Patient Safety Goals Unchanged—But Still Crucial
Posted On: December 27th, 2016
Clinical Product Manager, Change Healthcare
The Joint Commission’s National Patient Safety Goals in home health for 2017 remain the same as in the past couple of years, an indicator of their continued importance. These commonsense goals go a long way toward making patients’ lives better, improving outcomes and increasing positive perceptions of the care delivered.
The Joint Commission develops overall goals then breaks those down into eight disciplines, which is why numbering is not sequential. Many goals cut across many, if not all, of the disciplines. All home health goals, for example, are included in the hospital goals in some way, except for the provision about reducing patient fall risk. Let’s take a look at each one of the five goals:
Goal 1: Improve the accuracy of patient identification. The goal specifies using “at least two patient identifiers when providing care, treatment, or services.” (NPSG.01.01.01) In a home health setting, patient identifiers aren’t as important as in, say, an emergency department. But using two identifiers before initiating a treatment plan, providing therapy or giving medications will help reduce errors. Confirmation of home address can be one identifier, as can personal recognition after a time. However, a little more formality is preferred over making mistakes.
Goal 3: Improve the safety of using medications. “Maintain and communicate accurate patient medication information” (NPSG.03.06.01) denotes that an ongoing conversation about medication should continue to take place between patient and caregiver(s). With a higher incident of people living with one or more comorbidities—possibly combined with a hospital stay—means that medications are in flux for many patients. Be sure to communicate the importance of listing all medications taken (including over-the-counter medications) and communicating that to all caregivers as well as family. Use of clinical management software that includes medication reconciliation can help staff ensure medication lists are up to date.
Goal 7: Reduce the risk of health care–associated infections. The guideline (NPSG.07.01.01) specifically mentions hand hygiene, but home health workers who assist with patient bathing also should be trained to deal with surgical sites, catheters of all types and wounds. Since hospitals can be penalized for readmissions, proper hand hygiene and bathing techniques can help keep patients at home.
Goal 9: Reduce the risk of patient harm resulting from falls. Home health is ideally positioned on the front lines of this goal (NPSG.09.02.01) because of where care is delivered. The rationale for the goal suggests that an initial evaluation “could include a patient’s fall history; review of medications and alcohol consumption; gait and balance screening; assessment of walking aids, assistive technologies, and protective devices; and environmental assessments.” Patient and family education is important to underscore the need for whatever remediation or lifestyle modification might be required. But evaluation of fall risk is an ongoing process. With each visit, home health workers should be aware of any situations (new rugs, broken walker or cane, etc.) that may have changed that could harm patients.
Goal 15: The organization identifies safety risks inherent in its patient population. This goal (NPSG.15.02.01) zeroes in on the risk of using portable oxygen in the home. The biggest risk is among smokers, but other sources of open flame (candles, gas appliances) also should be evaluated and brought to the attention of patients and their families. Initial and ongoing documentation is important to this goal, to evaluate the situation at the onset and at organization-prescribed intervals, educating patients/families, assessing their comprehension and reporting any unsafe practices.
Especially during initial home visits, one more assessment or piece of documentation may seem like overkill. But the Joint Commission goals are important steps that home health organization should take to safeguard patients.