Condition H Staff Validation Tool

Intervention Title:
Developing a Patient/Family-Activated Rapid Response Team – University of Pittsburgh Medical Center, Pittsburgh, Pa.

Goal:
Develop a rapid response team that can be called by hospital patients and their families.

Innovation:
Staff developed Condition Help, a rapid response team that family members, visitors and patients may call if they feel like they need immediate assistance and are not getting appropriate attention.

Result:
In response to calls, staff identified unaddressed issues, such as pain management. Condition Help started at one hospital and in two years is now fully integrated in all hospitals in the health system.

Institution:
University of Pittsburgh Medical Center
200 Lothrop St.
Pittsburgh, PA 15213-2582
P: (412) 647-8762

From the experts:
“We are dedicated to making our hospital the safest place possible for patient care. Condition Help has enabled us to bring a lifeline to our patients to call for help when they feel it is needed.Our goal is that the care patients receive will warrant this service unnecessary, but we want patients and their families to have this resource available should they need it.”

Tami Merryman, R.N., M.S.N., F.A.C.H.E.
Chief Quality Officer
University of Pittsburgh Medical Center

Profile:
University of Pittsburgh Medical Center is composed of 19 hospitals and a network of other care sites across western Pennsylvania and throughout the world.

Clinical areas affected:

  • All hospital units

Staff involved:

  • Physician
  • Nursing supervisor
  • Patient relations coordinator
  • Operator

Timeline:
The team program was tested in 2005, refined in 2006, and spread throughout 2006 and 2007.

Contact:
Cindy Liberi, Program Manager
Center for Quality Improvement and Innovation
P: (412) 802-8065
liberica@upmc.edu

Innovation implementation:
The University of Pittsburgh Medical Center developed a rapid response team called Condition Help to address the needs of hospital patients who feel they are experiencing a medical emergency. If a patient or their family feels they have a critical situation that is not being properly addressed, they can call the emergency number from a hospital telephone. A trained operator receives the call. The caller is then instructed to provide the patient's name, caller's name, location and nature of the emergency. The hospital operator has a decision tree to determine if pager and overhead alerts should be triggered.

The Condition Help response team is composed of an internal medicine physician, an administrative nurse coordinator, a patient relations coordinator and a floor nurse. Patients and their visitors are introduced to the program at their point of entry to the hospital. Patients receive a trifold brochure about the program. Additionally, there are signs in patients' rooms, stickers on the telephones and signs in public areas reminding patients and families about Condition Help and how to activate it if necessary.

The day after a Condition Help code is activated, a patient relations coordinator visits with the caller to complete a questionnaire, which helps capture data about what initiated the call and how well the caller's concerns were addressed. This data collection helps to identify common precipitating events worthy of intervention by quality improvement specialists as well as improve the Condition Help program.

Advice and lessons learned:

  1. Give power to patients and families. Don't worry about patients and families having power. They don't abuse it.
  2. Train operators. Set up clear standards on how hospital operators should respond to a call.
  3. Limit who responds to the call. The final team included fewer members than initially planned. Too many people can make the response scary and overwhelming to patients and their families.
  4. Don't over-collect data. Do not waste time collecting data if there is no plan for analysis. Gather information to understand the nature of the calls and how to prevent them.

Cost/benefit estimate:
According to questionnaires, 86 percent of callers said the responding physician met their needs; 100 percent said their needs were met by the nursing staff; and 69 percent of Condition Help calls potentially prevented events that may have resulted in a patient incident.

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