Positive patient identification

1
Positive patient identification

• Alastair Bishop
• CHI Programme Manager
• Improvement Support Team
• Scottish Government Health Directorates

2
Overview

• What is positive patient identification?
• Why use PPI?
• What if we dont use PPI?
• PPI for the whole patient journey
• What about laboratory services?
• How does this relate to eHealth?
• What next?
• Questions

3
What is positive patient identification?

• A process by which the patients identity is
  checked and confirmed at every point in the
  patients journeye.g. at the point of sample
  collection
• Ask the patient
• Check against wristband
• Dont assume
• You have the right notes for the patient
• You have the right labels for the patient
• The patient is in the right bed!

4
Who should use PPI?

• Everyone involved with the patients care
• It is everyones duty to get it right first time
  and every time

5
Why use PPI?

• To improve patient safety
• To improve the patients experience
• To support better quality care
• To save wasted time

6
Improving patient safety

• Mixing up information about two different
  patients (e.g. with similar names, dates of
  birth)
• Failing to join together different information
  about the same patient (e.g. name or date of
  birth or ID numbers dont match)

7
Improving the patients experience

• Less need to repeat tests and investigations
  because previous results cant be found
• Less delay in finding required information
• Less need to ask patients the same questions
  again and again

8
Supporting better quality care

• By getting patient identification right every
  time
• Reduce delays
• Reduce repeated/duplicated work
• Provide clinical staff with more complete
  information on which to base decisions

9
To save wasted time

• Chasing results and other information
• Repeating tests
• Extra checking, phone calls and searches because
  patient details are incomplete or ambiguous

10
What if we dont use PPI?

• Risk of errors impact on patient safety
• Delay, stress and unnecessary tests for the
  patient
• Incomplete clinical information
• Wasted time for staff

11
What if we dont use PPI?

• Two District Nurses visited a gentleman at home
  and proceeded to give him a bath
• The following day they were asked why they had
  not been to bath 'Mr Smith'
• When they advised that they had, it became
  apparent they had visited the wrong 'John Smith'
• When they asked the patient who did receive the
  bath why he didn't say anything he replied, I
  was having a good time!

12
PPI for the whole patient journey

• There are many different ways of identifying
  patients
• CHI number
• Hospital numbers
• AE numbers
• Local identifiers
• Name and date of birth
• But patients move between different parts of the
  NHS in Scotland
• A single, consistent approach is required

13
The patient journey
14
The patient journey
Hello!
15
The patient journey
Hello!
16
The patient journey
Uh-oh!
17
The patient journey
18
The patient journey
19
The patient journey
Quick, get her to AE!
20
The patient journey
21
The patient journey
AE number
22
The patient journey
AE number
Right X-ray, crossmatch, UEs
23
The patient journey
AE number
She needs to be admitted
24
The patient journey
AE number
25
The patient journey
AE number
Hospital number
26
The patient journey
AE number
Hospital number
Where are her UEs? Never mind, well do them
again. LFTs too please.
27
The patient journey
AE number
Hospital number
Well pin her femur tomorrow.
28
The patient journey
AE number
Hospital number
29
The patient journey
AE number
Hospital number
30
The patient journey
AE number
I feel much better!
Hospital number
31
The patient journey
AE number
You can go home now. Well write to your GP.
Hospital number
32
The patient journey
AE number
Hospital number
33
The patient journey
AE number
Home at last!
Hospital number
34
The patient journey
AE number
Hospital number
Discharge letter
35
The patient journey
AE number
Hospital number
Discharge letter
36
The patient journey
AE number
Whats the point of sending us hospital numbers?
Grrr.
Hospital number
37
The patient journey
AE number
Hospital number
Time for a follow-up visit
38
The patient journey
AE number
Hospital number
39
The patient journey
Lets do an FBC
AE number
CHI number
Hospital number
40
The patient journey
Ill arrange for the physio to see you.
AE number
CHI number
Hospital number
41
The patient journey
AE number
CHI number
Hospital number
42
The patient journey
AE number
CHI number
Hospital number
43
The patient journey
AE number
CHI number
Hospital number
Alphabetical filing?
44
The patient journey
Im tired. I want to go home.
AE number
CHI number
Hospital number
Alphabetical filing?
45
The patient journey
AE number
CHI number
Hospital number
Alphabetical filing?
46
The patient journey
AE number
Uh-oh!
CHI number
Hospital number
Alphabetical filing?
47
Quiz time

• What is the best choice for a single, consistent
  identifier for patients in NHS Scotland?

48
Quiz time

• What is the best choice for a single, consistent
  identifier for patients in NHS Scotland?

CHI!
49
Quiz time

• What is the best choice for a single, consistent
  identifier for patients in NHS Scotland?
• So, any ideas?

50
Quiz time

• What is the best choice for a single, consistent
  identifier for patients in NHS Scotland?
• The CHI number

51
The CHI number

• The unique identifier for people receiving health
  care in NHS Scotland
• Use of CHI on clinical documents has improved
  significantly since September 2005
• Issues
• Some people dont currently get CHI numbers
• Links to CHI computer system are sometimes
  unreliable
• We still use all sorts of other identifiers
  across NHS Scotland

52
What about laboratories?

• Some topics for discussion
• Laboratorys role in supporting / encouraging /
  mandating use of CHI
• Patient identifier vs. case record identifier
• CHI as well vs. CHI instead
• Updating lab systems to use CHI as the only
  identifier
• What about patient records / results that already
  have CHI as a secondary identifier?

53
How does this relate to eHealth?

• A single, consistent approach to identifying
  patients across NHS Scotland allows us to
• Join up patient information easily and safely
• Better manage access to information who can see
  what?
• Improve patient safety - reduce risk and delay
• Support delivery of high quality care

54
What next?

• So far the CHI programme has worked with NHS
  Boards to make best use of CHI as it currently is
• In the future we need to think about how to
  develop CHI itself to fully support Positive
  Patient Identification
• We also need to change the way we think about
  identifying patients across NHS Scotland

55
Questions

• ?