Joining forces to promote patient safety

A culture of safety continues to take shape at Ross Memorial Hospital in Lindsay, Ontario. A circular shape, to be exact.

In 2009, the hospital adopted a multi-dimensional initiative to raise awareness and knowledge of both patient and staff safety. It involved three teams, Quality and Patient Safety, Infection Prevention and Control, and Occupational Health and Safety, joining forces to show that patient and staff safety are everyone’s responsibility and are of equal importance.

Together, the teams formed the ‘Circle of Safety.’

New ‘Circle of Safety’ boards were erected in six high-traffic locations in the hospital, for easy viewing by patients, visitors, staff, physicians and volunteers. Each team is featured, with themed posters showing clear safety messages which are changed regularly.

For example, in the Infection Prevention and Control section, six 8.5 x 11 displays use cartoons and clip art to highlight West Nile Virus:  How it is transmitted and how to avoid it, who is most at risk, what are the symptoms, and where West Nile positive mosquito populations have been identified to date.

Beside that information, in the Quality & Patient Safety section, the new sepsis education is featured, as well as the hospital’s hand hygiene compliance rates and inspirational quotes.

The Occupational Health and Safety section provides safe patient handling tips, a summary of the hospital’s workplace violence and harassment prevention policy, and the names and contact information for members of the Health and Safety committee.

Below the displays, a row of mounted sleeves hold binders containing the manuals, policies, and MSDS (Material Safety Data Sheets) lists that used to be located in dozens of binders on desks, shelves and in cupboards throughout the hospital.

The new system not only makes the information easy to locate, it’s also easier to update.

The combined safety messages made for interesting themes in a ‘Circle of Safety’ calendar, developed for 2012. For each month, a staff member was photographed, using safe work practices, such as using transfer belts, wearing gloves when using cleaning products, and using lift equipment to move heavy loads.

The ‘Circle of Safety’ approach is explained to new staff and volunteers during orientation and is emphasized annually in October.

Instead of recognizing Infection Prevention and Control week, Patient Safety week and Occupational Health and Safety weeks throughout the year, the Circle of Safety team focuses their efforts on patient, staff and public education initiatives that stretch over three weeks.

This year, the team is inviting the local media to learn how to don the appropriate personal protective equipment in order to enter a hospital room where a mock patient is under isolation precautions. While they’re in the room, they’ll be asked to comply with the four moments of hand hygiene, and recognize how many surfaces they touch while they’re there.

This exercise will provide a new angle for reporters to encourage coverage in the local news. The team will stress its safety message, and hopefully, dispel any myths regarding the isolation of patients and the stigma it often creates.

These messages will be repeated in the hospital’s report to the community, which is also published in October.

Patients will be reminded of the importance of their safety and the risks that exist within a hospital environment, using placemats on their food trays. Inpatients’ lunches will arrive with simple safety reminders involving the risk of falls, medication errors and hospital acquired infections.

Staff will be encouraged to tap into their knowledge of hospital safeguards with an interactive game that will be played with cues delivered through the weekly newsletter.

Employees will read the questions in the ‘Monday Report’ and on the ‘Pathway to Safety’ game board, displayed in the cafeteria, for example, “A process for assessing patients’ home medications against admission and discharge medication orders in a goal to ensure patients are taking correct and appropriate doses of medications.” They’ll print their answers on a game card, “What is medication reconciliation?”, and submit them using a drop box in the cafeteria, for a chance to win a prize.

There will be further internal focus on a new initiative to audit environmental cleaning practices with the use of glow gel on high-touch surfaces. Following a monthly schedule, a team of auditors will be randomly placing glow gel fingerprints in patient rooms throughout the hospital, returning the next day to check if these surfaces have been wiped clean.  Auditors will know that cleaning has taken place when they use a UV black light to see if the fingerprint dots remain on the surfaces, or have been wiped clean.

On-the-spot feedback is provided to the staff that has been responsible for the cleaning. This initiative is intended to enhance staff awareness of high-touch surfaces needing daily cleaning in patients’ environments. This initiative began at RMH in July 2012, with a goal to improve by 10 per cent by fiscal year end. The team will share the audit results with staff on a quarterly basis.

By focusing their time and talent in a concerted effort to raise safety awareness, the Circle of Safety team has enhanced the understanding of the links between patient and staff safety at RMH, and is ensuring that everyone knows they all play a role.