Guest Columnist

NEWLY DEVELOPED SITTER KIT AT METHODIST HOSPITAL | STONE OAK ELEVATES THE PATIENT CARE EXPERIENCE

I have served in healthcare for almost 20 years now and have had the privilege of taking care of patients suffering from mental illness on countless occasions. They all had commonalities, they want to be seen, heard, and confirmed. They enter our facility anxious, uncomfortable, scared, and sometimes embarrassed. As healthcare providers, we have to take someone who has courageously come forward out of an uncomfortable situation and into an even more uncomfortable situation for safety reasons. It takes a great deal of compassion and grace to do it well. Lack of consistency can intensify the discomfort for the patient, their family members, and our team members. Consistency is achieved through education. For varying reasons, we are faced with educational challenges that sometimes prevent us from doing what we all hope to do each day at work: provide excellent care and compassion to our patients and their families. As a leader of safety, it kept me up at night to think of all of the risk potentials due to a lack of process for effective management of this patient population. In response to these challenges, we teamed up and created a sitter tool kit comprised of all elements of our policies. Our sitter kit requires a key stakeholder team inclusive of security, house officer, facilities, patient safety, case management, food and nutrition, sitters, and our leadership team. Our kit is designed to position security as an educator and validator of the process. Facility Security Supervisor, Demetreus Ramirez stated, “It helps to have an educated person in the room who can assist us in deflecting risk. The increased communication across the board has had an

immensely positive impact on my team. I always say I cannot help you if I am not aware there is a potential.” Real-time education, completion of the required checklist, appropriate signage, paper scrubs, communication tools (iMobile/ mobile duress), and applicable policies are provided as part of the onset of the sitter process. A collective communication process to key stakeholders allows our patients to receive the appropriate meal tray and obtain screening for the next steps in their care via case management. Finally, a shift-to-shift handoff form is provided so each sitter has an opportunity to learn of any critical information and ask questions for safety. Courtney Burgoon, our beloved patient safety director shared, “From a Patient Safety perspective, implementation of the Sitter Kit process has allowed nursing teams to partner with security in a new way that enhances the safety of our patients and staff in an easy-touse kit.”

When we started this journey, we had a considerable number of fallouts with respect to implementing mitigation steps. Upon discovery, this caused us to have to go back to the patient and their family and ask for cooperation after their anxiety had settled. Sometimes this was the cause of behaviors that posed a risk to our environment. Our sitters were not always aware of why they were sitting on the patient. Essential communication tools were not provided for safety to the sitter. Jose Trevino, security shift supervisor says, “Our kit has enhanced the sitter’s awareness and allowed us to empower them to question risk, such as unsafe dietary trays, before they reach the patient.” Our sitter kit has been successfully implemented for approximately a year and a quarter. Since implementation, we have seen a 51% increase in mitigation compliance and a 35% decrease in disturbances. The feedback from our sitters has been very positive as they feel as though they are provided with the tools and equipment to do their job well. Additionally, our sitters are more confident in how “plugged in” others are to keep them safe while they do their job. Caitlyn Judge, security shift supervisor weighed in stating, “it allows us to keep track of where our sitters are and validate compliance with the policy shift to shift. We all know this information and can strategically schedule our patrols for safety.” We serve in an ecosystem made up of very complex parts that require an interminable supply of critical processes. We have learned that our problems are often not people problems but process problems. Our mission calls us to “Serve humanity to honor God by providing exceptional, cost-effective healthcare, accessible to all.” Our sitter kit process has opened up the opportunity for us to lock arms and fulfill our mission. I know I speak for the entire team when I say how passionate we all are about keeping our patients at the center of our care. We are all motivated to do all we can to compassionately support those we serve each day as well as each other in the process. It has been a relief for all of us to have found a way to achieve patient safety through this new process.

RONNI BISHOP,