The Joint Commission

NPSG.01.01.01
Use at least two patient identifiers when providing care, treatment, or services. For example, use the patient's name and date of birth. This is done to make sure that each patient gets the correct medicine and treatment.

MEDITECH Tools

MEDITECH's EHR ensures positive patient identification. In conjunction with swipe technology, caregivers can use filed medical numbers, health insurance numbers, account numbers, names, and birth dates to identify their patients.

MEDITECH's EHR helps to ensure safe medication administration through the Five Rights of medication management: Right Patient, Right Medication, Right Dosage, Right Route, and Right Time. To ensure that the right patient gets the right medication, MEDITECH's system offers a variety of patient identifiers, including the ability to scan barcodes on patient wristbands and medications to correctly identify the patient and the appropriate medication. Caregivers utilize barcode scanning technology prior to administering medications to confirm patient identity and medication information against data readily available via MEDITECH's on-line Medication Administration Record.

MEDITECH's Blood Bank and Patient Care and Patient Safety solutions are fully integrated, fostering the sharing of Blood Bank units and patient data between the two products. All data relevant to transfusions is updated in real time in the Transfusion Administration Record (TAR), a component of our Patient Care and Patient Safety solution.

The TAR, accessible to both nurses and Blood Bank personnel, is an electronic method for documenting patient vital signs and transfusion reactions before, during, and after blood transfusions. When used in conjunction with MEDITECH's Bedside Verification, staff can use barcode readers to scan and match patients with blood products to verify the right patient, blood product, and transfusion time, as well as donor blood type compatibility and blood product expiration dates.

While in the Operating Room area a patient can be identified by using a combination of methods such as the patient's name, date of birth, account number, medical record number, case number, and scanning the armband. Additionally, the World Health Organization's (WHO) Surgical Safety Checklist has been embedded within the timeout section of the surgical chart in an effort to make sure each patient gets the correct treatment.

The Imaging & Therapeutic Services / Imaging & Documentation Management application allows a patient to be identified by utilizing any of the available methods such as the patient's name, date of birth, account number, medical record number, requisition# and accession#. The requisition and accession#'s allow a given patient to be uniquely identified as well as the associated order(s). This not only helps streamline entry, but uniquely identifies both the patient and the associated order(s).

In Ambulatory, the new Letter Format Dictionary can be configured to include Page Headers that ensure patient identifiers display on all pages of printed output. Separate headers can be defined for page 1 and page 2/subsequent pages to provide flexibility with header display, while still uniquely identifying the patient on all output. For more information regarding how to setup this functionality, please review the below Enhancement guide:

• Ambulatory Letters: Define Headers/Footers and Control Margins

NPSG.02.03.01
Get important test results to the right staff person on time.

MEDITECH Tools

MEDITECH's fully-integrated system facilitates comprehensive, enterprise-wide communication throughout a healthcare organization. Physician desktops and nursing status boards act as global views of caregivers' patients and serve as central points from which to process all aspects of patient care. Status Boards can display new test results, with abnormal values flagged. Notifications can be created if needed for abnormal results.

MEDITECH's table-driven system helps your organization meet The Joint Commission's list of "Do Not Use" abbreviations, acronyms, and symbols. Relevant clinical data displays provide readily available, real-time patient information when managing medication therapies at the point of order entry and during medication administration. When ordering or administering medications, clinicians have the right information at the right time for critical decision making.

MEDITECH has several Best Practices and Workflow Guides that can be utilized to assist in the usage of notifications through the Physician Desktop:

• Provider Workload: Results Task Management
• Workload Functionality Guide (Ambulatory, Emergency Dept Mgmt, Physician Care Mgr)
• Workload Dictionary Setup Guide (Ambulatory, Emergency Dept Mgmt, Physician Care Mgr)

Integrated capabilities throughout the MEDITECH EHR ensure coordinated and safe ordering processes. The entire care team, including pharmacists, nurses, laboratory technicians, and radiology technicians, are included in the physician-initiated process. Physicians can also sign verbal orders and view results anywhere throughout the continuum.

MEDITECH's Expanse Patient Care's Handoff routine can be leveraged to facilitate transitions of care and shift change communication among care providers, replacing the current practice of documenting on paper. Customized handoff formats are embedded directly into the home screen or tracker to create a concise, streamlined workflow for capturing both objective and subjective data.

Special Indicator data items can be added to the trackers in the Emergency Department and in Surgical Services to facilitate communication between caregivers. Result Indicators can be utilized on the Big Boards in Operating Room Management (ORM) and Trackers in Surgical Services (SUR). Additionally, the World Health Organization's (WHO) Surgical Safety Checklist, embedded within the timeout section of the surgical chart, helps to decrease errors and adverse events and increase teamwork and communication in surgery.

The MEDITECH Imaging & Therapeutic Services / Imaging & Documentation Management routine allows for a customized public and private tracker (6.1 & Expanse releases.) This allows for the data on the screen to be tailored to the users given workflow, helping improve clinical decision-making and patient safety accordingly. Additionally, standard order and report-based desktops allow for data to appear in an organized fashion based on user preference (All Platforms.)

The New Activity List in Pharmacy (PHA) allows pharmacists to review changes to patient accounts, including order activity and test results. For orders that are generated via computerized physician order entry (CPOE), Pharmacists can utilize the New Activity List to review and verify orders generated outside of the Pharmacy as well.

NPSG.03.04.01
Label all medications, medication containers, and other solutions on and off the sterile field in perioperative and other procedural settings. Note: Medication containers include syringes, medicine cups, and basins.

NPSG.03.05.01
Reduce the likelihood of patient harm associated with the use of anticoagulant therapy.

NPSG.03.06.01
Record and pass along correct information about a patient's medicines. Find out what medicines the patient is taking. Compare those medicines to new medicines given to the patient. Give the patient written information about the medicines they need to take. Tell the patient it is important to bring their up-to-date list of medicines every time they visit a doctor.

MEDITECH Tools

MEDITECH supports users in providing the capability of printing labels in supporting applications. Labels can be printed for each drug dose as well as be used for eMAR scanning. Cart labels can also be printed and associated to the drawers on a medication cart in order to identify which patients medications are contained within the drawer.

MEDITECH's clinical applications can provide alerts for patients on blood thinning medications and can highlight dosage and interaction warnings. Nurses can also get easy access to the patient's latest international normalized ratio (INR) values.

Staff can use MEDITECH's clinical applications to accurately collect home medication information during triage or the admission process using structured data, including retrieval of Medication Lists from a patient's claim and pharmacy fill medication histories, Continuity of Care Documents (CCD), and the Patient Portal. The Home Medication List consists of medications prescribed within MEDITECH, ordered outside of the hospital network, or taken over-the-counter. During a patient's visit, any medication orders placed using computerized provider order entry (CPOE) or Pharmacy (PHA) appear on the patient's Active Medication List. Medication lists, containing both home and inpatient medications, can be viewed within the Medication Reconciliation and Discharge routines, as well as via the Summary Panel in the patient's electronic record. Full medication information and instructions are provided to patients at discharge.

Patients can review full medication information and instructions at any time in the Patient Portal, including dosage, form, route, frequency, prescribing physician, available refills, special instructions, and more information about the medication. Patients may request refills of current medication, request removal of medications no longer being taken, or report new medications received either over-the-counter (OTC) or prescribed by another physician.

Medications can be used safely while a patient is in the Operating Room area by printing labels for syringes for each drug dose and making use of medication carts. Med Reconciliation and Medication Lists can be utilized to review a patient's medication. In addition, PHA rules and label comments are applicable to Operating Room Management (ORM) and Surgical Services (SUR). Bedside Medication Verification (BMV) can be implemented in the preoperative and postoperative phases of the surgical encounter to ensure the 5 patient rights are followed and help avoid potential medical administration errors.

The Pharmacy product ensures patient safety by performing medication conflict checking when orders are created, edited and verified. Conflict checking capabilities include allergy interactions, drug-drug, drug-food, and drug-condition interactions, IV incompatibilities, contraindications, duplicate medications, dose range checking and lifetime dose checks.

NPSG.07.01.01
Use the hand cleaning guidelines from the Centers for Disease Control and Prevention (CDC) hand hygiene guidelines or the World Health Organization (WHO). Set goals for improving hand cleaning. Use the goals to improve hand cleaning.

MEDITECH Tools

The infection control functionality of MEDITECH's Laboratory Information System helps providers effectively and efficiently identify healthcare-associated infections. An organization's infection control group can easily track patient infections by automatically flagging organisms with markers or through other Customer-Defined screens. Staff can generate reports based on patient, location, physician, site of the infection, and type of organism–whether sensitive or resistant to certain antibiotics. Depending on the outcome of the reports, the infection control group can automatically receive alerts to help track nosocomial infections.

Evidence Based Links associated with Interventions and Outcomes provide valuable information to assist care providers in preventing infections. Status Board Condition Lists also provide a method of monitoring patient specific indicators and lab results that can be acted upon as needed to prevent infection from developing.

Authorized clinicians can also pull data from the MEDITECH EHR and store it in a secure database for robust reporting and benchmarking. Organizations can track and report on a variety of issues such as patient and visitor incidents, adverse drug events, employee health and safety, blood utilization, and infections with complete confidentiality. Staff can effectively analyze their efforts and devise strategies for improving outcomes and regulatory compliance.

MEDITECH has several toolkits and Best Practices that can be utilized to assist in reducing the risk of healthcare associated infections such as the:

• Catheter-Associated Urinary Tract Infections (CAUTI) Toolkit.
• Sepsis Management Toolkit.
• Multidrug-Resistant Organism (MDRO) Response & Containment Guidelines.

NPSG.09.02.01
Find out which patients are most likely to fall. For example, is the patient taking any medicines that might make them weak, dizzy or sleepy? Take action to prevent falls for these patients.

MEDITECH Tools

Authorized care providers can use MEDITECH's clinical applications to promote proactive fall risk management best practices across the continuum of care. Built-in nursing assessment algorithms — adapted for both the ambulatory and acute care settings — use sophisticated rules and calculations to evaluate the patient's risk level, requiring care team members to take precautionary measures. Electronic alerts communicate the patient's increased risk, cueing care team members to take action. Finally, integrated clinical decision support (CDS) embedded in nursing, ordering, and documentation tools streamlines workflow — facilitating effective identification and management to improve outcomes.

See MEDITECH's Expanse Fall Risk Management Toolkit.

NPSG.14.01.01
Assess and periodically reassess each patient's and resident's risk for either developing a pressure injury or worsening of their existing pressure injury. Take action to address any identified risks.

MEDITECH Tools

Care providers can use MEDITECH's Patient Care System to document assessments and interventions at the point of care, including documentation on the integumentary system, wounds, and pressure injuries. The use of directions on assessments can trigger a visual reminder that the assessment is due on the nurse's Status Board. Caregivers can also document risk assessments such as the Braden Scale to identify patients who may be at risk for developing a pressure injury during their encounter. In addition, care providers can annotate images to document details about injuries or wounds.

Quality management (QM) teams can monitor patients at risk for developing pressure injuries using MEDITECH's Quality Management Surveillance solution. Surveillance profiles create cohorts of patients that are being monitored for different conditions, such as those with documented pressure injuries, those with advanced-stage pressure injuries, and those at risk of developing pressure injuries based on elevated risk screening results. Quality managers or clinical staff can take action directly from surveillance profiles, initiating order sets, care plans, or physician notifications.

Finally, clinicians can use Status Boards and rounding lists to continue monitoring patients with pressure injuries, including:

• Viewing pertinent client demographic and clinical data.
• Quickly scanning due/overdue interventions, orders, and medications.
• Displaying query responses such as risk levels and current pressure injuries so they can be tracked and easily monitored.

NPSG.15.01.01
Reduce the risk for suicide.

NPSG.15.02.01
Find out if there are any risks for patients who are getting oxygen. For example, fires in the patient's home.

MEDITECH Tools

Authorized care providers can use MEDITECH's clinical applications to document standard and user-defined assessments which help caregivers identify at-risk patients, as well as tools to track and trend outcomes. In addition, clinicians use fixed or mobile devices to document everything from assessments to medication administrations at the point of care.

Patients in Long Term Care may include social appointments in the Patient Portal. Family or proxy users can track the patient's attendance to determine if the patient is withdrawing or disengaging from their social support network.

Within MEDITECH Expanse, embedded within inpatient nursing and provider workflows, patients can be proactively screened for depression and suicide risk. Global screening — and the subsequent guidance based on screening results — enables organizations to quickly identify at-risk patients and to initiate the recommended interventions and referrals for treatment.

See MEDITECH's Depression Screening and Suicide Prevention Toolkit.

NPSG.16.01.01

Improving health care equity is a quality and patient safety priority. For example, health care disparities in the patient population are identified and a written plan describes ways to improve health care equity.

MEDITECH Tools:

MEDITECH's Social Determinants of Health (SDOH) resource page provides links to:

• Current regulatory requirements related to health equity and social determinants of health (SDOH) & resources for defining organizational policies
• MEDITECH guidance for workflow and build
• Industry resources

UP.01.01.01
Make sure that the correct surgery is done on the correct patient and at the correct place on the patient's body.

UP.01.02.01
Mark the correct place on the patient's body where the surgery is to be done.

UP.01.03.01
Pause before the surgery to make sure that a mistake is not being made.

MEDITECH Tools

MEDITECH's Operating Room Management (ORM) and Surgical Services (SUR) solutions contain a customizable nursing documentation tool surgical staff can use to document the surgical "Time Out" and Surgical Safety Checklist. The World Health Organization's Surgical Safety Checklist within the timeout section of the surgical chart helps to reduce the risk of errors and adverse events.