Improve the Accuracy of Patient Identification
Identifying patients accurately and matching the patient’s identify with the correct treatment or service is an important component of patient safety. The misidentification of inpatients and outpatients can happen all too easily given the fast-paced nature of medical care, and unfortunately, we have had and continue to have our share of these errors. This is why the Joint Commission has made patient identification the first of its national Patient Safety Goals. More to the point, if we cannot identify patients properly, how can we expect them to trust us with their care? Therefore we are changing our expectations for how this process should be performed.
The Joint Commission requires that “two identifiers” be used (neither to be the patient’s room number) whenever administering medications or blood products; taking blood samples and other specimens for clinical testing, or providing any other treatments or procedures.
At CKHS we have chosen the patient’s name, date of birth, and/or the Medical Record Number as choices for the two identifiers. Other acceptable identifiers for your office, in addition to the patient’s name may include:
- Telephone number – but a drawback to using this is that the patient may forget their number or may change it frequently
- Social Security number – use of Social Security number may present a risk of identity theft if overheard and some patients don’t know their Social Security numbers
Safest practice, whenever possible, is to have the patient identify themselves. While it may seem unlikely, many patients will respond to incorrect names. Recently, a physician reported he went to his waiting room and called for Mrs. Smith. There was only one person in the waiting room and she followed him to the exam room. At the conclusion of the exam when asked if she had any questions, she stated, “Only one. Why do you keep calling me Mrs. Smith? I am Mrs. Jones.” You can imagine the physician’s surprise. This has also happened in the outpatient testing and treatment areas of our facilities with patients even receiving testing that was not prescribed for them. Often this occurs because patients are apprehensive and intimidated by being in a hospital or outpatient setting or, with increasing frequency in older patients, because they are hearing impaired.
It’s the Policy of Crozer-Keystone Health System (CKHS) that before any procedure is performed, a minimum of two identifiers are to be used to confirm that we are addressing the correct patient. Identifiers to be used by CKHS staff, in order of priority, are:
- Patient Name
- Patient Date of Birth
- Medical Record Number
In a fundamental change of behavior, staff should NOT state the name, date of birth, and ask the patient to confirm it. Instead, proper patient identification requires the staff to ask the patient to state his or her name and date of birth. Not only do we want to properly identify the patient, but we also want to protect our staff and physicians from the risk of misidentifying patients in the fast paced, high turnover environment they work in.
Every intervention with a patient in any area of the hospital, especially before a procedure or service, must include confirmation and verification of the patient’s identification using a minimum of two of the three prescribed patient identifiers before the service or procedure is performed. This information must be actively obtained from the patient, and be verified by matching it with the medical record, as well as confirming the nature and laterality of the procedure or service. This is also a good practice to adopt in your office.
Patients may wonder why their identity is confirmed so often. Staff members should always explain that it is done to ensure the right care is provided to the right patient all the time.
The practice of having the patient involved in identifying themselves and using “two patient identifiers” is essential in improving the reliability of the patient’s identification process. The use of two identifiers also helps ensure that a correct match is made between the service or treatment and the individual. This process will help eliminate errors and enhance patient care.
Improve the Accuracy of Patient Identification Risk Management Quiz and Answers
Improve the Accuracy of Patient Identification Quiz (December 2007)
Improve the Accuracy of Patient Identification Answers (December 2007)