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Our Commitment to Patient Safety

The University of Wisconsin Hospital and Clinics vision is to be the safest hospital in the country. For many years we have made the safety of our patients a top priority and have been at the forefront of a number of patient safety initiatives.

 

Medication Safety

 barcode technology

On the national level, it's estimated that 19% of medications administered in U.S. hospitals are administered in error, and approximately 2% of patients admitted to U.S. hospitals experience a harmful medication error (a preventable adverse drug event).*

 

Medication use in hospitals and health systems is highly complex and often involves many distinct steps - each of which offers possibilities for error and patient harm.

 

A medication error is "any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the health care professional, patient, or consumer," according to the National Coordinating Council for Medication Error Reporting and Prevention.

 

To reduce the opportunity for medication errors to occur at UW Hospital and Clinics, we have pioneered several medication safety initiatives:

  • In 1993, UW Hospital and Clinics was the second hospital in the country to implement a robotic barcode medication dispensing technology to help eliminate medication errors than can harm patients.

     

  • Soon afterward, the hospital added AcuDose medication storage units on the inpatient units, creating another level of monitoring. The AcuDose-Rx medication dispensing cabinets provide decentralized but highly secure medication access for nurses. They also speed restocking and improve inventory tracking: When a medication falls below a specified level, the cabinet automatically notifies the pharmacy to restock.

     

  • In 2001, UW Hospital and Clinics was one of the first hospitals to implement a barcode scanning system used at the patient's bedside. The handheld wireless barcode medication scanning system uses a three-way bar code check to assure that the right medicine is being delivered in the right dosage, to the right patient, at the right time. Learn more about Medications and Bar Code Technology

     

  • In 2003, "smart" intravenous infusion pumps were implemented throughout UW Hospital and Clinics. These pumps help prevent harmful medication infusion errors, which nationally are among the most common type of medication errors. Learn more about Infusion Pump Technology

As a result of these and other medication safety initiatives, UW Hospital and Clinics now has a comprehensive system that incorporates bar codes throughout every phase of the medication use process – improving the dispensing, administering and monitoring of medication therapy. 
 
Learn More About Our Medication Safety Initiatives

Preventing Falls

 

preventing fallsPatient falls are among the most common occurrences reported in hospitals across the country. Of those patients who fall while hospitalized, as many as half of them sustain injuries that reduce their mobility and independence, according to a report by the Institute for Healthcare Improvement.

  • What We're Doing to Prevent Falls:As part of a hospital-wide effort to reduce and prevent patient injuries from falls, all patient beds are equipped with exit alarms to alert nursing staff. The alarms are part of a fall risk prevention program that includes frequent risk assessment as well as staff and patient/family education.

     

  • What You Can Do to Prevent Falls: Getting out of bed to use the bathroom is the most common precursor to a fall while in the hospital. Patients and families are encouraged to call the nurse to ask for assistance getting to the bathroom rather than trying to do so independently.

    Read more about how patients can partner with their health care team to enhance safety: Patients as Partners: Optimizing Your Care
Staying Safe: Things Patients Can Do
 
Feeling vulnerable and exposed on an exam table or in a hospital bed, it's easy for a patient to feel overwhelmed, afraid and powerless. But there are many things that you as a patient can do to empower yourself when it comes to your own health care. Learn more: Staying Safe - Things Patients Can Do
 
 

UW Health medical staff; creating a culture of safetyA Culture of Safety

 

At the University of Wisconsin Hospital and Clinics, we take seriously our pledge to our patients to provide the safest possible care.

 

In 2007 we began asking our staff and physicians to give us feedback by taking an annual Culture of Safety Survey. The results tell us how we are doing in important areas such as perception of our overall safety climate, and in the areas of teamwork and communication. We use this information to target safety improvement work.

 

In 2007, 74% of survey respondents gave UW Hospital and Clinics an Excellent or Very Good overall patient safety score. Our score compared favorably to nearly 400 other hospitals that participated in the survey.

 

One important aspect of a hospital's safety culture is the willingness of staff to inform our Patient Safety Team about ways we can improve our systems and the safety of our care. Many of our improvement initiatives result from the feedback of our dedicated health care professionals. Some recent examples include:

  • The purchase of a piece of equipment that enhances the safe placement of small-bore feeding tubes in patients, significantly reducing the possibility of misplacement of the tube and the incidence of accidental punctures of the lung.

     

  • Specimen Labeling Performance Improvement Team: An important patient safety strategy is ensuring that specimens are properly labeled with patient identifiers such as name, date of birth, medical record number and that the labels are legible.

    Proper labeling helps assure that the right test is run for the right patient. As an important safety strategy, our laboratory requires all of this information to be affixed to the specimen container and requisition slip before it will process the specimen. UW Hospital and Clinics currently has an organization-wide improvement initiative to decrease specimen labeling errors which is yielding impressive results.

     

  • MRI Safety Proactive Risk Assessment: Magnetic Resonance Imaging (MRI) uses a large magnet to scan patients for a variety of symptoms/conditions. Because of the enormous power of the magnet used during this diagnostic test, a metal object can be rapidly pulled toward the scanner and potentially injure staff or patients. For this reason, patients are carefully screened to assure personal items such as combs, keys or other metal objects are removed prior to testing.

    Recently, UW Hospital and Clinics performed a full review of important MRI safety strategies after The Joint Commission issued a Sentinel Event Advisory informing hospitals of the safety risks and the best practices.
Nurse Staffing

UW Hospital and Clinics is proud to provide excellent nursing care to our patients and their families. Ensuring that appropriate numbers of nurses are available to care for patients is an organizational priority. Nurse staffing levels are deigned to:
  • Ensure that nurses care for a reasonable number of patients
  • Meet national standards where they are available
  • Ensure individualized patient care

UW Hospital and Clinics nurses are well prepared academically and a BSN education has been shown to improve patient care outcomes in a statistically significant way.

  • 73% of our nurses hold a BSN or higher
  • 66% hold a BSN
  • 11% hold a Masters degree
  • 7% hold a Masters in Nursing
  • 0.5% hold an earned doctorate
* Statistical sources:
 
Barker KN, Flynn EA, Pepper GA et al. Medication errors observed in 36 health care facilities. Arch Intern Med. 2002; 162:1897-1903.
 
Kohn LT, Corrigan JM, Donaldson MS, ed. To err is human: building a safer health system. Washington D.C.: National Academy Press; 1999.