Beebe focuses on patient safety

At Beebe Medical Center, safety posters in patient rooms, walkways and surgery centers aim to improve patient safety during hospital stays.

An independent hospital ratings group recently recognized Beebe for its safety protocol. The Leapfrog Group Hospital Safety Score program grades hospitals on overall performance in keeping patients safe from preventable harm and medical errors.

Beebe spokeswoman Susan Towers, said Beebe received the top “A” rating.

In a statement, a spokesman for The Leapfrog Group said, “Approximately 400 people die every day because of hospital errors – the equivalent of a jet crashing every day and killing all aboard. In response to this silent epidemic, more than 2,600 U.S. hospitals will now receive an A, B, C, D or F Hospital Safety Score based on patient safety via a first-of-its-kind initiative.”

To find the hospital safety score, a panel of university officials used 26 measures of publicly available hospital safety data to determine a hospital’s ability to keep patients safe from infections, injuries, and medical and medication errors.

Of the 2,652 general hospitals issued a Hospital Safety Score, 729, or more than one in four, earned an A, 679 earned a B, and 1,243 earned a C or below.

Safety starts from the ground up, said Ellen Tolbert, director of Beebe patient relations. She said Beebe has started including safety questions about accidents and hand-washing techniques to its patient satisfaction surveys. Over the past two years, the surveys found lapses in safety procedures, which have been since corrected by hospital personnel.

“We were one of the first hospitals to put safety questions on the survey,” Tolbert said.

At Beebe, whole-hospital efforts have been made to make sure these mistakes are limited.

Nurses now visit patients on an hourly basis to make sure each patient is comfortable and positioned correctly, as well as to assess their pain levels and assist with bathroom needs, Tolbert said. These checks reduce accidents because patients are assisted to the bathroom, she said.

“Since we’ve done this, patient satisfaction has skyrocketed,” she said.

Handwashing is one way Beebe tries to reduce the spread of germs, which can lead to longer hospital stays. By keeping patients healthy and happy, they are moving them more quickly to recovery, lowering the cost of hospital stays.

Theresa Houston, infection control specialist, said the handwashing stations used to be located outside rooms, but hospital staff found patients were concerned medical personnel weren’t washing. In the past year, Beebe has installed handwashing stations in halls, as well as in all patient rooms to encourage more regular washing.

“We do a lot of hand-hygiene observation, as well as secret shoppers who are looking at handwashing and team members who watch out as well,” Houston said. Each visit to the patient's room is scripted, requiring every nurse and doctor to first wash his or her hands, and talk about hand hygiene.

The newest initiative, started more than three months ago, allows patients to participate in promoting hygiene. Beebe hands out cards for patients to fill out, recording what they saw related to handwashing.

“We have had lots of positive feedback,” Houston said. “In our first three months, more than 90 percent of the feedback has been positive.”

Scott Olewiler, infectious disease specialist at Beebe, said it's not just observation, it’s also perceptions of what hygiene achieves.

“We have alcohol dispensers in all the rooms so patients can see doctors and nurses washing their hands,” Olewiler said. “But we also encourage patients and visitors to wash as well.”

Prescribing medicine

Beebe received high marks on prescription dispensing, primarily because the hospital installed a computerized system.

Beebe Pharmacy Director Sam Roberts said Beebe was one of the first hospitals of its size use a computerized arm for prescription dispensing.

“The robotic system eliminates personnel error,” Roberts said. “There are more than 2,500 items in the pharmacy, so the robot prevents errors.”

The computer keeps track of dispensing and expiration dates. A new program at Beebe also does bedside scanning.

Before dispensing any medication to a patient, the nurse scans a barcode on the patient’s wristband to make sure it is the proper time and dose. Once the computer verifies the information, the nurse dispenses the medicine.

“We now use safety tracking tools through the national database; we found with this new process we prevent between 400 and 500 errors a year,” Roberts said.

“That’s the great part about investing in these new technologies,” he said.

Surgical safety

According to National Healthcare Safety Network’s 2009 report, most surgical procedures carry less than a 1 percent risk of surgical-site infection. The network emphasizes having checklists to ensure all precautions are taken.

Beebe's average surgical infection rate is less than 1 percent, a rate considered low by the Centers for Disease Control. Beebe has maintained this rate since 2009.

At Beebe, surgical teams have white boards with checklists or posters with checklists in all surgery rooms, said Marcy Jack, risk-management specialist.

The first checklist includes routine patient data that must be confirmed before any procedure, including patient name, procedure planned, area marked with indelible ink, allergies, risk of blood loss and whether the patient has a difficult airway.

Once in the operating room, a new checklist is in play, which requires all team members to introduce themselves by name and role, followed by a second confirmation of the patient and planned procedure. Prior to being given anesthesia, the patient is asked about any concerns. All questions are answered, and the surgery begins.

The final surgical checklist requires personnel to count the equipment to make sure it is all accounted for, then record the name of the procedure and any concerns about the patient's recovery.

Beebe's risk management team is constantly working to improve safety within the hospital, said Jack.

“We live in a culture of safety where everyone works together,” she said.

It was more than a year ago that Beebe started using checklists in surgery rooms, said Wendy Scott, the operating room nurse manager.

“I think it’s working really well because it gets all parties involved in the process. Before the anesthesia is given, the surgeon talks to the patient, so that the patient can participate,” which reduces the chance of mistakes, Scott said.

For more information on Beebe’s hospital safety score, go to http://hospitalsafetyscore.org/hospital-details.html?location_id=471#