Before you start taking care of a patient, follow these important steps. Doing them each time helps you remember and makes them a habit, ensuring both you and your patient are safe and comfortable.
1. Wash Your Hands:
Washing your hands helps stop the spread of germs and keeps everyone healthy. Many illnesses spread if hands are not washed properly. Always wash your hands before you start taking care of a patient.
How to Wash Your Hands:
Soap and Water: If you have soap and water, scrub your hands with soap for at least 20 seconds. Make sure to wash all parts of your hands, including between your fingers and under your nails.
Rinse: Rinse your hands with clean, running water.
Hand Sanitizer: If soap and water are not available, use hand sanitizer with at least 60% alcohol. Rub it all over your hands until they are dry.
Tip: You might need to wash your hands more than once during patient care. Always wash before starting any new task.
2. Explain the Procedure to the Patient and Family
Tell the patient and their family what you are going to do. This helps them feel less worried and more willing to help.
How to Communicate:
Speak Slowly: Use simple words that are easy to understand.
Speak Clearly: Make sure your words are clear and easy to hear.
Eye Contact: Look at the person you are talking to. This helps build trust and ensures they are listening.
Tip: Talking calmly and clearly can help reduce anxiety and make the procedure go more smoothly.
3. Give the Patient Privacy
Make sure the patient feels comfortable and respected by giving them privacy during care.
How to Provide Privacy:
Close Curtains or Doors: Use curtains or doors to create a private space.
Cover the Patient: Use sheets or blankets to cover the patient as needed.
Tip: Privacy helps the patient feel more at ease and respected during care.
4. Keep the Patient Safe
Ensure the patient is safe throughout the care process.
Safety Measures for Patients
Adjustable Bed: If the patient is in a bed that can move, lower the bed to the lowest position and lock the wheels to prevent movement.
Wheelchair: If the patient is in a wheelchair, lock the wheels to keep the chair stable.
Tip: Regularly check that the bed and wheelchair are in the correct position and locked properly.
5. Think About Your Safety
Your safety is also important. Proper positioning and adjustments help prevent injury.
Safety Tips for Caregivers:
Adjustable Bed: Adjust the bed to a height that is comfortable for you to avoid bending or reaching awkwardly.
Proper positioning: Make sure you are in a good position to avoid straining your back or hurting yourself. Use proper lifting techniques.
Tip: If the bed or chair needs to be adjusted, do so before starting the procedure to make it easier and safer for you.
Additional Tips
Routine Checks: Regularly review these steps to ensure you are following them correctly.
Ask for Help: If you are unsure about any procedure or need assistance, ask a supervisor or colleague.
It’s important to follow these steps after you finish taking care of a patient. Doing these steps every time helps you remember them and makes them a habit. This helps keep both you and your patients safe and healthy.
1. Lower the Patient’s Bed
If you raised the bed to take care of the patient, be sure to lower it back down to its lowest position. This helps prevent falls and keeps the patient safe.
Tip: Always check that the bed is locked in place after lowering it.
2. Wash Your Hands
Washing your hands stops the spread of germs and helps keep everyone healthy. Always wash your hands after finishing any patient care.
How to Wash Your Hands:
Soap and Water: Scrub your hands with soap for at least 20 seconds. Make sure to wash all parts of your hands, including between your fingers and under your nails.
Rinse: Rinse your hands with clean, running water.
Hand Sanitizer: If soap and water aren’t available, use hand sanitizer with at least 60% alcohol. Rub it all over your hands until they are dry.
3. Write Down What You Did
Take notes about the care you provided, how the patient is doing, and any important information about the family or caregiver. Writing down what you did helps ensure the patient gets the best care.
Why It’s Important:
Communication: Your notes help the healthcare team understand the patient’s condition and decide if any changes are needed in their care.
Quality of Care: Detailed notes ensure the patient receives consistent and high-quality care.
Legal Requirement: Accurate documentation is required by law. If you don’t record what you did, it’s as if the care never happened.
How to Document:
Be Detailed: Write clearly about the care provided and any changes in the patient’s condition.
Include Quotes: If the patient or family member says something important, use quotation marks to note their exact words.
Additional Tips:
Double-Check: Before leaving, make sure the bed is in the correct position and locked, and confirm that all documentation is complete.
Consistency: Make these steps a routine part of your care process to ensure nothing is missed.
Creating and using benchmarks to compare your company’s hiring demographics against those used by government agencies like the EEOC (Equal Employment Opportunity Commission) is crucial. Benchmarking helps ensure that your company’s hiring practices are fair and compliant with federal regulations. Here’s are some considerations to keep in mind when you consider the right benchmarks
Why Benchmarking Matters
Government agencies monitor and require companies to report on the demographic composition of their workforce, especially larger companies. For instance, the EEOC uses benchmarks to compare a company’s demographics against broader population data from sources like the U.S. Census and the American Community Survey. Knowing how your company’s demographics stack up against these benchmarks is essential for several reasons:
Diversity Goals: Meeting your company’s diversity and inclusion goals.
Fair Hiring Practices: Ensuring fair and unbiased hiring practices.
Best Practices for Benchmarking
Collect Internal Data: Gather detailed demographic data of your current workforce and applicants.
Ensure you track data on race, gender, age, and other relevant demographics.
Choose the Right External Data: Depending on your hiring scope, use national, regional, or local data. For example, if you recruit nationwide, use national benchmarks. For local hires, consider regional data.
Occupation and Industry-Specific Data: Align your benchmarks with the specific occupations and industries relevant to your company. Different industries and roles may have distinct demographic compositions.
Adjust for Educational Requirements: Consider the educational requirements for the roles you are hiring. This will help you compare your applicant pool against the qualified population.
Use Census Data: The U.S. Census Bureau provides comprehensive data that can be segmented by occupation, geography, and other factors. This data is a good starting point for creating your benchmarks.
Ensuring Fair Selection
To avoid over- or under-selecting any protected group, follow these steps:
Regularly Update Benchmarks: Demographic data changes over time. Ensure your benchmarks are based on the most recent data.
Monitor Hiring Practices: Continuously monitor your hiring practices and outcomes against your benchmarks.
Training and Awareness: Educate hiring managers on the importance of diversity and compliance with hiring practices.
External Data Sources
Looking at external data sources is important because it provides a broader context for your internal data. It helps you understand the labor market and demographic trends in your industry and location. External benchmarks serve as a snapshot of the current workforce composition, which can change over time.
Creating effective benchmarks involves a blend of using accurate external data and understanding your company’s unique needs. By comparing your company’s demographics against reliable benchmarks, you can ensure fair and compliant hiring practices. Regularly updating these benchmarks and educating your hiring team on best practices will help maintain a diverse and inclusive workforce.
Where Can You Find Additional Information?
Of Significance: Don’t Miss the Mark! Podcast on what to keep in mind when creating benchmarks
Harvard Business Review: Smart benchmarking starts with knowing whom to compare yourself to
The podcasts cover a wide range of interesting and timely topics such as leadership, workplace violence, revenue capture, AI, use of technology, and how to best work with healthcare consultants.
Plan to listen while you are driving to patient visits!
Check back often to see what new podcasts have been released.
Root Cause Analysis (RCA) is a systematic and structured process used to identify the root causes that results in an undesirable outcome or adverse event and to develop corrective actions. The goal of RCA is not just to treat the symptoms of a problem but to delve into the underlying causes of the failure. By understanding these causes, a hospice agency can develop strategies to mitigate risks and implement corrective actions to prevent future occurrences. This approach to addressing adverse events will lead to improved patient safety and enhanced quality of care. Further, by promoting a culture of safety, RCA fosters a culture of transparency, accountability, and continuous improvement in the hospice agency.
When is root cause analysis used
A hospice agency can use root cause analysis to investigate any unexpected occurrences such as hospice acquired pressure ulcers, medication errors, or process variations where recurrence could result in serious adverse outcomes. Candidates for RCA may be identified via patient satisfaction surveys, incident reports, surveys, or other reports and audit activities. A root cause analysis focuses on systems and processes, rather than individuals in the agency. The objective of the RCA is to reduce the risk of recurrence by identifying opportunities to improve or redesign systems or processes. By implementing system changes, this will lead to sustained system improvement.
Elements of root cause analysis
A comprehensive root cause analysis includes the following elements:
Problem identification: Identify the adverse event to be investigated and gather preliminary information. Events and issues can come from many sources such as patients and their families, staff, or regulatory bodies. The agency should have a process for deciding what events are selected for RCA.
Define the event: Clearly describe the adverse event, error, or near miss. Include specifics such as what happened, where, when, and who was involved.
Gather initial data: Collect all relevant information about the event including incident reports, patient records, and witness statements.
Assemble RCA team: Select the members of the RCA team and the team facilitator. Team members should be knowledgeable about the processes and systems that they will be investigating.
Multidisciplinary team: Form a team that includes individuals with diverse expertise and perspectives. This may include clinicians, administrators, and support staff.
Assign roles and responsibilities: Clearly define the roles and responsibilities of each team member to ensure an organized and effective RCA process.
Data collection and investigation: Collect and organize the facts about the adverse event that will be investigated.
Detailed event timeline: Create a detailed timeline of events leading up to, during, and after the incident. This helps in understanding the sequence of events.
Conduct interviews: Interview staff involved in the event to gain insights into what happened and why. Ensure a non-punitive approach to encourage open and honest communication. Review documentation: Examine all relevant documentation including patient records, policy and procedure manuals, and any relevant logs.
Identify contributing factors and root causes: Identify the situation, circumstances, or conditions that increased the likelihood of the adverse event. Conduct a thorough analysis of contributing factors that lead to identification of underlying process and system issues.
Cause and effect analysis: Use tools such as fishbone diagrams (Ishikawa) or flow charts to map out the possible causes and identify the root causes. Five whys technique: Ask “why” repeatedly (usually five times) to drill down to the underlying root cause(s) of the problem.
Develop action plan: Develop plan for best changing the processes and systems to reduce the likelihood of another similar event. Design and implement changes to eliminate the root causes. This may involve creating new processes.
Corrective actions: Develop specific, measurable, achievable, relevant, and timebound (SMART) corrective actions to address the root causes.
Assign responsibility: Assign responsibility for implementing each corrective action to specific individuals or teams. Timeline: Establish a timeline for the implementation of each corrective action
Implementation and Monitoring: Implement the plan and evaluate its performance. Create mechanisms to gather data that can be used to measure the success of changes that were introduced.
Implement changes: Put the corrective actions into practice. Ensure that staff are trained and aware of changes to procedures or policies. Monitor effectiveness: Continuously monitor the effectiveness of the corrective actions. This may involve regular audits, follow up assessments, and a feedback mechanism.
Documentation and Reporting: Create documentation of the RCA process including all findings, root causes, and corrective actions taken. Share findings with stakeholders, promoting a culture of transparency.
Detailed Reports: Document the entire RCA process, including findings, root causes, corrective actions, and implementation outcomes.
Communicate findings: Share the RCA findings and action plans with all stakeholders including staff, patients, and regulatory bodies.
Continuous improvement: Review the RCA process on a periodic basis to identify any necessary modifications or areas that could benefit from improvement. Continuous improvement ensures that the agency promotes a culture of growth and continuous learning.
Review and revise: periodically review the RCA process and outcomes to ensure sustained improvements. Revise strategies as necessary based on new data and feedback.
Promote a learning culture: Foster an environment where continuous learning and improvement are encouraged and staff feel empowered to report issues and participate in problem solving.
Root cause analysis is a vital tool in hospice care for understanding and addressing the underlying causes of adverse events and errors. By systematically identifying and correcting these root causes, hospice agencies can significantly enhance patient safety, improve quality of care, and promote a culture of continuous improvement. A well-executed RCA resolves the immediate issue and provides valuable insights to prevent future occurrences, thereby ensuring better outcomes for patients and their families.
