Safety Issues Relating to Healthcare Facilities

Healthcare facilities are governed under stringent safety protocols, most of which are related to the prevention of infections or accidental injury to patients. The unique nature of the industry allows for convenient benchmarking of each facility's relative performance on a handful of safety issues. Many patients who need an elective procedure performed refer to industry websites for information about each facility's safety scores.

Infections

• Hospital-acquired (nosocomial) infections can kill. According to the Centers for Disease Control, "if we assume a nosocomial infection rate of 5 percent, of which 10 percent are bloodstream infections, and an attributable mortality rate of 15 percent, bloodstream infections would represent the eighth-leading cause of death in the United States."

  Most healthcare facilities practice "universal precautions," which include rigorous hand washing after every patient encounter and the use of protective gloves and masks when dealing with biological material. Many facilities submit data to watchdogs like The Leapfrog Group, which then share information with the general public about how a facility compares against best-practice standards and competitors within the community. For infection control, Leapfrog mixes 17 individual measures under a broad standard of "steps to prevent harm."

Medication Administration

• According to the Food and Drug Administration, patient injury and even death can result from medication errors. Common errors include physicians lacking critical patient information including allergies, improper dosing, unclear drug labeling and poor handwriting or other communication challenges. Many facilities are attempting to improve patient safety by eliminating unclear abbreviations and moving to computer-assisted order entry to dispense entirely with handwritten prescriptions.

Positive Patient Identification

• Doctors and nurses see a lot of patients--too many to remember their names accurately. Most facilities have implemented a patient-wristbanding strategy to allow for the positive identification of a patient. Before any drugs are administered or tests performed, the clinical professional should verify the patient's identity against the written medical order before proceeding. Careless patient identification has led to the wrong patient receiving powerful drugs or even having improper surgeries.

Surgery Safety

• Careless surgery errors often grab headlines, and for good reason. There is no reason for a highly trained surgeon to amputate the wrong limb or leave a forceps inside the abdominal cavity. To promote surgery safety, hospitals and ambulatory surgery centers use detailed checklists that include presurgical marking of body parts and the counting of surgical instruments both before and after the procedure.

  The Joint Commission on the Accreditation of Healthcare Organizations recommends that patients speak with with their surgeons to discuss and mark affected body parts and to clearly discuss expectations for what will happen during and after the surgery.

Environment of Care

• The Joint Commission sets comprehensive standards for safety and cleanliness that fall under the general heading of "environment of care." Environmental issues include preventing slip-and-fall accidents, protecting patient privacy, reducing fire hazards, locking medication cabinets and reducing clutter in common areas.

  A savvy patient should keep an eye on a facility's environment of care: Is a dirty facility with gurneys in hallways and stained floors really more likely than a clean facility to practice hand washing and ensure positive identification? The devil is often in the details, and the Environment of Care standards attempts to set a high standard across the board by ensuring that the entire facility is in proper order, even down to the cleanliness of the linoleum.