Incorporating the brand new Middle for Medicare & Medicaid Companies (“CMS”) SAFER Information advisable practices into the configuration of your digital well being document (“EHR”) system can produce substantial advantages past compliance. These suggestions characterize a roadmap for lowering errors in affected person care, resulting in a discount in affected person hurt, medical malpractice and different monetary dangers.
Of the 9 SAFER guides, the 4 “scientific course of guides” (#s 6-9) embrace many highly effective countermeasures that may be utilized throughout the continuum of care. They’re targeted on affected person evaluation, diagnostic decision-making, check ordering and interpretation, and follow-up in supplier/supplier communications.
Whereas the brand new CMS necessities mandate an annual self-attestation as as to whether you will have accomplished every particular suggestion, there’s at the moment no penalty related to responding within the destructive. Nevertheless, devoting time and sources to assembly the SAFER Information suggestions can deal with vital gaps in your establishment’s affected person security course of and program.
This will present a possible aggressive benefit by lowering affected person hurt, limiting medical legal responsibility publicity, rising clinician and workers confidence and satisfaction, and defending your group’s model within the market.
The place Malpractice Claims Occur within the Strategy of Care
All through the supply of affected person care, there are numerous areas of threat that may be mitigated by optimizing your EHR system, as proven in Desk 1. The left-hand column enumerates a typical 12-step “affected person journey.” The column on the appropriate incorporates the frequency, of which every discrete step is related to medical malpractice claims from a whitepaper revealed by CRICO, the malpractice and risk-prevention analysis arm of the Harvard Hospital Programs. The information was extracted from a nationwide cohort of high-performing hospitals that contribute instances to CRICO’s claims comparative database:
|Strategy of Care Step||% of Malpractice Circumstances|
|1. Affected person notes drawback and seeks care||1%|
|2. Historical past/bodily||8%|
|3. Affected person evaluation/analysis of signs||31%|
|4. Diagnostic processing||35%|
|5. Order of diagnostic/lab check||31%|
|6. Efficiency of exams||3%|
|7. Interpretation of exams||23%|
|8. Receipt/transmittal of check outcomes (to supplier)||5%|
|9. Doctor observe up with affected person||18%|
|10. Referral administration||21%|
|11. Supplier-to-provider communication||12%|
|12. Affected person compliance with follow-up plan||17%|
Desk 1: Strategy of care map with related frequency of med-mal claims.
The place the SAFER Guides Make a Affected person Security Affect:
Every SAFER Information suggestion can impression multiple process-of-care step, thereby multiplying its impact on stopping affected person hurt and reducing monetary threat. The desk beneath maps two instance suggestions from every of the 4 scientific course of SAFER Guides and hyperlinks these suggestions to the person strategy of care step(s) that may obtain a security enchancment and threat discount as a consequence of its implementation.
Desk 2 reveals examples that exhibit the connection between SAFER scientific course of information suggestions and reaching reductions in frequent medical errors all through the affected person journey. The highly effective threat and security countermeasures contained within the SAFER scientific course of guides may help your group scale back affected person hurt and decrease monetary dangers associated to errors in care supply. These enhancements can translate right into a aggressive benefit by way of diminished affected person hurt, decreased monetary threat and elevated workers satisfaction.
|SAFER Medical Course of Information||SAFER Advisable Observe||Course of-of-Care Step Affect|
|#6 Affected person Identification||An enterprise-wide grasp affected person index that features sufferers’ demographic data and medical document quantity(s) from totally different components of the identical group to determine sufferers.||1, 5, 6, 8, 10|
|#6 Affected person Identification||Info required to precisely determine the affected person is clearly displayed on all pc screens, wristbands and printouts.||5, 7, 8, 9, 11|
|#7 Computerized Supplier Order Entry with Determination Assist||Coded allergen and response data, or No Identified Allergy symptoms (“NKA”), is entered and up to date within the EHR previous to any order entry.||2, 4, 5, 9|
|#7 Computerized Supplier Order Entry with Determination Assist||Proof-based order units can be found within the EHR for frequent duties/circumstances and are up to date frequently.||5|
|#8 Check Outcomes Reporting and Observe-Up||Workflows which are notably susceptible to mishandling of check outcomes, particularly vital ones, are recognized. Again-up procedures guarantee check outcomes are obtained by somebody answerable for the affected affected person’s care.||5, 6, 8, 9|
|#8 Check Outcomes Reporting and Observe-Up||Automated, non-interruptive outcomes notifications, (additionally referred to as in-basket alerts or flags), are restricted to people who are clinically related as a way to decrease alert fatigue.||3, 4, 11|
|#9 Clinician Communication||Workflows which are notably susceptible to mishandling of check outcomes, particularly vital ones, are recognized. Again-up procedures guarantee check outcomes are obtained by somebody answerable for the affected affected person’s care.||5, 6, 8, 9|
|#9 Clinician Communication||Automated, non-interruptive outcomes notifications, (additionally referred to as in-basket alerts or flags), are restricted to people who are clinically related as a way to decrease alert fatigue.||3, 4, 11|
Desk 2: Potential strategy of care impression of implementation of instance suggestions from the SAFER Medical Course of Guides, numbers 6-9.