University of Pittsburgh Medical Center - UPMC Shadyside and Children’s Hospital of Pittsburgh
Beth Kuzminsky, RN, MSN, Associate - Center of Quality Improvement and Innovation
Tami Minnier, RN, MSN, FACHE, Vice President - Center for Quality Improvement and Innovation
Sandy Rader, RN, MSA, Chief Nursing Officer and Vice President - Patient Care Services
Children's Hospital of Pittsburgh:
Diane Hupp, RN, MSN, Chief Nursing Officer and Vice President - Patient Care Services
Michael Decker, MD, The Paul C. Gaffney Diagnostic Referral Service, Physician Lead for Condition H
Michele Carlson, BSN, RN, Unit Director, Supplemental Staffing Pool Administrator on Duty/Patient Flow Coordinator
How the Program Came to Be
According to Tami Minnier, “Listening to Sorrel King tell her tragic story left a lasting impression with me. ‘If I would have been able to call a rapid response team, I believe Josie would be here today,’ says Sorrel King. Providing the highest quality care for patients and their families is UPMC’s history. I knew that we had to bring a family life line to our patients.”
UPMC Shadyside's Condition H model was created to address the needs of the patient and family in case of an emergency or when the patient is unable to get the attention of a healthcare provider in an emergency situation. The call provides our patients and families an avenue to call for immediate help when:
- they feel they are not receiving adequate medical attention; or
- if they become concerned with what is happening.
When Condition H is called, a rapid response team arrives to the patient’s bedside within minutes.
Who is on the Team
- Internal Medicine House Physician
- Patient Relations Coordinator
- Administrative Nursing Coordinator
- Floor staff where the Condition H is called
Goals for the Program
The program has been designed to be a safety net for patients as UPMC strives to make hospitals safer. In many cases, it is the family who knows the patient better than we do. Condition H should be called in an emergency situation if a patient, family member, or friend:
- has concerns over what is happening;
- is not receiving the attention they feel is necessary; or
- when there is confusion over what needs to be done in a critical situation,
Our trained response team will arrive within minutes to stabilize the situation and work to meet patient and family needs. We believe in partnering in care delivery with the patients and families we care for; Condition H is for our patients.
How It is Implemented
Patient education is provided to patients at time of hospital admission. A Condition H educational brochure is provided to patients with instructions on how to call the Condition H line if necessary. Also, Josie King’s story is available on the patient Bedside Education System and room signage and telephone stickers providing instructions on how to call the Condition H line are available in all patient rooms.
To call the Condition H line, patients and families are instructed to dial 3-3131 from any hospital telephone. The trained hospital operator receives the call, announces the condition, and enters information into the responding teams’ pagers. Within minutes the team arrives to the patient bedside to remedy the problem. Information is collected on a survey questionnaire after the situation is stabilized. Within twenty-four hours of the Condition H call, a team member revisits the caller to ensure the patients needs have been met.
Follow up calls are also made to patients once they are discharged from the hospital to learn more about patient satisfaction with the program. This process allows UPMC Shadyside to learn where areas of program opportunity exist.
Why It Makes Sense
There is no good reason why a hospital should not implement a rapid response team that can be called by patients and families. If people are able to call 911 from their home, why is this control taken away from them when hospitalized? Condition H can save lives and on patient and family interviews, we have found they feel it is the right thing to do. Patients and families reported that knowing that UPMC Shadyside has Condition H makes them have more confidence in the hospital and also makes them feel safer while hospitalized.
In year one, we found that:
What People are Saying
- 90% of patients who called Condition H would call it again if they felt it was needed;
- 100% of callers felt their needs were met by the responding nurse; and
- the data suggests that 69% of Condition H calls would have led to potentially harmful patient situations if Condition H had not been called.
UPMC is proud of this program and knows it is the right thing to do. Condition H can help healthcare providers when tough situations occur. At first we may have had concerns that Condition H calls may drain our resources, but that just hasn’t happened.
Who Else is Implementing
UPMC is an 18 hospital healthcare system in Western Pennsylvania. Since 2007, the entire UPMC system has Condition H programs in place.
Due to the success of Condition H at UPMC, health care systems all over the country are beginning to implement patient- and family-activated rapid response teams.
How Other Hospitals Can Implement
- Gain support from hospital leadership.
- Build the rapid response team.
- Start small: one patient or one nursing unit.
- Learn from the pilot and then expand to other units.
- Show staff The Josie King Story DVD.
- Talk one on one with staff and patients.
- Involve patients and front line staff in building the program.
- Train all staff on the program.
- Educate all patients on admission.
- Collect data and meet monthly to learn from calls received.
Documents to Download
Condition H Brochure (PDF)
Condition H Poster (PDF)
Condition H Flier (PDF)
Condition H Admit Info (PDF)
Condition H FAQs (PDF)
Condition H Post Training Questionnaire (PDF)
Condition H Follow-Up Questionnaire (PDF)
A Condition H toolkit is available for free online from the Maryland Patient Safety Center.
How the Josie King Foundation Contributes
The Josie King Foundation funded some of the initial needs of Condition H. Specifically, the foundation funded the initial patient educational brochure and the production of a video detailing Condition H at UPMC which patients view while hospitalized.
For More Information
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