Patient Safety Tools

The Institute of Medicine (IOM) defined patient safety as "freedom from accidental injury: avoidance, prevention and amelioration of adverse outcomes, or injuries stemming from the process of care".¹

After reporting the results of studies estimating that approximately 98,000 people die each year while hospitalized, the IOM identified 6 aims to improve the quality of our healthcare system.

Quality healthcare is care that is safe, effective, patient-centered, timely, efficient and equitable, all identified as IOM Aims to improving the quality of healthcare.²

TEAMWORK: Patient care transcends those who see patients directly to all professionals involved in healthcare.

Six IOM Aims
How can the clinical laboratory improve the quality of healthcare for patients with respect to each of the six IOM aims?

1. Safety: Focus on patient safety so that we do not harm patients at any phase of the Total Testing Process while treating them.
2. Effectiveness: Provide services based on the benefit to the patient using evidence-based practice to avoid overuse, underuse and misuse of services.
3. Patient-centered: Involve the patient in making decisions about their medical care; be respectful of each patient's values and preferences and insure that these characteristics guide clinical decisions.
4. Timeliness: Reduce the time to provide care to prevent harm to the patient.
5. Efficiency: Avoid waste of resources used in providing clinical laboratory test information.
6. Equitable: Provide quality care that does not vary according to gender, race, ethnicity, geographic location and socioeconomic status.

Patient Centeredness
Clinical laboratory practitioners may describe patient centeredness as those situations in which the practitioner actually sees the patient, such as phlebotomists who collect samples.

Certainly that is true, however, it is more than that, it is ensuring that patients have all the necessary information regarding their clinical laboratory testing--sample preparation requirements, post-sample collection information, information about timeliness--all provided in a manner that is respectful of their understanding.

As professionals who provide clinical laboratory services, it is our responsibility to provide this information to patients. It is not the responsibility of other healthcare practitioners to tell patients what fasting means, what is important with respect to performing a venipuncture for sample collection, or when the clinical laboratory test results will be available, it is ours.

With these principles in mind, the ASCLS Patient Safety Committee has developed three products for clinical laboratory professionals to distribute to patients:

• the Personal Pocket Laboratory Guide;
• Laboratory Patient Safety Tips: What is Fasting?
• Laboratory Patient Safety Tips: Blood Specimen Collection (Venipuncture).

Each of these three-color documents is available on the ASCLS Web site, www.ascls.org/leadership/psc, at the Patient Safety Committee Web page. All products have space to personalize the document with the clinical laboratory contact number and address.

Personal Pocket Laboratory Guide
The Personal Pocket Laboratory Guide is a 3.25 × 6 inch double sided tri-fold credit card sized document. When opened, it displays a place for patients to record the date, name of laboratory test and its result and reference range. Five tips to safeguard laboratory testing are listed on one of the outer folds of the guide.

Hand these to patients at the conclusion of the phlebotomy encounter, display them in the laboratory waiting area, or distribute them at screening events held by the clinical laboratory.

Handing these directly to patients provides the best opportunity to explain the purpose of the guide--to keep a record of important laboratory test result information along with the safety tips. This method of distribution also provides an avenue for clinical laboratorians to become involved in the care patients receive and to show patients the face of our profession.

Laboratory Patient Safety Tips
Both of the Laboratory Patient Safety Tips fliers are double-sided 3.25 × 8 inch documents. One side of the What is Fasting flier describes what fasting means and what not to do before a fasting sample is collected, in a clear color coded manner. The reverse side has a list of questions and answers.

The front side of the Blood Specimen Collection flier describes clinical information a patient should share with the laboratory professional prior to sample collection, as well as tips for care after a venipuncture. The reverse side of this flier also has a list of questions and answers on how to avoid complications after a venipuncture.

These fliers can be distributed to patients in the same manner as the Personal Pocket Laboratory Guide; however, they can also be dispersed to clinicians and nurses to share with their patients who need clinical laboratory testing.

Asking other healthcare practitioners to share these tips fliers will provide patients with critical information to not only enhance the quality of their laboratory test information, but it may also prevent unnecessary repeat testing or extra visits to the laboratory because patients were not adequately prepared for the clinical laboratory test.

It also provides an opportunity to share clinical laboratory practice expertise with other members of the healthcare team.

ASCLS Patient Safety Tools
All of these patient safety tools can be found on the ASCLS Web site on the Patient Safety Committee Web page, www.ascls.org/leadership/psc. They are all complimentary, however, please ensure that the ASCLS logo is printed on each flier and guide to recognize who is responsible for their development. Lastly, please consider joining ASCLS to support the effort to improve patient safety for clinical laboratory services.

Dr. Otto served as chair of the ASCLS Patient Safety Committee 2006-2010

References
1. Committee on Quality of Healthcare in America: To Err is Human, Building a Safer Health System. Washington, DC: National Academy Press, 2000.
2. Committee on Quality of Healthcare in America: Crossing the Quality Chasm, A New Health System for the 21st Century. Washington, DC: National Academy Press, 2001