical Group
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OMH MedCare Walk-In Clinic
OMH Medical Group–Gaylord
OMH N’Orthopedics
OMH Medical Group–Lewiston
OMH Medical Group–Indian River
OMH Medical Group–Urology
OMH Medical Group–Boyne Valley
• OMH Auxiliary
• Munson Healthcare
• Munson Home Care/
Home Services
Workforce: 575+ Full Time Employees
Physicians: 100+ Affiliated including
70 employed providers
Beds:
46 Acute Care (Hospital)
34 Long Term/Skilled (McReynolds)
225,000+ Annual Patient Visits
To provide exceptional
healthcare that meets the
needs of our patients and the
communities we serve.
Our service area includes:
Gaylord, Elmira, Wolverine, Vanderbilt,
Johannesburg, Atlanta, Lewiston, Indian
River, Cheboygan, Frederic and Waters
To be the center of northern
Michigan’s patient focused
alliance dedicated to
healthcare excellence.
Appreciating diversity and treating all
with compassion, dignity and courtesy
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Show the person you are interacting with that they
are your priority
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Convey empathy – put yourself in others’ shoes
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Listen to and honor the personal, cultural and
spiritual needs of patients and families
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Recognize that every job is important and has value
Unwavering commitment to honesty
and trust
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Do the right thing for the right reason
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Protect confidentiality and privacy
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Discuss differences constructively, directly and
tactfully
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Advocate for our patients, employees and
organization
Teamwork and communication dedicated
to understanding and exceeding expectations
of quality, safety and customer service
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Take initiative to promote a culture of accomplishment,
enthusiasm and expertise; take pride in your work
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Promote an exceptional healing environment based on individual needs
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Be open to giving and receiving feedback to accomplish mutual goals
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Achieve the best results in all we do
Accepting Responsibility for our actions
See It
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Be engaged to contribute positively
Acknowledge opportunities by learning from our experiences
Own It
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Understand how individual actions contribute to desired outcomes
Solve It
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Follow through on commitments and responsibilities
Customer Service
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Patient satisfaction is directly related to
how we treat our customers
You will be receiving addition education
regarding our customer service
The following are the behaviors we ask
our employees to exhibit
Customer Service
Greet
 Value as a customer
 Ask how you can help
 Listen words, tone and body language
 Help meet their needs
 Invite them to contact us
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Rights as a Patient
Patients have a right to:
• Considerate and respectful care
• Understandable information
– Patients will have a green dot on their ID
bracelet if they have difficulty
understanding basic communication
– Please see their chart for more information
regarding their communication challenge
Rights as a Patient
Patients have a right to:
• Be free from seclusion and
physical/chemical restraint (refer to
policy)
• Consent or refuse treatment
• Appropriate pain assessment/symptom
management (see scale)
Pain Assessment
When assessing pain, a number value should be
assigned by the patient to make for consistent
measurement
FLACC Scale Non Verbal
Rights
Patients have a right to:
• Privacy
• Treatment records are confidential
• Review their medical records
• Be free from discrimination
• Discuss continuing care needed after
hospitalization
Rights
Patients have a right to:
• Know the hospital rules
• Consult the Ethics committee
• Know the physician who has primary
responsibility
• A second opinion
• Advanced Directive
Rights
Patients have a right to:
• Be informed of outcomes of care
including unanticipated outcomes
• Raise concerns through a formal
grievance
• Access Protective Services
Rights
Patients have a right to:
• Comfort measures/peace and dignity at
end of life
• Patients who have a Do Not Resuscitate status
will have a purple armband placed around their
wrist
• McReynold's Hall patients have a purple dot
placed on their identification bracelet
• Spiritual and pastoral care
• Appropriate screening and stabilization
before transfer to another facility
Patient Responsibilities
Patients need to:
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Provide Accurate Information
Keep Appointments
Understand consequences of refusing treatment
Follow hospital rules
Be considerate of others
Be responsible for financial obligation
Notify staff of communication issues
Ask questions if they do not understand
No Alcohol, recreational drugs, or firearms/weapons
Advance Directives
Advance Directives are:
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A legal document that gives the
appointed advocate permission to make
medical decisions when the patient is
deemed incompetent by 2 physicians
OMH Process for Advanced
Directives
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Pt. are given information about
advanced directives, if not familiar, at
admission
Copies of advance directives are
scanned into the medical record
Upon admission, the advance directive
should be available to the area where
the patient will be located
Infection Control
Washing or sanitizing your hands
frequently and properly is the single
most important action you can take
to prevent the spread of infection.
Infection Control
Hand Sanitizer is effective for hand
hygiene but you should wash with
soap and water if hands are soiled
or if caring for someone with C. diff
Infection Control
Keystone Initiative
Wash your hands upon entering
a patient-care area and upon leaving
WASH IN WASH OUT
Infection Control
Standard Precautions
“All the patients, all the time”
Infection Control
Standard Precautions
• Specific behaviors that healthcare
workers (HCW) follow to protect
both themselves and patients from
infection
• Practice 100% of the time
Infection Control
• Apply to blood, all body fluids, excretions
and secretions except sweat, plus nonintact skin and mucous membranes
• Protect against bloodborne pathogens
such as HIV, hepatitis B and hepatitis C
• Protect against pathogens from moist
body substances
Infection Control
•Wear gloves when touching blood, body fluids,
excretions, and contaminated surfaces
• Wash your hands after contact with body
substance even if gloves are worn
• Wash your hands and change gloves between
patients and between touching clean and dirty
sites on the same patient
• Wear a mask, eye protection and a gown if
splashes or spatters are possible
(Latex free products are available)
Infection Control
Practice Respiratory Etiquette all year
•Use mouthpieces, resuscitation or other
ventilation devices as an alternative to “mouth to
mouth” resuscitation methods
• Be sure reusable equipment is cleaned and
disinfected before used on another patient
Infection Control
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Handle all patient care equipment to prevent
exposure to other patients, visitors, and
healthcare workers
• Keep used patient equipment including soiled
linens away from your skin, mucous membranes
and clothing
• Don’t let used equipment or linens contaminate
surfaces or clean items
Sharps Safety
Never
bend, recap, or break
used needles unless the
procedure requires it
Place
used sharps in a
designated disposable
container immediately after
use
Infection Control
Transmission Based Precautions
• Additional precautions that healthcare
workers practice when a patient is suspected
of having an illness that spreads very easily
and is based on how the infection is spread-
CONTACT-AIRBORNE-DROPLET
AIRBORNE Precautions
Requires patients to be in a negative
pressure room and staff need to wear a
PAPR (Powered Air Purifying
Respirator)
 Good ventilation is important for
preventing the spread of TB
 Active TB patients need to wear a mask
if they go outside of the room
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Exposure to
Blood or Fluids
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Wash vigorously the area immediately with
soap and water
Report the exposure to the supervisor of your
Department
Complete the “Exposure Form”
Report to ED for evaluation
If exposure to eyes, flush for 15 minutes at
eye wash station with COLD water
PERSONAL PROTECTIVE EQUIPMENT (PPE)
ORDER FOR DRESSING IN PPE
ORDER FOR REMOVING PPE
Age Specific Care
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Be aware that all ages have different
physical, psychological, and social needs
• Tailor education to the patient’s age and
needs
• If staff and volunteers are aware
then it is a safer environment
• Involve family in the care
Abuse
Types of abuse:
• Elders
• Physical Abuse, Neglect, Exploitation
• Child
• Abuse, Neglect
• Observed or suspected
– we are required by law to report it!
Patient Safety:
A National Issue
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In an effort to prevent medical errors for all
patients in the healthcare setting, the Joint
Commission issues annual National Patient
Safety Goals
• National Patient Safety Goals are
developed as medical errors that occur
across the nation are analyzed and the root
causes identified
How National Patient Safety
Goals affect your practice
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Your understanding
and compliance with
the National Patient
Safety Goals and
hospital policy is
vital to our patients
safety and your
success at OMH
Goal 1: Improve the Accuracy of
Patient/resident/client Identification.
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To prevent medical errors, a patient must be
identified by comparing two types of
identifiers
• According to OMH policy, the two patient
identifiers include the patients name and
date of birth found in the medical record
documents and on the identification bracelet
Implementation Expectations 1A
Use at least two patient identifiers whenever:
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Collecting lab samples
Administering
medications or blood
products
Providing any treatment
or procedure
Label sample collection
containers in the
presence of the patient.
1B: Implement the Universal Protocol
for Invasive Procedures
The “time out” final
verification process to
confirm the correct
patient, procedure,
site, and availability of
documents and
equipment must occur
in the location where
the procedure is to be
done and should
involve the entire team
Goal 2: Improve Effectiveness of
Communication
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For verbal or telephone orders or for
telephonic reporting of critical test results,
verify the complete order or test result by
having the person receiving the order or
test result write down then “read back” the
complete order or test result
Standardize a list of abbreviations, acronyms,
and symbols that are not to be used
throughout the organization
The “Do Not Use” abbreviation list applies
to all orders and other medication-related
documentation when handwritten, entered
as free text into a computer, or on pre-printed
forms
The Official OMH
“Do Not Use” List Includes:
Do Not Use:
Write this Instead:
Trailing Zero (1.0)
1mg
Lack of leading zero
0.5mg
U, u, IU, or iu
Units or international
units
Daily or every other day
q.d., QD, Q.D., Q.O.D.
MS, MS04, MgS04
Morphine or Magnesium
Sulfate
2E: Hand Off Communication
Implement a
standardized
approach to
“hand off”
communications,
including an
opportunity to ask
and respond to
questions
Implementation Expectations
“In health care there are numerous types of
hand offs, including but not limited to:
• Nursing shift changes
• Physicians transferring complete
responsibility for a patient
• Physicians transferring on call
responsibility…
SBAR
S=Situation
B=Background
A=Assessment
R=Recommendation
Any Questions?
Example
S=Admitted an 82 year old with pneumonia,
possible aspiration.
B=History of stroke, has been having
increased cough x 3 weeks per family,
fever began today..
A=RR is 24 and unlabored, temp is 101
degrees F, swallowing evaluation ordered
for a.m., alert and oriented x2. First
antibiotic completed at 0300.
R=Keep HOB elevated at least 30 degrees,
remain NPO until swallowing sturdy
complete and recommendations added to
care plan. Next antibiotic is due at 0900.
Additional assessment and care plan
includes patient is a high risk for falls, bed
alarm on and frequent rounds to assist
with toileting needs.
Verify Labels
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Label all medications, medication
containers, (e.g., syringes, medicine cups,
basins), or other solutions on and off the
sterile field in perioperative and other
procedural settings
Implementation Expectations:
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All labels are verified both verbally and visually by
two qualified individuals.
No more than one medication is labeled at one time.
Unlabeled medications or solutions are discarded.
All original containers remain available for
reference in the perioperative area until the
conclusion of the procedure.
At shift change/break, all medications and solutions
both on and off the sterile field are reviewed by
entering and exiting personnel.
Anticoagulation Therapy
Reduce patient harm associated with
anticoagulation therapy
Goal 4 : Eliminate Wrong-site, Wrong Patient,
Wrong Procedure Surgery.
Create and use a
preoperative
verification
process such as a
checklist to confirm
that appropriate
documents are
available
Goal 4B Implement a Process to Mark the
Surgical Site and Involve the Patient in the
Marking Process
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Marking is required in
all cases involving
right/left distinction,
multiple structures or
levels of the spine.
Procedures done
through a midline
incision intended for a
right/left distinction are
subject to site marking.
“YES”
Goal 7 Reduce the Risk of Health
Care Associated Infections
Compliance with the CDC hand hygiene
guidelines will reduce the
transmission of infectious agents by
staff to patients/clients/residents,
thereby decreasing the incidence of
healthcare associated infections (HAI)
WASH IN WASH OUT
Goal 7C MDRO
Prevent healthcare–associated infections due to
multidrug-resistant organisms
• Hand Hygiene
• Infection prevention and control
• Flag charts and communicate information to staff
regarding patients known to be infected with MDRO
• Educate staff and patients on prevention
• Careful use of antimicrobials
• Clean, disinfect, and sterilize appropriately
• De-colonize persons with specific MDRO
Goal 8 Accurately and Completely Reconcile
Medications Across the Continuum of Care.
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Implement a process for
obtaining and
documenting a
complete list of the
patient/resident/client’s
current medications
upon the
patient/resident/client’s
admission/entry to the
organization and with
the involvement of the
patient/resident/client.
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A complete list of the
patient/resident/client’s
medication is
communicated to the
next provider of
service when a
patient/resident/client is
referred or transferred
to another setting,
service, practitioner, or
level of care within or
outside the
organization.
Reduce the Risk of Patient/resident/client Harm
Resulting From Falls
Implement a fall
reduction
program and
evaluate the
effectiveness of
the program
Use the Fall Risk
Assessment
Identify Safety Risks
The organization
identifies
safety risks
inherent in
its patient
population
Goal 15A:
The organization
identifies patients
at risk for suicide
Suicide Risk Assessment
“Suicide Risk Assessment”
is found :
Hospital Information Page
Forms
Nursing
Rapid Response Team
Improve recognition and responses to
changes in a patients condition:
Rapid Response Team
To implement early intervention and prevent
deaths in patients, outside of the ICU, who
are progressively failing
Rapid Response Team
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Team consists of critical care nurses,
respiratory therapists and primary care nurse.
• The rapid assessment team may be called
at any time by anyone in the hospital to
assist in the care of a patient who appears
acutely ill or who shows signs of decline.
• Team assists patient’s nurse in assessing
condition and provides support in
communicating findings to patient’s physician.
OMH Patient Safety Plan
Purpose:
To reduce risk to
patients through
an environment
that encourages:
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Recognition and
acknowledgement of
risks to patient safety
and healthcare errors
• Actions to reduce risks
• Internal reporting
• Focus on
systems/processes,
minimizing individual
blame
• Learning from errors
Reporting a Medical/Safety
Occurrence
Report the
occurrence to the
charge nurse and
complete an
Occurrence Form
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Examples:
Medication error
Patient fall
Needle stick
Treatment error
Reporting an Employee Incidence
If something
happens to an
employee,
they use an
Employee
Incident Form
Variance Report
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This form is used to report near misses,
safety concerns, and quality concerns
It can be submitted anonymously
Variance Report
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What is a near miss?
Any unintended provision of care which
could have constituted a medical
occurrence but was intercepted before it
actually reached the patient
By reporting near misses we can help
avoid errors from occurring
C.U.S.P.
Comprehensive Unit Safety Program
“Tapping The Wisdom of The Frontline”
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Create and maintain a culture of safety
and quality throughout the campus.
98,000 patients are harmed each year
because of medical errors caused by
healthcare defects.
Corporate Compliance
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The purpose of a Corporate Compliance Plan
is to prevent, detect and/or respond to
violations of statutes and regulations dealing
with such things as fraud and abuse
Corporate Compliance
Suspected corporate compliance violations are
to be reported via the Corporate
Compliance Hotline at x 17720 or by
completing a Compliance Violation Report
You Are Valuable to OMH
and Our Patients
Your knowledge and
compliance is vital
to our patients
safety:
– Hospital policies
and procedures
– National Patient
Safety Goals
– Reporting
occurrences and
concerns
Reporting a Concern
Please contact the Patient Safety and
Corporate Compliance Officer,
Bonnie Byram
at 731-7703
Employees also have the choice of reporting
safety or quality concerns to the
Joint Commission at (630) 792-5636 or
[email protected]
Performance Improvement
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Otsego Memorial Hospital is committed
to providing quality care to the patients
we serve. The Performance
Improvement Plan outlines the
systematic approach the organization
takes towards continuous quality
improvement.
Plan
Do
Check
Act
Professional Work
Environment
• Professional Work Environment
• Everyone has the right to be treated with
dignity and respect
• Prohibited Conduct
• Sexual Harassment
• Hostile Work Environment
• Report to CEO or HR Director
Professional Work
Environment
Prohibited Conduct
• Crude or offensive language, sounds,
innuendoes or jokes, whether
communicated verbally, by electronic
mail or otherwise relating to race,
color, religion, national origin, sex,
age, height, weight, marital status,
disability or other protected
classification;
Professional Work
Environment
Prohibited Conduct
• The display of sexually suggestive or
otherwise offensive objects, pictures,
letters, gestures, or graffiti relating to
race, color, religion, national origin,
sex, age, height, weight, marital
status, disability or other protected
classification;
Professional Work
Environment
Prohibited Conduct
• Unwanted sexual advances, including
offensive touching, pinching, brushing
the body, or impeding or blocking
movement.
Environmental Safety
Awareness
Any time an emergency alarm or “Code” is
paged, plan to remain with the patients until
instructed otherwise by hospital staff.
Should evacuation become necessary, you
will be instructed in specific actions to ensure
personal safety of the patient and yourself.
OMH Codes
To announce an emergency an overhead
paging system is in place:
• Dial 477
• Speak Slowly, Loudly & Clearly
• Room numbers posted in each room
OMH Codes
Code Red = Fire
– OMH Code Red Policy
– Doors are numbered and lettered for Fire
Department
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H – hospital
M – McReynolds
P - PMB
OMH Codes
Code Red
• Return to your work area, if safe
• Do not use elevators
• Feel doors, do not open if hot
• Close all doors & windows
• Clear corridors and exits
• Assign staff to answer phones
OMH Codes
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Code Red
Response
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Fire Extinguisher
use
– R = Remove persons
– P = Pull the pin
from area
– A = Activate fire
alarm
– C = Contain fire and
smoke
– E = Extinguish fire or
evacuate
– A = Aim toward the
base of the fire
– S = Squeeze the
handle
– S = Sweep the base
of the fire
OMH Codes
Code Blue
– Cardiac Arrest
– Near Arrest
• Activation
• Code Blue Buttons
• Page Overhead 477
• Signs near patient beds
• Response
– BLS - ALS (on arrival of
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cart)
ICU Nurse
Respiratory Therapist
ED Nurse
Physicians
OMH Codes
Code Yellow
• Bomb or Bomb Threat
• If receiving the call….
• Page Code Yellow & Location
• Check area for packages, report anything
suspicious, but do not touch!
• Incident Commander will determine the
need for evacuation
OMH Codes
Code Grey
• Security Situation/Potential for violence
• Page overhead 3 times with location
• Code Grey “Assist”
• Code Grey “911”
• All available personnel go to area
• Show of force
• When to call for help …. Signs of agitation
OMH Codes
Code Pink
• Missing Person/Possible Abduction
• Page Code Pink, Gender, Age,
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Department
Observe exits and parking lots
Search your department
Observe and be able to describe all
persons
Do not attempt to detain persons
OMH Codes
Code Silver
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If you are confronted
by an individual with
a weapon OR
• If you observe a
hostage situation on
Hospital property
Initiating Code Silver Plan
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Seek cover and discretely warn others (close
by) of the situation
• Dial “12345”- Report the location, number of
suspects/hostages, type of weapons
• Operator will dial 911
• Operator will page “Code Silver”+ location 3
times
Workplace Violence
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Healthcare and social service workers
face an increased risk of work-related
assaults
If threat is imminent, call Code Grey
Assist or Code Grey 911
Workplace Violence
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OMH has “Zero Tolerance” towards all
expressions of violence.
Individuals who commit such acts may
be removed from the premises and may
be subject to criminal penalties.
OMH Codes
Code Triage
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Shift Coordinator in area or department
impacted will declare “Code Triage”
Any event that impacts or has high potential
to impact normal operations of the facility
Code Triage Internal
Code Triage Standby
Code Triage External
OMH Codes
Code Triage Responsibilities
• Return to department
• Phones for disaster business only
• Management will implement HICS
• Hospital Wide Disaster Plan
• Department-Specific Plan
OMH Codes
Severe Weather
• Emergency Department has weather alert
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radio
ED also notified by MI State Police Dispatch
ED Shift Coordinator will announce warnings
overhead
Return to your department
Non-clinical employees go to basement
Prepare for evacuation if ordered
Hospital Incident Command System
(HICS)
• Chain of command for decision and
communication
• Semi-defined roles
• All staff respond to only one individual
(upward)
• All supervisors manage 5-7 people
(in command structure)
• HICS implemented in all codes
– Your manager may have additional responsibilities
Infant Abandonment
Michigan law states that a parent or adult
can surrender a newborn up to 72
hours old
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We must accept the newborn
• Call Birthing Center
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Do not press for information
HIPAA
The HIPAA Privacy Rule protects a patient’s
fundamental right to privacy and
confidentiality
• ANY information obtained about another
person’s medical condition is treated as
confidential and is not to be discussed or
revealed to unauthorized persons
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HIPAA
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Protected Health Information is
anything that connects a patient to his
or her health information: Date of Birth,
SS#, diagnosis, address, etc.
HIPAA
HIPAA’s focus is on the rights of the patient and
the confidentiality of their information.
Patients have the right to:
• Request an amendment of their medical record
• Request to inspect and copy their record
• Restrict what information is shared
• Receive confidential communication
• Complain about a disclosure of their information
Ethics Committee
OMH has an Ethics Committee that consists of
a diverse group of members including:
• Providers
• Licensed professionals
• Frontline staff
• Community members
• Any staff member can make a referral to the
Ethics Committee
Appropriate Ethics Referrals
A staff member’s
belief system is in
conflict with a
patient’s treatment
plan.
• A family/patient is in
conflict with the
proposed treatment.
• Resource allocation
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Revising/updating
policies/practices
with ethical
implications.
• Offering support for
clinical or medical
issues with ethical
implications.
Medical Record
Documentation
The purpose of medical record documentation
includes:
•To record complete and accurate clinical information
•To communicate with other members of the healthcare team
•To comply with legal, regulatory and accreditation requirements
•To ensure adequate reimbursement
Documentation that has missing information (time,date),
misspelled words, unapproved abbreviations and policy
variances (R.A.W.) could be interpreted as an indication of
substandard care
Impaired Health Professional
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If someone comes to work and seems
unable to do their job due to impairment
because of alcohol, drug use or mental
illness-we must report it immediately to
the Administrator-on-call.
The call schedule is in the Hospital
Information folder.
Environment of Care
We have 7 plans in place to assure the safety of our
patients and our staff:
Plan 1: Biomedical Equipment Management
Plan 2: Life safety Management
Plan 3: Hazardous Material and Waste
Management
Plan 4: Utility systems Management
Plan 5: Security Management
Plan 6: Safety Management
Chemical Hazards
“Right To Know”
Employees have the right to know how to keep themselves safe on
the job
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MSDS-material safety data sheets available online
(Web link in the Hospital Information)
• Use of eyewash station-flush for 15 minutes with
COLD water
• Know where eye wash stations are located. Eye
wash stations are checked daily
MRI Safety
(Magnetic Resonance Imaging)
MRI Safety
(Magnetic Resonance Imaging)
• All employees need orientation in magnet safety
• Large metal objects of any kind shall not be
permitted in the scan room until they are checked for
ferromagnetism. Magnetic items should be kept out
of the room at all times
• All items will be tested with a hand held magnet and
found not to be attracted to the magnet before being
permitted in the Magnet/Scan Room
• Do not enter room for Code Blue-patient will be
brought out to the hallway!
• Hearing protection required for patients
Ergonomics and Back Safety
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Our goal is to use this science of ergonomics
to reduce work-related Musculoskeletal
disorders (MSD’s)
• Everyone, not only those involved in direct
patient care, needs to have training in proper
body mechanics and lifting
Safe Lifting
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Use your strong leg muscles
Keep objects close
Tighten abdominal muscles
Bend knees and squat
Use proper lift equipment
Ask for help when needed
Keep head and shoulders up (keeps spine
curves in alignment)
Comfort and Care
at the End of Life
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Managing symptoms is the goal
• Even if patients are not responsive,
always explain care/treatment
• Respect personal choices and values
Organ and Tissue Donation
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Gift of Life-we do participate!
Organ procurement done in OR
Tissues procurement can be done at
hospital or funeral home
Hospital required to call all imminent
deaths to Transplantation Society of
Michigan
Cultural Competence
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Treat every patient as an individual
Communicate respect
Language issues-seek translation if
needed
Be aware of non-verbal communication
Questions
•
Any questions about this information
can be directed to the HR Department,
instructor or your department director.
The End
Welcome