Five-Minute Consult

Rosemary (Bunny) Smith
Vice President/Chief Nursing Officer
Cabell-Huntington Hospital
Huntington, WV

As 313-licensed-bed Cabell Huntington Hospital neared completion of its new bed tower in 2008, nursing leadership decided to revamp its failure modes analysis team, a group charged with preventing failures in patient care. Patients needed to be moved, and not only did the team want to prevent any errors with transferring patients, it needed to devise new plans to incorporate the amenities in the new tower. Rosemary (Bunny) Smith, the hospital's vice president and chief nursing officer, worked with Valerie Smith, her director of quality assurance, to ensure security of medical records and the acclimation of physicians and residents to the new system and layout, among other patient safeguards.

Bunny Smith: When a failure modes team is formed, they look at the moving process, flowchart it, and determine the risk points that could fail that would have an effect on patient safety. For example, if a patient had a cardiac arrest, would they know how to get to that patient with new floors and new bed numbers? What happens if there's a fire? Does the staff know how to evacuate that new bed tower? Another emphasis was on medical records. Patient records were outside the patient's door in the old building. Now we have a nurse server, a wall unit which was much more secure, but we needed to plan a new work process there. Also, the nursing unit layout was completely different than our old building, so we revamped processes there. We also developed an educational online program—mandatory for all employees—which taught everyone about the new tower, its features, and where supplies are located. You should start early and make sure you have all the players at the table.

—Philip Betbeze