Clinical Center Improves Patient Safety

Accurate and timely documentation is very important when documenting clinical issues in the patient’s EHR. The NIH Clinical Center’s (CC) Health Information Management Department tracks key quality metrics related to patient care.

The CC made key improvements to improve patient care during 2016 and is continuing into 2017. A new Patient Safety, Clinical Practice, and Quality Committee was established to include front-line licensed independent practitioners and patient care staff that reports to the Clinical Center CEO and the Medical Executive Committee.

Also, the CC established the Office of Research Support and Compliance to ensure that research conducted across all NIH Institutes and Centers whether in or outside of the Clinical Center, adheres to the highest regulatory, professional, and ethical standards. In addition, all NIH intramural researchers and research staff were retrained to ensure awareness and compliance when reporting requirements.

To upgrade one of systems, the Clinical Center implemented a new report system called the “Safety Tracking and Reporting System” referred to as STARS STARS was initially referred to as the “Occurrence Reporting System”.

The staff at the Clinical Center are using the new STARS patient safety event reporting system to alert the Clinical Center on a variety of safety and quality concerns. These concerns include information on errors, near misses, and service quality such as delays and unsafe environmental conditions.

In dealing effectively with medication safety, NIH’s Clinical Center uses an improved infusion pump system called “Alaris” which continually or intermittently delivers fluids, medicines, blood, and blood products to adult, pediatric, or neonatal patients.

This system is equipped with a dose error reduction system called “Guardrails Safety Software”. This software is a program within the pump that is designed to detect intravenous medication errors at the critical point of infusion delivery to the patient.  The goal is to increase the use of this software by 90 percent in 2017.

In addition, to supporting medication management, point-of-care barcode scanning was deployed in 2014. Today, the use of the appropriate use of medication scanning at the bedside has consistently increased medication safety by 95 percent since the use of the point-of-care barcode scanning was initiated.

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