Bed side manner and Patient safety

Prepared by Dr. Bhupendra P Makwana,MHM, PGDHA, PGDHR, BHMS.Hospital administrator,Bankers Heart and Multi Specialty Hospital,Vadodara.

What is bed side manner ??? In short BSM means “a doctor's or any health profession

approach or attitude to a patient.” Healthcare professionals neglect interpersonal skills in

favor of clinical ones. It is easy to forget that a good bedside manner is one of

the main tools for diagnosis. As a physician, you should be able to read your patients’

body language and master your own in order to put those you treat at ease.

You should also know how to listen and communicate effectively so that you can fully understand the patient’s condition.

These skills are collectively referred to as "bedside manner."

Important of Bedside manner

Growing awareness of the need for interprofessional cooperation in healthcare.

The Countless studies have shown that genuine teamwork and team intelligence are critical to patient safety.

Poor communication among health care personnel is a major factor in hospital errors, even more so than the level of staff competence and experience.

This is why many schools for health professionals and major health care employers now promote interprofessional education and cooperation.

Bedside Manners is a play about workplace relations among physicians, nurses, others who work in health care, and patients—and how their interaction affects the quality of patient care, for better or worse.

( Refer book and review of Bedside Manners,Play and Workbook by author Suzanne Gordon, Lisa Hayes, Scott Reeves foreword by Lucian L. Leape)

Who involved

Consultant and doctors. Nursing staff. Technicians. House keeping staff. Managers and administrator. Even security and drivers also.

Bed side manner value:- Patient satisfaction can be improved if patients are encouraged to express

their ideas, concerns, and expectations. A healthcare provider’s bedside manner encompasses their medical

knowledge, personality, and ability to understand the patient and communicate their concern for them.

Healthcare involves many personal interactions with a variety of people. Etiquette in healthcare is more than just good manners; it is about establishing respectable relationships with patients, colleagues, and supervisors.

In a medical setting, healthcare professionals must set the tone for the interaction with patients and visitors. They are constantly in contact with people who will assess them based on the way they communicate, body language, and appearance.

Healthcare professionals have a tremendous obligation,” says Dr. Robert J. Wolff, PhD, program director of Health Science at South University, Columbia. “The most important thing is that healthcare professionals have higher standards than most professions because they are dealing with the dignity of patients and their ability to be healed.”

Simple term to judge BSM San Diego, California-based medical

marketing firm Sullivan Luallin Group created the C.L.E.A.R. protocol.

According to the Sullivan Luallin Group, service performance is as important as clinical performance; just as there are clinical guidelines, service protocols are necessary too.

(http://source.southuniversity.edu/healthcare-professionalism-how-important-is-proper-bedside-manner-132067.aspx)

C.L.E.A.R. Healthcare Service Model

Acknowledge immediately Establish eye contact and smile Use the patient’s name Use a friendly, helpful voice tone Say “please” and “thank you”

1. Connect

2. Listen

Maintain eye contact Be relaxed Don’t interrupt Use “active” listening techniques Repeat information for accuracy

C.L.E.A.R. Healthcare Service Model

3. Explain

Describe what’s going to happen Answer questions with patience Let patients know about expected

delays Speak slowly; repeat as necessary

C.L.E.A.R. Healthcare Service Model

4. Ask

“Were all your questions answered?” “Is there anything else I can do…?” “Did you understand…”

C.L.E.A.R. Healthcare Service Model

5. Re-connect

Check back frequently with waiting patients

Direct patient where to go next End with a friendly parting comment

C.L.E.A.R. Healthcare Service Model

Patient safety.

Safety full form :-1. S – sense the error.2. A – Act to prevent it.3. F – Follow safety Guidelines.4. E – Enquire into accidents/Deaths.5. T – Take appropriate remedial

Measure.6. Y – Your responsibility.

Patient safety is the absence of preventable harm to patient during the process of health care.

The discipline of patient safety is the coordinated efforts to prevent harm to patients caused by the process of health care itself.

It is generally agreed upon that the meaning of patient safety is …” please do not harm.

Hospital safety related to

Hospital safety

Hospital property

PeoplePatients

SAFETRY OF PLACE

INFRASTRUCTURE FIRE ELECTRICAL AND MECHANICAL

SAFETY OF PROPERTY

SAFETY OF PROPERTY

SAFETY OF PEOPLE

PATIENT

VISITORS

STAFF

Current Envirorment.

Errors and system failures repeated. Action or known risks is very slow. Detection systems in their infancy. Many events not reported. Understanding of causes limited. Few examples of successful scale up. Limited measurement of impact. Blame culture ‘alive and well’ Defensiveness and secrecy.

Medical Errors 1 in 10 patients admitted to hospital suffers

an adverse event. The institute of medicine in their study found

out that in USA. Medical Error Injures 1 in 25 hospital patients. Kills about 44000 to 98000 patients every

years. Medical errors cost the united states billions

of dollars each years. In India this condition is very worse as no

dates are properly maintained.

How Dangerous is Health Care Less than one death per 100,000 encounters. Nuclear power. European Rail Roads. Scheduled airlines. One death in less than 100000 but more than

1000 encounters. Driving. Chemical Manufacturing. More than one death per 1000 encounters. Bungee jumping ( Tying Rope on leg). Mountain climbing. Health care.

WHO Error

66 & 16% •16% accident due to error by hospital staff.

14% & 4% •14% accidents staff and patient both equally responsible and 4% accidents due to physical, Mechanical or Electrical Errors.

Patient Safety Goal

Principle of Patient Safety.

Principle of Patient safety

Type of Safety

Bed side manner and patient safety relation Both have equal relationship. Increase bed side manner increase

patient safety with patient satisfaction.

As per JCI safety check list

7 Barriers to implementation1. Competing priorities for scarce resources in a

system where patient safety is not considered a top priority.

2. Lack of resources.3. Availability and cost of patient safety.4. Resistance to change.5. Culture of blame.6. Lack of senior leadership understanding of and

involvement with patient safety issues.7. Culture of health care work force, perceptions,

attitudes and behaviors of error “ Cover Up”.

Practice of Patient safety as per WHO Be aware of Look alike, Sound alike Medication Names. Proper Patient Identification. Explain in detail during patient Hand & take Overs. Performance of Correct procedure at correct body site. Careful about electrolyte imbalance. Assuring proper treatment during shifting. Avoid Catheter and tubing, wrong Connections. Single use of injection syringes. Improved Hand Hygiene to prevent Health care

associated infections. Proper Disposal of BMW and Good House Keeping

Practice Surgical Safety Guide Lines.

Tip for improving patient safety. Constitution of Patient Safety Committee. Dvelop Clear Policies and Protocols for Patient Safety. Discuss Regularly patient safety initiative within hospital

staff. Orientation, Re – orientation of Hospital staff on patient

safety. Encourage transparency in the regular death review. Non – punitive incident reporting by staff. Each department to devise their own patient safety

protocols. Investigate each accident/incident reported and take

remedial measures. Review, monitor and evaluate safety procedures regularly.