April 14, 2003
HOUSTON, TX - Ensuring correct-site surgery and procedure is one of the 2003 National Patient Safety Goals set by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO).
According to a November 1999 report from the Institute of Medicine, health care in the United States is not as safe as it should be - and can be. At least 44,000 people, and perhaps as many as 98,000 people, die in hospitals each year as a result of medical errors that could have been prevented. Even using the lower estimate, preventable medical errors in hospitals exceed attributable deaths to such feared threats as motor-vehicle wrecks, breast cancer, and AIDS.
Effective January 1, 2003, accredited health care organizations across the United States will be required to focus attention on a series of specific actions to prevent medical mistakes. These actions will help to avoid confusion in identifying patients, miscommunication among caregivers, wrong-site surgery, unsafe use of infusion pumps, medication mix-ups, and problems with equipment alarm systems.
Acknowledging that all health care providers make errors, the VA's National Center for Patient Safety took the initiative and recently introduced new processes that identify, prevent, and fix problems that can result in error, patient injury, or death.
Towards this goal, the Houston VA Medical Center was one of ten medical centers within the VA system that participated in the Veterans Health Administration (VHA) work group focusing on ensuring correct site surgery.
During the past year, the HVAMC has tested these preventive steps to ensure patient safety and patient satisfaction. We implemented several safeguards and processes to educate and familiarize all of our health care professionals about the actions that need to be taken to prevent adverse events from happening.
With support from the HVAMC executive leadership, education and training of staff members is on-going, and we have made the procedures part of our staff's daily routine.
Our ultimate goal is to continue to provide high quality and safe care to you, our veteran patient.
The processes now in place will help veterans and family members understand what will happen before surgery, and what steps your doctors and nurses are taking to make sure everything goes as planned.
The following timeline can give you an idea what will happen before your surgical procedure at the HVAMC:First: Days to a Few Hours Before Your Surgery
First, you will review all the information on the HVAMC consent form before you sign it. You, or your legal guardian, must sign the consent form before any surgery can take place. It should be written in words that you can understand. If it is not or you are not sure about something, ask your physician.
It is very important for you to tell your doctor about the medicines that you are taking and any allergies that you may have. Write down this information and show it to your doctor.
Also take this opportunity to ask your doctor any questions you might have. Many of your questions will be answered just by reading the consent form, but here are a few good questions to keep handy in order to better understand your surgery:
The doctor or another member of your surgical team will make a mark with a pen on the part of your body where the surgery will happen. This should be done before you go into the operating room.
Many doctors will sign their name or initials. Some doctors will make an "X" or "Yes" mark on the correct body part.
Check to make sure the mark does not rub off. This mark will be very important for the doctors and nurses to see while you are asleep during your surgery. Tell your doctor or nurse if the mark rubs or washes off before the surgery.Second: An Hour or Less Before Your Surgery
While you are still awake, a doctor or nurse will ask you to say your full name, your social security number or birth date, and the part of your body that will be operated on. Don't be alarmed by these questions; your doctor and nurse know who you are. This is how they make sure they have everything right.Third: Right Before Your Surgery
Just before your surgery begins, everyone in the operating room will take a short "time out." This means everyone - the doctors, the nurses, and the surgical technicians - everyone. They will check for the last time that they have the right patient and are doing the right operation on the right body part. You will probably be asleep when this happens.
The HVAMC doctors and nurses are taking these important steps to make sure everything goes as planned during your surgery.
Together, with you playing an important part in the process, we can prevent errors from happening and ensure that you receive high-quality, safe health care.
Written by Beverly Green-Rashad, RN, MSN, HVAMC Operative Care Line Nurse Executive and Debra Lewis, RN, HVAMC Patient Safety Improvement Coordinator
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Point of Contact: VHAHOU Public Affairs04/21/04 08:25