Objective: For this assignment, you will create a Domestic Violence Protocol for a Community Health Center that you will be able to choose (Any Health Care Facility).The Domestic Violence Protocol is designed to provide guidelines and establishes standards for public safety call takers, dispatchers, first responders and investigators in handling domestic violence incidents. The Protocol seeks to interpret and apply statutory and case law relating to domestic violence incident response and investigation. Particular attention is given to protecting victims of domestic violence, including children, other members of the household and pets, through enforcement of restraining orders, medical care, and working with support agencies to provide alternate shelter, relocation services, counseling and Legal services.You are encouraged to choose (Any Health Care Facility: Hospital, Doctor Office, Emergency Care Center, etc.).The paper will be 8-10 pages long. ASSIGNMENT GUIDELINES (2 points /10%): Students will create a Domestic Violence Protocol for the Institution of your choosing.The purpose of this protocol is to set a standard to improve both the quality of the care given by individual health care providers and the overall CPHS response to domestic violence.This protocol outlines the elements of an effective response. You need to read the article (in the additional weekly reading resources localize in the Syllabus and also in the Lectures link) assigned for this week and develop a 8-10-page paper reflecting your understanding and ability to apply the readings to your Health Care Setting. Each paper must be typewritten with 12-point font and double-spaced with standard margins. Follow APA format when referring to the selected articles and include a reference page. EACH PAPER SHOULD INCLUDE THE FOLLOWING: Introduction (5 points / 25%) Offer an abstract that provide a brief outlook of the protocol and explaining in your own words what is meant by a Domestic Violence Protocol for a Health care Facility. 2. Your Domestic Violence Protocol (10 points 50%) a. Presentation Page: PROJECT NAME ORGANIZATION NAME BUSINESS ADDRESS CITY, ST, ZIP TELEPHONE NUMBER FACSIMILE NUMBER WEBSITE ADDRESS EMAIL ADDRESS b. Definition and Guiding Principles: What is Domestic Violence, sings of violence, and mention the principles of this protocol. c. Screening: In all primary care clinics, family planning clinics, prenatal clinics, mental health clinics, social work intakes, PHN intakes: Screen all women and adolescent girls.Also, screen men and boys presenting with symptoms or signs of domestic violence d. Assessment: Obtain history of present complaint.Physical examination:Request that patient disrobe for a more thorough exam.Provider should examine for evidence of further injuries or scars. e. Intervention f. Documentation: Health care providers should complete a legible medical record for each known or suspected victim of domestic violence.This record should include the following:• A description of domestic violence history, including present complaints or injuries, past experiences of physical/sexual abuse and frequency of abuse.Include date, time and location of domestic violence incidents.• Whenever appropriate use the patient’s own words in quotation marks.• A description of patient’s injuries, including type, location, size, color and age.Document injuries on a body map (See Appendix E for sample Body Map). • Alleged perpetrator’s name, address, and relationship to patient (and children, if any), if patient is willing to provide this information.• A description of other health problems, physical or mental, which may be related to the abuse g. Mandatory Report of Injury h. Continuity of Care 3. Conclusion (3 points / 15%) Briefly recapitulate your thoughts & conclusion to you Domestic Violence Protocol. How did this plan impact your thoughts on Health Care Administrator and Human Resource Department? Evaluation will be based on how clearly you respond to the above, in particular: a) The clarity with which you associate, relates, stablish and apply your knowledge to generate the Domestic Violence Protocol; b) The Complexity, depth, scope, Profundity and organization of your paper; and, c) Your conclusions, including a description of the impact of the Domestic Violence Protocol on any Health Care Setting.Chapter 25
Culture of Safety
• Discuss a process for developing a culture of
safety in healthcare organizations.
• Describe a variety of organizations that are
dedicated to improving patient care and
• Explain the process of communications and
why different people often have different
views on various discussion topics.
• Explain how the checklist tool can be used for
evaluating the quality of patient care.
• Discuss how performance improvement
processes, adoption of best practices, risk
management programs, failure mode effects
analysis, and addressing sentinel events can
be effectual in developing a culture of safety.
Institute of Medicine
• Mission to advance & disseminate scientific
knowledge to improve human health . . .
• IOM reports 98,000 May Die Annually in U.S.
Hospitals Due to Human Errors.
• 8th Leading Cause of Death in the U.S.
Improving Safety
• Zero Tolerance Policy
• Focus on How to do Things Right the First
• Develop a Culture of Safety
• Reduce Risks
– Implement National Patient Safety Goals
– Ensure an effective Patient Complaint Process
Developing Culture of Safety – I
• Ensure accountability & responsibility has
been assigned for monitoring an
organization’s safety initiatives.
• Involve the medical staff.
• Educate all staff as to their individual roles in
establishing & maintaining a safe environment
for patients.
• Encourage patients to question their care.
Developing Culture of Safety – II
• Establish a patient safety committee with
responsibility for oversight of the organization’s
patient safety program.
• Set up a dedicated safety hotline.
• Participate in the Institute for Healthcare
Improvement’s 100K Lives Campaign by committing
to the implementation of its life saving initiatives.
• Utilize online tools released by Agency for Healthcare
Research & Quality (AHRQ) to assist organizations in
evaluating & improving safe care.
Agency for Healthcare
Research & Quality
• Lead federal agency charged with improving
– Quality of healthcare
– Safety
– Efficiency
– Effectiveness
Joint Commission Patient Safety Goals
• National patient safety goals in JC
accreditation process
– two patient identifiers
– improving the effectiveness of
– timely reporting of critical test results
– see: www.jointcommission.org
National Quality Forum
• A non-profit corporation.
– Mission to develop & implement a national
strategy for health care quality.
– Identifies safe practices that should be
adopted in all care settings.
Institute for
Healthcare Improvement
• Improve Healthcare throughout the World
• Reduce Medical Errors
• Promote Safe Practices
The Leapfrog Group for Safety
• Promotes Safety Delivery of Healthcare
• Provides Consumers with Education
Emergency Care Research Institute
• Evidenced Based Best Practices Center
• Mission to Promote Highest Standards of
– safety
– quality
– cost-effective care
Improve Communications
• Communications
– exchange of thoughts & information through
speech, the written word, or behavior
• Words are the tools of thought
• Challenge
• better understand the communications
• See Chapter Communications figures
Evaluating Safe Patient Care – I

Credentialing Licensed Practitioners
Human Resources Process
Patient Education
– Discouraging Abbreviations
– Improving Handwriting
• Emergency Services
Evaluating Safe Patient Care – II
• Critical Tests
– Timely Reporting
• Security
• Emergency Preparedness
• Patient Identification
– At least 2 patient identifiers.
• Infection Control
– Hand Hygiene
Evaluating Safe Patient Care – III

Laboratory Services
Surgical Specimens
Medication Safety
Patient Assessments
Surgery & Invasive Procedures
– Universal Precautions
Spiritual Care Services
• Spiritual needs of patients are addressed, and
patients know such services are available and how to
access them.
• Organizational policies and procedures address the
psychosocial, spiritual, & cultural variables that
influence one’s understanding /perception of illness.
• Referrals are made by caregivers for spiritual
assessment, reassessment, & follow-up.
• Documentation is placed in the patient’s medical
record to indicate that the patient’s spiritual needs
have been addressed.
Performance Improvement:
Continuous Quality Improvement
• Approach to improving quality on a continuing
• CQI Data Collection
– Volume Indicators
– Clinical Indicators
– Occurrence Screens
– Focused Reviews
– Clinical Pertinence Reviews
• Paradigm Shift
Best Practices
• Specialty societies either have drafted or are
drafting practice guidelines for their medical
area of expertise.
• Practices not valuable unless implemented.
Risk Management
• Purpose to reduce patient care &
environmental risks
– number of patient injuries
– minimize exposure of an organization to lawsuits
– sensitivity to providing a safe environment
• Minimize exposure to lawsuits
Failure Mode Effects Analysis
• Methodology used for identifying &
preventing product & process problems
before they occur.
Sentinel Events – I
• Unexpected occurrence involving death or
serious injury.
• Includes, for example
– blood transfusion reaction
– surgery on the wrong patient or body part
– leaving an unintended foreign object in a patient’s
body during surgery
Sentinel Events – II
• Root cause analysis (RCA) of a sentinel event
• review an event to identify what, how, why,
when, and where an unwanted event
• used to help prevent reoccurrence of the
same or similar events
Questions – I
1. What is this chapter referring to when it
speaks of a zero-tolerance policy?
2. Why are organizations encouraged to create a
culture of safety?
3. Describe steps hospitals can take in order to
achieve a culture of safety?
4. What is the purpose of the Joint Commission’s
national patient safety goals?
Questions – II
5. What is the purpose of the Joint Commission’s
complaint process?
6. What is the mission of the National Quality Forum?
7. What is the mission of the Agency for Healthcare
Research and Quality?
8. What is the mission of the Institute for Healthcare
9. What is the mission of the Leapfrog Group for
Patient Safety?
Questions – III
10. Describe how the risk management process
can be helpful in reducing the number of
malpractice claims.
11. Describe the continuous quality
improvement process as it applies to health
care organizations.
Chapter 26
World Wide Search
© 2014 Jones and Bartlett Publishers
• Describe how the Internet is an invaluable tool
for improving patient care.
• Explain the use of search engines, browsers,
and search tips.
• Determine the trustworthiness of healthcare
• Identify a variety of legal, ethics, and
government related websites.
© 2014 Jones and Bartlett Publishers
Knowledge is of two kinds.
We know a subject ourselves,
Or we know where to find information upon it.
−Samuel Johnson 1709 -1784
© 2014 Jones and Bartlett Publishers
Evaluating Websites
• Health on the Net Foundations (HON)
– Non-profit organizatiion
– Code of conduct for evaluating websites.
– www.hon.ch
© 2014 Jones and Bartlett Publishers
Search Engine
• A program that searches the World Wide Web
– Google
– Yahoo
– Internet Exployer
– Medscape, etc.
© 2014 Jones and Bartlett Publishers
Search Tips – I
• Review the search tips that various search
engines provide.
• Use quote marks around phrases to ensure
adjacency of words.
• Use a variety of search engines if you are
having difficulty locating a particular topic.
• Domain names describe the location of the
server where the information being sought is
© 2014 Jones and Bartlett Publishers
Search Tips – I
• Knowing domain names where files are stored is
helpful when conducting random searches for
information. Domain Web sites include the following:
– .com: commercial organizations (businesses)
– .edu: educational organizations
– .gov: government agencies
– .mil: military
– .org: miscellaneous organizations
– .net: network providers
• A path name follows the domain name and identifies
the location of an item on the server.
© 2014 Jones and Bartlett Publishers
• Web guide to health care fraud.
• Health sources not recommended for health
• See: www.quackwatch.com
© 2014 Jones and Bartlett Publishers
Accreditation Information

Interpretative Guidelines
Survey and Certification Letters
CMS Home Page
CMS Survey and Certification Home Page
Electronic CFR
Social Security Act
© 2014 Jones and Bartlett Publishers

Best Practices
Hospital & Physician Finders
Health Care Resources
International Medical Websites
© 2014 Jones and Bartlett Publishers
1.What is the importance of HON?
2.What is a search engine?
3.What is Telemedicine?
4.What is Quackwatch (www.quackwatch.com)?
© 2014 Jones and Bartlett Publishers
Chapter 27
Journey to Excellence
• Discuss the meaning of Journey to Excellence.
• Describe a variety ideas for beginning the
Journey to Excellence.
• Discuss why a healthcare war room is a
valuable tool for organizations.
• Describe several ways in which a project can
be funded and a vision become reality.
• Explain the purpose of the Baldrige award.
Excellence can be attained if you . . .
Care more than others think is wise,
Risk more than others think is safe,
Dream more than others think is practical,
Expect more than others think is possible.
Author Unknown
“there is nothing more
difficult . . . than to take the
lead in new things”
The Journey
• Begins with a Vision for Improving Patient
• Supported by Leadership
• Allocation of Time
• Provision of Resources
• A Passion for Excellence
Ideas for Getting Started

Healthcare War Room
Ambassadors Worldwide
Professional Exchange Programs
Partners in Education
Best Practices
Information Technology
Artificial Intelligence
Ideas for Getting Started

Streamline Data Collection and Evaluation
Medical Information Repository
Focus on Preventative Medicine
The Five Senses
The War Room
• Designed & Dedicated to
– Brainstorming
– Encouraging Vision & New Ideas

Prioritizing Ideas for Implementation
Funding Your Dreams – I
The way to predict the future is to create it.
Vision is the gift to see or do
what others only dream.
—Author Unknown
Funding Your Dreams – II
• Adopt a Hospital
• Visually display your vision on an electronic
dream board
• for all to see: high- traffic areas, hospital
lobby, emergency department
The way to predict the future
is to create it.
Vision is the gift to see or
do what others only dream.
−Author Unknown
Performance Excellence Program – I
• Malcolm Baldrige National Quality Award
– Malcolm Baldrige Secretary of Commerce
– Congress named the award
• highest level of national recognition for
performance excellence that a U.S.
organization can receive
Performance Excellence Program – II
• Organization must have a role-model
organizational management system that
– ensures continuous improvement in the
delivery of products and/or services
– demonstrates efficient and effective
– provides a way of engaging & responding to
customers and other stakeholders
Baldrige and Health Care: New Survey
Reaffirms a Proven Partnership for Success
For the second time in two years, Truven Health Analytics, a
major healthcare survey research and data analysis
organization, has linked hospitals that adopt and use the
Baldrige Criteria… to successful operations, management
practices and overall performance. The program has long
been the gold standard for leadership practices to drive higher
quality and organizational performance. Our effort to use the
100 Top Hospitals National Balanced Scorecard to identify the
use of these practices is an early step in the establishment of
evidence-based management practices,” said Jean
Chenoweth, senior vice president at Truven Health Analytics,
in a Nov. 20, 2012, news release.
−Micahel E. Newman, NIST Tech Beat, December 2012
Accept the challenges
so that you may feel
the exhilaration of victory.
−Author Unknown
1. What message is the author attempting to
convey in this chapter?
2. Discuss ideas for getting started?
3. What are dream boards?
4. What is the Malcolm Baldrige National
Quality Award?

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