Condition H

Nurses General Nursing

Published

good day everyone - happy 4th :)

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 :)

https://www.patientsafetygroup.org/uploads/projects/162/wallsigndraft2.doc

the story.

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.

The real or perceived need for this seems to me to be a result of chronic understaffing.

I saw this Nightline recent http://www.msnbc.msn.com/id/9818616/ this man was at his wife's bedside and kept trying to get help for her while her condition deteriorated, but no one thought it was as serious as it turned out to be. By the time they figured out she had meningitis (possibly from a dirty epidrual), it was too late...

I'm not sure why people are assuming that patients would call a condition H for not having a fluffy pillow or a bigger chunk of pie with dinner. If patients were informed that the system only handled medical concerns, I honestly doubt too many would be calling over cosmetic or frivolous concerns. Maybe the phone number to the condition H hotline should only given out after a patient expressed a concern with care/medical issues, then they wouldn't have the option of using it for lesser issues.

Specializes in Day Surgery/Infusion/ED.
There's a fine line between respectfully bringing up a concern with a professional (Nurse, judge, teacher) and harrassing and belittling said professional on baseless grounds. Unfortunately the latter is what most often occurs with professions that are already deemed as less worthy of respect, such as teaching and nursing. In the case of this little girl there were some huge mistakes made. The system is at fault, not one individual. As long as a Code H system looks at the whole picture and is not there to point fingers at one individual, it could work. There also needs to be some criteria for taking action so that the idiot whose pillow didn't get fluffed on time doesn't get the right to call a Code H. In theory it's a good idea, but knowing that management/administration often likes to point fingers at individuals rather than address system wide problems, I'm dubious about how well the idea would work in practice.

I agree. People these days have such an attitude of entitlement that there is a huge potential for abuse.

When you hear "Code Blue" being paged, you pretty much have a good idea what you're getting into. With a nebulous "Code H" designation, you have no idea what the problem could be. Medical emergency? Wacked out family member? An acute case of "FMPBMS"? (Fluff My Pillow Bend My Straw)

Specializes in Day Surgery/Infusion/ED.
I'm not sure why people are assuming that patients would call a condition H for not having a fluffy pillow or a bigger chunk of pie with dinner. If patients were informed that the system only handled medical concerns, I honestly doubt too many would be calling over cosmetic or frivolous concerns. Maybe the phone number to the condition H hotline should only given out after a patient expressed a concern with care/medical issues, then they wouldn't have the option of using it for lesser issues.

Perhaps if they were informed that they would be slapped with a hefty surchage for frivolous use of the "Code H" system, that might help.

I think it's a great idea. There are mostly wonderful nurses, doctors, aides, therapists, etc. out there. But we are all prone to error and can miss things, too, being human. Also, there are a few who intentionally harm patients. It sounds like the nurse who gave the methadone to Josie King was possibly one of the latter.

Sorry, I think that, no matter how much aggravation it is for staff, families need this venue. I know that I personally would not wait for a team, Code, whatever. I'd be in Administration's office, the DON's office, or on the phone to the attending myself in a heartbeat if I thought it was warranted. The uninitiated, though, either don't know of these options or are reluctant to use them. Thus, the family initiated Code Team is needed.

If not done in a punitive way, if used only to have another pair of eyes and ears assess a situation, if not met with defensiveness and ego by the staff who are being questioned, it should really not prove any more aggravating or time-consuming than the way we handle things now, should it? Perhaps lives can be saved and morbidity averted. Lawsuits could become far fewer, too.

When I worked in post anesthesia at our hospital, it would have been lovely to have a rapid response team. And I understand that they have since initiated a program like that.

A couple of times when I had concerns about a patients respiratory status, and couldn't get ahold of the doctor, we finally grabbed a passing anesthetist who gave orders - that way it didn't get to 'code' status.

Specializes in Spinal Cord injuries, Emergency+EMS.

this is absolutely bonkers, but a symptom of the world wide phenomena that 'quality hospital care' is what the patient ( or more importantly sometimes i nthe eyes of damagement the patient's family) thinks it is ...

having rapid response / criticla care outreach is a very useful CLINICAL tool

by all means have a way for family to call Patiuent relations /PALS and the duty senior nurse ( duty matron / nurse manager during the day - night supervisor / Clinicla site managaer OOH) but not a critical care outreach / code team response ...

Specializes in cardiac ICU.

Perhaps if it were renamed Code Why Your Problem is Not a Medical Emergency, Just Like The Nurse Explained To You Repeatedly.:lol2::trout:

I worked in a hospital with the Rapid Response Team-their name for Code H. Anyone (pt's, families or staff) could call and describe their situation to an 'on call' nurse who then assembles the team (usually an ICU nurse, critical care manager, etc.) to come up to see the patient. I saw it used many times by staff for pt's with crashing glucoses, change in LOC, etc. I too thought when I first got there that it could be abused, but this really didn't seem to happen.

Nurses were encouraged to use it and it mostly seemed to, yes, help confirm what the nurse already thought was going on/needing back up..

Specializes in Spinal Cord injuries, Emergency+EMS.

funinsun

i don't think anyone disputes the value of rapid response / critical care outreach where it's initiated by Nursign staff or junior medicla staff , the concenr is with it's misuse if patients or their visitors are allowed to call the team , that it will beused for non clinical problems or for none relevant things...

Hi ZippyGBR,

I didn't mean to sound like I was debating the validity of the Rapid Response element-just saying that I have actually worked where both staff and families could use it (they posted the number everywhere for all to use..) and there wasn't a big problem with families misusing it as far as I saw/our unit..

I was skeptical at first as well-that families would misuse it-but those that did seemed to be the same families doing it repeatedly because they were more difficult to please than others..

The team seemed to be able to sort out really quickly if their concerns were valid or not..

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