i had a question i wanted to put out there for opinions.
do any of the organizations you work for have a "condition h" procedure in place. for those of you who are unfamiliar with it (i was until very recently) i've pasted information below with the source link. if your hospital does have this procedure, how has it worked? is it effective? what are your opinions in general, even if your hospital does not have this in place. i look forward to the discussion. thanks :)
josie king was an 18 month little girl who died because of hospital errors in one of the best hospitals in our country. through the creation of a patient safety program, the king family's hope is to help prevent this from ever happening to another patient.
the josie king call "condition h" has been created here at upmc shadyside out of our desire to provide our patients and families an avenue to call for immediate help when they feel it is needed. josie's mother, sorrel king, has worked with upmc shadyside to design condition h. we are dedicated to making the hospital the safest place possible for patient care to happen.
condition h -- what does the h stand for? help -- "condition help" patients and families can call for help by initiating a "rapid response team". a rapid response team is made up of designated members of the hospital's healthcare team, including at least a doctor and nurse, who come to the patient's bedside in an emergency and manage the situation, much like an ambulance team does in the community.
the reasons for the condition h can be:
a report from a family member or visitor to a healthcare provider (i.e. nurses, physicians) of a serious noted change in the patient's condition that is not being addressed
an emergency situation where a noted change in the patient's condition is not being recognized by the caregiver or does not receive the attention deemed appropriate by the family.
if after speaking with a member of the healthcare team, confusion or conflict of what needs to be done for the patient is evident.
who will respond to a condition h? an internal medicine physician or nurse practitioner, the administrative nursing coordinator/supervisor. a floor nurse, and a patient relations coordinator, when in house.
we hope that you never need to call a condition h; however, this valuable resource for patients and families is another way that upmc shadyside hospital is partnering with patients and families to provide the highest quality and safestcare possible.
I think it's an excellent idea. It can give families in crisis peace of mind, an emergency "second opinion" is sometimes needed. The system might be abused by some disgruntled families, but I think this is a valueable tool for the nurses involved in the care of these particular patients. Imagine the following scenario:
Your patient's family is disatisfied with the level of care you are giving. Perhaps they are being obnoxious or whatever. They call a Condition H hotline and a team of doctors/nurses arrives to evaluate the situation. If the family is wrong, the care you are giving will resume and if anything goes wrong, you will be backed up with documentation that several objective health care professionals concluded that your care was appropriate. This becomes extremely valuable if this disgruntled family should sue.
So it seems to me that while it might look like as if this policy could cater to frivolous issues from an obnoxious family, it's actually a safety net for the nurse and the hospital.
I remember discussing this on this forum a long time ago. It's interesting that her mother has become a crusader for hospital safety when the little girl first received those third-degree burns in her own house! I am totally opposed to this idea and if you read the article(it's long and you have to wade through some garbage about her pediatrician being Greek and what she liked to cook), I am not sure that calling a code H would have prevented her daughter's death anyway. In fact, I'm sure of it. I don't like the idea of families having mechanisms to bypass nurses' care and judgment if they don't think you are "up to snuff". They can already go the charge nurse and then the nursing supervisor if they have concerns, that should be adequate.
I too can see the potential for abuse but ultimately, I think it's a positive thing. Anyone that has kids knows that even the best parents have expeienced a child slippng from under supervision and getting hurt so I refuse to point fingers at the mother for that. Mothers also know when there is something "off" about their child. Docs and nurses also are not perfect and by their own admission in the article, they goofed on several occasions. My feeling is-if you are truly providing the best care for your patient, you should not be afraid of a second opinion and a fresh pair of eyes. Most places that have these "rapid response" teams assign staff to them so you're not pulling people away from other patients. In theory, going to the nursing supervisor should be enough but sometimes, particularly if there is a friendship involved, he/she will immediately back up the caregiver even if there is a legitimate problem.
I remember discussing this on this forum a long time ago. It's interesting that her mother has become a crusader for hospital safety when the little girl first received those third-degree burns in her own house!
So in other words, if there's an accident in the house the parents are to blame and if they should later become advocates for change they should be viewed as hypocrites?
It's fine, in theory, as long as it's the CARE TEAM that calls the Condition H and not the family. If the family states the pt is getting worse but there is no objective data to back it up, I would be hesitant to call it.
I think a well-executed plan in place could be very beneficial to help reducing medical errors and lawsuits. I don't think you can discount it because of possible abuse since the fact is hospitals are doing a poor job when it comes to medical errors. Something has to give, and it's going to have be some loss of ego for medical professionals in wanting to control everything that goes on during a patients stay.
I remember discussing this on this forum a long time ago. It's interesting that her mother has become a crusader for hospital safety when the little girl first received those third-degree burns in her own house! I am totally opposed to this idea and if you read the article(it's long and you have to wade through some garbage about her pediatrician being Greek and what she liked to cook), I am not sure that calling a code H would have prevented her daughter's death anyway. In fact, I'm sure of it. I don't like the idea of families having mechanisms to bypass nurses' care and judgment if they don't think you are "up to snuff". They can already go the charge nurse and then the nursing supervisor if they have concerns, that should be adequate.
Certainly you are not saying that all nurses possess correct judgement and they always act appropriately and in the best interest of the patient. I'm a nurse advocate, but I'm a patient advocate first, and I've seen first hand what types of mistakes are made when nurses are not "up to snuff" as you put it. It happens. It's a reality. I agree with the poster who said we have to put our egos aside as medical professionals. That is so true. Physicians are not the only ones who can be cocky and arrogant. I've had handful of colleagues who fit that profile.
The system and lines of communication are broken. If hospitals/nurses/physicians were perfect we would not have to have this type of procedure in place. I think the pros definitely outweigh the cons in this situation.
The hospital I work at has "patient advocates". When a pt is admitted, an advocate gives them their card and a number they can always be reached at. They help out with everything from minor pt dissatisfactions all the way up to situations such as this story explained. Of course, no one knows if this would have helped in this situation; however, I think the idea is a good one. I feel bad for this little girl and her family.
I've heard of Rapid Response Teams but these seem to be called when a pt is starting to circle the drain but is not quite ready to code. RT, lab, and a few extra nurses come running and is considered an emergency. This Condition H sounds good in theory but I can see it being abused.
Like others have said, I hope that pts don't get wind about this or the hospitals might have Condition H's for visitors who don't get coffee on time or something petty like that. There need to be safeguards in it to prevent the abuse of having a condition like this in this "I want it NOW society" of the hospital.
Specializes in cardiac/critical care/ informatics.
I could see how it would be abused big time, families would call it because a meal tray was missed... don't laugh you know it is true We have a rapid response team, they are to be called anytime you feel the patient isn't getting the treatment that is needed for a potentially serious situation. Doctors are ignoring the pages or just not taking it seriously. But the family is not to call them.
I would assume that if it was something minor like a missed dinner tray they would be able to deny the request for a Condition H based on pre-existing protocls.
WE have a rapid response team, for pt's ready to code but not quite there. (a nurse called one today for a bradycardic/hypoxic woman)
Now, this condition H-does the family call it on their own, or do they have to request the nurse to call a condition H? (which would be pointless, since in theory, you call if you disagree with the nurse)
SOMETIMES it could work. SOMETIMES it could be greatly abused.
So in other words, if there's an accident in the house the parents are to blame and if they should later become advocates for change they should be viewed as hypocrites?
That's pretty much what I got out of your post.
Well......yeah. It seems logical to me that if they wanted to put a lot of energy into being advocates for change, why not start with preventative measures? I'm funny like that, I think we should stop a problem before it starts. And safety in the home is a big issue; I think there should be a lot of attention aimed at education and prevention measures.
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DaFreak71
601 Posts
I think it's an excellent idea. It can give families in crisis peace of mind, an emergency "second opinion" is sometimes needed. The system might be abused by some disgruntled families, but I think this is a valueable tool for the nurses involved in the care of these particular patients. Imagine the following scenario:
Your patient's family is disatisfied with the level of care you are giving. Perhaps they are being obnoxious or whatever. They call a Condition H hotline and a team of doctors/nurses arrives to evaluate the situation. If the family is wrong, the care you are giving will resume and if anything goes wrong, you will be backed up with documentation that several objective health care professionals concluded that your care was appropriate. This becomes extremely valuable if this disgruntled family should sue.
So it seems to me that while it might look like as if this policy could cater to frivolous issues from an obnoxious family, it's actually a safety net for the nurse and the hospital.