We may not think of ourselves as such, but hospitalists can be extremely effective coaches and equipment managers. They can help create and maintain safe and effective gear for themselves and those patients and providers around them. They can be a mentor for displaying how vitally import this gear is and can work to improve it when it proves to be imperfect.
Although we don’t tend to think of these things as “safety gear,” these things do, in fact, keep us and our patients safe. Some of these include:
- Computerized physician order entry (CPOE) with decision support (or order sets without CPOE);
- Checklists;
- Procedural time-outs;
- Protocols;
- Medication dosing guidelines;
- Handheld devices (for quick lookup of medication doses, side effects, predictive scoring systems, medical calculators, etc.); and
- Gowns and gloves.
Additional “gear” for the patients can include:
- Arm bands for identification and medication scanning;
- Telemetry;
- Bed alarms;
- IV pumps with guard rails around dosing;
- Antibiotic impregnated central lines; and
- Early mobilization protocols.
The Next Level
To take the medical industry to the next level of safe reliability, we need all providers to accept and embrace the concept of “safety gear” for themselves and for their patients. We need to make it perfectly obvious when that gear is missing. It should invoke a reaction of ghastly fear when we witness anyone (provider, patient, or family) skimping on their gear: removing an armband for convenience, bypassing a smart pump, or skipping decision support in CPOE. And for the current gear that is imperfect, slows us down, beeps too often, or reduces our agility, the solution should include improving the gear, not ignoring it or discounting its importance.
So before you go to work today (every day?), think about what you need to keep yourself and your patients safe. And get your gear on.
Dr. Scheurer is a hospitalist and chief quality officer at the Medical University of South Carolina in Charleston. She is physician editor of The Hospitalist. Email her at [email protected].