Lewis Blackman Hospital Patient Safety Act SC Code Ann' 4473410 et seq'

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Lewis Blackman Hospital Patient Safety ActSC
Code Ann. 44-7-3410 et seq.

• Annette Drachman, JD, MHA
• Director, MUHA Legal Affairs
• Rosemary Ellis, MSN
• Director, Quality and Patient Safety

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Background

• 15 year old , Lewis W. Blackman was
• hospitalized at Childrens Hospital at MUSC
• in late October 2000 for elective surgery.
• Over the weekend, his mother reported
• Lewis having some post-op complaints.
• Lewis was seen by the upper level Resident,
• who communicated the symptoms to the Attending.

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What happened next?

• On Monday, November 2, the new Attending
  received a verbal report from the Resident that
  the patient was stable. The Attending then went
  to the OR.

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• Lewis died later that day from internal
• bleeding

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For more than a year Helen Haskills been
fighting to get a modest bill enacted in South
Carolina that would require hospitals to display
the ranks of medical personnel on name badges, to
explain their roles in a patients care and to
give families an emergency number to call if they
believe their patient is not getting proper
medical attention. Fatal
Mistakes By Trudy Lieberman November
2004 Lewis was Helen Haskills son
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Lewis Blackman Hospital Patient Safety Act

• Three Primary Areas in the Act
• Name Badges
• Informing Patients who is involved in their care
• Establish a mechanism to contact the Attending
  Physician

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Name Badges

• Identify all clinical staff (includes persons
  who work in a hospital whose duties include
  personal care or Medical treatment of patients)
  
• Must include
• Name (first and last)
• Department
• Job or trainee title
• Must be
• Clearly visible
• In terms or abbreviations reasonably understood

All Identification Badges for direct clinical
care staff are being replaced.
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Informing Patients(Written Information)

• This act requires specific information be
  provided to all inpatient and ambulatory surgery
  patients at the time of admission or as soon as
  possible thereafter.
• Information includes identification of who is
  involved in their care and the mechanism to
  contact the attending.
• We have designed a brochure that includes all the
  information required by the act.
• Patient registration staff are required to give
  the brochure to the patient.
• We are revising the general consent for treatment
  toinclude documentation of the patients receipt
  of the brochure.

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Check to make sure your patient has received
this brochure.
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Mechanism to contacting the Attending Physician

• Whenever the patient or family member asks to
  speak to the attending
• physician about their medical care
• Determine what concerns the patient or family
  have to determine if you can take care of it
  immediately.
• If you are not able to respond to the concern -
  page the attending physician by calling 2-8080.
  
• Rationale Monitoring the documentation
• If the patient or family member would like to
  page the attending themselves, give them this
  number 792-8080.
• Document all patient/family member requests to
  and your actions in the interdisciplinary
  progress notes of the medical record.
• Never give out personal pager numbers.

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HOW DO I COMPLY?

• Follow MUSC requirements by
• Completing ALL information on white
• board at the BEGINNING of the shift, if
• utilized in your area.
• Wear your name badge in a visible
• location (eye level is recommended)

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HOW DO I COMPLY?

• If unable to respond to requests appropriately,
  contact the
• Attending MD (or attending designee) at patient
• (or patient representative) request regarding
• medical concerns.
• If you page the attending physician at the
  request of the
• patient, you must document that in the progress
  note in
• the medical record (see pocket card).
• Ensure that patient/family has copy of MUSC
• pamphlet An Academic Medical Center of
  Excellence

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WHAT IF I CANT REMEMBER WHAT I AM SUPPOSED TO DO?

• Check the poster supplied to your unit.
• Keep your pocket card handy

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STATE Enforcement

• Enforced by DHEC against the HOSPITALs license
• DHEC will investigate complaints and issue
  citations
• Added to routine inspections

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Policy changes

• The following policies have been revised to
  reflect the requirement
• C-124 Paging Responsibilities and Response Time
• C-109 Chain of Command Policy
• A-7 Identification Cards
• C-74 Resident Supervision

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• The following slides contain helpful information
  that is not a part of the act.

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Activate the chain of command when you believe
the patient to be at risk and there is a delay
in medical response
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Stat page the MD and request a bedside assessment
when
? You are concerned/worried about the patient
? Acute change in any of the following ?
heart rate lt40 or gt 130 bpm ? systolic
blood pressure lt90 mmHg ? respiratory rate
lt8 or gt 24 per min. ? blood oxygen
saturation less then 90 despite O2 ?
mental status (delirium, confusion, agitation)
? urinary output lt50 ml in 4 hours ?
Fractional inspired oxygen (FiO2) of 50 or
greater ? New, repeated, or prolonged seizures
? Failure to respond to treatment for an acute
problem/symptom ? Blood Glucose lt70 mg/dL
(after initiating hypoglycemia protocol)

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Paging a Physician
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Remember

• A Resident MD is not an
• Attending physician.