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Attention “Condition H”
[Staff Reporters]
For the fifth straight year, an analysis of errors in our nation’s hospitals found that the most reported patient safety risk is a little-known, but always-fatal, problem called “failure to rescue.”
Definition
The term Failure-To-Rescue [FTR] refers to cases where hospital doctors, nurses or caregivers fail to notice symptoms, or respond adequately or swiftly enough to clinical signs, when a patient is dying of preventable complications in a hospital.
The situation is not new. The term “failure to rescue” was first coined in the early 1990s by Dr. Jeffrey H. Silber, director of the Center for Health Outcomes and Policy Research [CHOPR]. He was looking for a way to characterize the matrix of institutional and individual errors that contribute to patient deaths.
Call ‘Condition H’
Today, to help mitigate the FTR problem, a growing numbers of hospitals across the country allow patients to speak up by activating ‘Condition H,’ a code that summons immediate help.
Assessment
In a Condition “H “alert, patients call the same emergency number that doctors and nurses use.
MORE: Before Code Blue: Who’s minding the patient? [Little-known ‘failure to rescue’ is most common hospital safety mistake. www.msnbc.msn.com/id/24002334
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A recent article in USA Today highlights a study showing that nurses, student nurses and people with no health care backgrounds all “reported a greater likeliness to forgo resuscitation if ‘allow natural death’ was used.”
Palliative care physician Christian Sinclair sheds more light on the topic, noting the ambiguity of “Allow Natural Death.”
“What did it mean exactly as a medical order?” writes Dr. Sinclair. “Is morphine natural? Are antibiotics natural? Does this patient consider artificial hydration or nutrition as natural (to some that is a contradiction – but others would disagree)? It left too many questions for me to consider it a helpful or accurate medical order.”
It appears, anecdotally, that families see “Allow Natural Death” to be more compassionate wording in end-of-life situations.
But, is that compassion from the order itself, or “in the communication of the medical plan once the goals have been delineated?”
In other words, it may not be so much what you order, but how you say it.
Jane
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