Quality & Safety

 Excellence Everyday Tips O' the Day!

 

Skip to your favorite tip:


Credentialing
Documentation
Fire Safety
Hand Hygiene
Hours of Operation
Legibility of Notes: Type 'em
Statistics
Patient Involvement In Care
Patient Identification



STATISTICS: A necessary evil

Documentation often gets the top billing in the "if you didn't write it down, it didn't happen" class of work, but the same is true for entering your stats. In order to get "credit" for the work you do, your statistics are the only quantitative measure that reflect the volume of your work. Don't sell yourself short!!

1. Input your Stats EVERYDAY. You can enter your statistics for the day of service until 11 am the following day. Think of it like taking meds - do it at the same time each day so you are less likely to forget!
2. Indicate the current location of service. This helps track volume on the different units and services.
3. Primary v. Secondary: In order to keep a patient in your "caseload," make yourself the primary provider. If there's another SW involved but not active, they can be placed in the secondary category.
4. Accurate stats require ORGANIZATION. If you have difficulty remembering to input your stats, or you suspect that you're not capturing the full scope of your practice and the time you're putting in each day, survey your colleagues for their tips!
   



Q: What are the hours of operation Social Service at MGH?
A: 24/7/365! In other words, anytime - day or night!

While most of us work a standard 8(ish) hour day (8:30-5), there is a system in place to ensure 24-hour coverage for the hospital, 7 days a week, every single day of the year.

During the week, the ED is staffed from 8:30 am - 11 pm. On the weekends, the on-site coverage is available from 8:30a -5p (with the ED being covered from 11a-11p). When there is no on-site coverage (e.g. the middle of the night), there is ALWAYS a social worker on-call. There is even a back up schedule to this system (about 2x a year, you're on back-up duty!).

This coverage system works best when we inform our covering colleagues of potential problems over the evening or weekend shifts. When disaster strikes, arming your colleagues with information and advanced warning are the best protections for them and their time. THANK YOU ED WORKERS and the ON-SITE/ON-CALL TEAM for keeping us covered 24/7/365!




Have you started TYPING your notes yet??

Remember: legibility counts!!

So do titles of notes, including date/time, signature, credentials and contact information!!

Here are some tips to get you started in the computer age of documentation:

1) Your H: drive is accessible from any computer in the hospital! Store copies of the forms for SW notes (assessment, brief intervention, progress) on your H: drive with your name, credentials and pager/contact number.

2) Save your notes for easy access in a folder on your H: drive. When one of your colleagues needs your note it'll be accessible to you (and email-able to your peers!)

3) When saving your notes, title them with the patient's last name _ date of service (e.g., MacDonald_0707), as the time stamp on the notes template is the current date and time. This way, you'll have easy reference to the date the service was provided.

Any questions? There will be computer training courses planned for the Fall coming soon! In the meantime, let me (Abby MacDonald) know if you want to get started and need some help!




*NEW* NEW* *NEW*
(to our practice, anyway!)

PATIENT IDENTIFICATION: it's not just for direct medical care, anymore!

The hospital protocol dictates that Name/MRN (for outpatients, the blue card; for inpatients, the wristband) be validated before the initiation of any treatment or clinical service - every time.

SOCIAL WORKERS USE A DIFFERENT SET OF PATIENT IDENTIFIERS than our interdisciplinary colleagues. Do you know what they are? (See limerick below for today's answer!)

There are no requirements that we specifically document this practice, but if ever asked (especially by a Joint Commission surveyor!), I wanted you to be aware of this requirement. Please make an effort to begin to integrate this into your practice, if you haven't already.

There once was a patient named Renee
ID was not done, to our dismay.
The Joint Commission was mad
The worker said "my bad"
Identifiers are name and birthday!


 



 

PATIENT INVOLVEMENT IN CARE - It's what we do!

The question is, HOW?! Here are some examples of the ways we involve patients/families in their care:

• We ASSESS a patient or family's understanding of their illness, treatment plan or expectations for discharge.
• We ADVOCATE for interpreter services to be used if the patient is non-English speaking
• We REMIND patients/families to SPEAK UP if they notice or worry about a change in their medical condition
• We OFFER resources (including referrals to the Office of Patient Advocacy) for patients/families' to offer feedback about their care.

Think about other ways that you empower your patients or families to be more involved in the care they receive! And as requested, an EED limerick:

There once as a guy named Kent
He was offered Informed Consent
He made his own choices
The house staff rejoices
They can proceed with no lament!


 



 


HAND HYGIENE is EVERYONE'S responsibility.

This is likely to be a focus for the upcoming survey, given the recent H1N1 pandemic.

CAL STAT before and after EVERY contact!!

WASH YOUR HANDS if visibly soiled, seeing a patient with C-diff, after using the toilet and before eating! (Joint Commission: Guide to a Successful Survey, p. 15)

For more information, see the MGH Policies & Procedures intraweb (path: Infection Control/Prevention of Healthcare-associated Infections/Hand Hygiene).

Check out our own MGH Same Day Surgery CAL STAT RAP @ http://www.youtube.com/watch?v=wjg5LxRRQfA!!

 

 

DOCUMENTATION
You had to know this one was coming: DOCUMENTATION TIPS!!

Remember: All documentation must include the following: DATE, TIME, SIGNATURE and CONTACT INFO (pager or extension). Legibility counts - if it can't be read, you don't get credit! Another benefit to typing your inpatient notes: all you have to do is sign!

TITLES OF NOTES MUST MEET OUR DOCUMENTATION POLICY! Make sure you're consistent!!
Templates for Inpatient Documentation are available online at:
http://healthcare.partners.org/ss/ssframebottom/staffresources/StaffAccess/Forms&Policies.html#D

Do you know how long you have to respond to a consult? If you didn't say "Why, 24 hours, of course!" It's time to brush up on your Inpatient Documentation Policy: http://healthcare.partners.org/ss/ssframebottom/images/SS%20Documentation%20-%20Inpatient.pdf

SBAR (Situation-Background-Assessment-Recommendation) is the HAND-OFF STANDARD for the Social Service Department. Learn more with the instruction sheet posted on the website: http://healthcare.partners.org/ss/ssframebottom/staffresources/New%20Site/MGH%20I&R/Q&S/SBAR-Hand-Offs.pdf

 

 

FIRE SAFETY
What would you do in a fire emergency?!

Hopefully, you would RACE to the rescue!!

RESCUE - Remove anyone in danger of flames or smoke.
ALARM - Pull alarm, then call 6-3333 and state location for Code Red.
CONFINE - Close all doors and windows.
EXTINGUISH/EVACUATE - Put out fire, and if ordered, leave the area.

Don't forget - you have the answers to this question on the orange "emergency contact" card on your ID badge!

- Smokey the Social Worker

 

CREDENTIALING

How would you respond to someone asking how you were qualified to do your job? This is a JC favorite, so consider the following information:

Given your employment here, you definitely:
1) Attended a two-year, accredited Social Work masters program
2) Maintain a Massachusetts Licensure in Clinical Social Work
a) LICSW: You've completed two years (3,500 hours) post-MSW documented clinical experience with 50 face-to-face supervision hours per year (100 hours total) under a LICSW
b) LCSW: You are in the process of completing the above protocol for obtaining your LICSW
3) Continuing Education: 30 hours every two years. CEUs are available during monthly SW grand rounds.

Additional considerations:
If you are in a specialized service, consider any service-specific training you've received in the past. Have you attended any conferences while employed here? Did you intern here or at another hospital/health care setting?

 

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