The first year of Patient Safety First - Presidential Commission

AORN Journal,  Oct, 2003  by Laura Casanova

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In April 2002, AORN's then President Donna S. Watson, RN, MSN, CNOR, ARNP, FNP-C, launched the Patient Safety First initiative at AORN's annual Congress. The program was created to address growing public and professional concerns about patient safety. Sandel Medical Industries, Inc, became the exclusive sponsor of Patient Safety First by donating $1 million to help support the initiative. At the same time, Watson announced formation of the AORN Presidential Commission on Patient Safety, a group of individuals with expertise and experience to provide critical guidance in setting AORN's agenda related to patient safety in surgical settings. Current members are Patricia C. Seifert, RN, MSN, CNOR, CRNFA, FAAN, chair; Linda Groah, RN, MS, CNOR, CNAA, FAAN; Stella Harrington, KN, BSN, CNOR; Aileen Killen, RN, PhD, CNOR; Barbara Rusynko, RN, MSEd, CNOR; Betty Shultz, RN, CNOR, AORN President; Doreen Wagner, RN, MSN, CNOR; Linda Wanzer, RN, CNOR; Donna Watson; Brenda Gregory Dawes, RN, MSN, CNOR, representing Sandel Medical industries, Inc; Dan Sandel, chairman and chief executive officer of Sandel Medical Industries, Inc; and Tom Cooper, CAE, AORN Executive Director.

Since the initiative was launched, Presidential Commission members have developed and provided various types of information and services related to patient safety. Following are some of the accomplishments achieved by the Presidential Commission through the Patient Safety First program.

WEB SITE, E-MAIL ADDRESS, AND HOTLINE

Before the program was announced, a Patient Safety First web site (http://www.patientsafetyfirst.org) was developed to provide information to health care providers, and an e-mail address (patientsafetyfirst@aorn.org) and toll-free hotline at (866) 285-5209 were set up to take inquiries about patient safety. The total number of visitor sessions on the web site as of June 30, 2003, was 103,145. In addition, there have been approximately 275 calls to the hotline.

One area of the web site that has become extremely popular is the "Ask an Expert" page. Using this page, individuals can submit a question related to patient safety and receive an answer from a nurse expert. Approximately 600 questions have been submitted to the nurse experts since November when the function became available.

PATIENT SAFETY COLUMNS

A new "Patient Safety First" column was introduced in the AORN Journal in May 2002. The column focuses on surgical patient safety issues and is intended to provide up-to-date information and resources related to safe practices in perioperative settings. To date, topics have included problems with and tracking of medical devices (October 2002, January 2003), creating a culture of safety (July 2002), ensuring correct site surgery (November 2002), patient identification errors (September 2002), near misses (February 2003), and medication allergies (March 2003). The column is written by Suzanne C. Beyea, RN, PhD, FAAN, and members of the Presidential Commission on Patient Safety.

AORN's member newsletter, AORN Connections, also features a patient safety first column. Topics have included the work of the Presidential Commission (January 2003), AORN's collaboration with the American College of Surgeons (ACS) on "Guidelines to eliminate wrong site surgery" (February 2003), AORN's "Position statement on correct site surgery" (March 2003), human factors training (April 2003), AORN's Patient Safety audio-conference series (May 2003), and a report on the National Patient Safety Foundation's annual congress (June 2003).

GUIDELINES AND POSITION STATEMENT

AORN worked with the ACS to develop guidelines on correct site surgery that both organizations could support and that met the guidelines of the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). The result is "Guidelines to eliminate wrong site surgery," which appears in the February 2003 issue of AORN Member News and on the Patient Safety First web site at http://www.patientsafetyfirst.org/Information_Resources/Guidance.asp. AORN revised its "Position statement on correct site surgery" to align with JCAHO requirements as well. The revised version appears in the March 2003 issue of AORN Member News, and on the Patient Safety First web site at http://www.patientsafetyfirst.org/Information_Resources/Guidance.asp. Information about the correct site guidelines issued by JCAHO is available at http://www.patientsafetyfirst.org/special.asp.

AUDIOCONFERENCES

Presidential Commission members also recommended that audioconferences focusing on patient safety be developed. Ann Kobs, RN, MSN, senior director of project development, in collaboration with AORN's Center for Perioperative Education, planned and developed AORN's Patient Safety audioconference series. Each audioconference is approximately one hour long and includes handouts, a posttest, a bibliography, participation in a question-and-answer session, and the opportunity to earn one contact hour. To date, audio-conferences have focused on correct site surgery, medication errors, and surgical and postoperative complications.