the practitioner remediation and enhancement partnership prep 4 patient safety mark speicher board...
TRANSCRIPT
The Practitioner Remediation
and Enhancement Partnership
PREP 4 PATIENT SAFETY
Mark Speicher Board Member,
Citizen Advocacy Center
Presented at the 2004 CLEAR Annual Conference
September 30 – October 2 Kansas City, Missouri
Presented at the 2004 CLEAR Annual ConferenceSeptember 30 – October 2 Kansas City, Missouri
PreP For Patient Safety
A Program of the Citizen Advocacy Center (CAC) Under Contract With
HRSA
Presented at the 2004 CLEAR Annual ConferenceSeptember 30 – October 2 Kansas City, Missouri
PHILOSOPHY OF PREP 4 Patient Safety PROGRAM
PhilosophyTo create a new paradigm where hospitals and the Boards of Medicine and Nursing serve as safety advocates and provide a means whereby practitioners having deficits in knowledge, skills or abilities remain in the work setting and receive remediation to improve safe patient care and enhance public protection.
Presented at the 2004 CLEAR Annual ConferenceSeptember 30 – October 2 Kansas City, Missouri
FOCUS OF PREP 4 Patient Safety
Identification of problems before versus after harm occurs
Non-punitive versus “blame and punish”
Presented at the 2004 CLEAR Annual ConferenceSeptember 30 – October 2 Kansas City, Missouri
Voluntary participation of licensee
Privacy of participation—treated as non-public information
ESSENTIAL PROGRAM ELEMENTSESSENTIAL PROGRAM ELEMENTS
Presented at the 2004 CLEAR Annual ConferenceSeptember 30 – October 2 Kansas City, Missouri
• Competency –• practitioners who
demonstrate a deficit in knowledge, skills, abilities or judgment believed to be amenable to remediation
DUAL TRACKS OF PREPDUAL TRACKS OF PREP 4 Patient Safety
• Errors –• minor violations
of the practice act isolated incidents not subject to serious board action
Presented at the 2004 CLEAR Annual ConferenceSeptember 30 – October 2 Kansas City, Missouri
• Identified deficiency or incident must be associated with an individual, recognizing that the individual is part of a complex environment
• Identified individual must be eligible for continued practice privileges or employment with participating pilot hospital
CRITERIA FOR PARTICIPATIONCRITERIA FOR PARTICIPATION
Presented at the 2004 CLEAR Annual ConferenceSeptember 30 – October 2 Kansas City, Missouri
CRITERIA FOR PARTICIPATION
• Cases must NOT involve suspected drug diversion, reckless conduct, deceitful behavior or sexual misconduct
• Cases involving serious patient harm or prior disciplinary action not “PREP” cases
Presented at the 2004 CLEAR Annual ConferenceSeptember 30 – October 2 Kansas City, Missouri
• Policies/Procedures for Boards and Hospital
• Identification of problem/deficit• Consultation/determination of eligibility• Assessment• Remediation Plan• Contractual Agreement• Monitoring• Reporting
PROGRAM COMPONENTSPROGRAM COMPONENTS SUPPORTED BY CAC
Presented at the 2004 CLEAR Annual ConferenceSeptember 30 – October 2 Kansas City, Missouri
PATHWAYS TO ENTER PREP 4 Patient Safety
1. Hospital Initiated2. Board Initiated
Presented at the 2004 CLEAR Annual ConferenceSeptember 30 – October 2 Kansas City, Missouri
PARTICIPATING BOARDS
BOARDS OF MEDICINE
(1) California(2) Minnesota(3) Missouri(4) North Carolina(5) Oregon(6) Rhode Island
BOARDS OF NURSING
(1) Colorado(2) Maryland(3) Nebraska(4) North Carolina(5) Oregon(6) South Carolina(7) West Virginia (LPN)
Presented at the 2004 CLEAR Annual ConferenceSeptember 30 – October 2 Kansas City, Missouri
POSITIVE RESPONSES TO PREP 4 Patient Safety
• Improved communication and trust between pilot hospitals and boards
• Enhanced collaboration• Recognition/resolution of systems problems as
by-product of internal review• Favorable reception from licensees for
proactive, non-punitive approach by licensing board.
Presented at the 2004 CLEAR Annual ConferenceSeptember 30 – October 2 Kansas City, Missouri
Support to Members: Assessment and
Remediation• CAC (Through AIM and NCSBN)
conducts survey of all boards• Availability and Use of
Assessment and Remediation Programs
• Goals: Discover Utilization Rates and ID Current Programs
Presented at the 2004 CLEAR Annual ConferenceSeptember 30 – October 2 Kansas City, Missouri
Report Includes State-of-the-Art Info
• Background on Assessment and Remediation
• Current Status of Assessment and Remediation (Surveys of Medical and Nursing Boards)
• State-of-the-Art: Assessment
• State-of-the-Art: Remediation
• Resource Summary• Future Directions
Presented at the 2004 CLEAR Annual ConferenceSeptember 30 – October 2 Kansas City, Missouri
Findings
• Survey Responses from 19 of 53 Nursing Boards and 46 of 63 Medical Boards
• Shows Low Utilization of Assessments, More but Still Low Use of Remediation
• Lists 40+ Assessment or Remediation Resources
Presented at the 2004 CLEAR Annual ConferenceSeptember 30 – October 2 Kansas City, Missouri
Likely Direction
• Use of Assessments Today– Problem ID is the
assessment– Nurses get small, ongoing,
formalized assessment using an employment model
– Physicians get larger, one-time assessments using a peer review model
– Part of a punitive process• Use of Assessments
Tomorrow– More Use of Assessments– Staged Assessments– Not Punitive– Part of Larger Continuing
Competence Where Everyone Is Assessed
• Use of Remediation Today– More widely used than
outside assessments– Little objective follow-
up– For Boards, often part
of a punitive process• Use of Remediation
Tomorrow– User-friendly (i.e.
distance learning)– Not part of punitive
process– Outcomes are tracked
Presented at the 2004 CLEAR Annual ConferenceSeptember 30 – October 2 Kansas City, Missouri
Summary
MORE THAN 125 PARTICIPANTS TO DATE
• WHAT WE’VE LEARNED SO FAR
• WHAT WE STILL HAVE TO LEARN
• GOAL FOR 2005: MORE BOARDS, MORE PROFESSIONS!
Presented at the 2004 CLEAR Annual ConferenceSeptember 30 – October 2 Kansas City, Missouri
More Information on PreP For Patient Safety
PREP 4 Patient Safety WEB SITE
www.4patientsafety.net
Presented at the 2004 CLEAR Annual ConferenceSeptember 30 – October 2 Kansas City, Missouri
• Mark SpeicherOptiMed Resources Inc.15826 N. 9th Ave., Phoenix AZ 85023(602) 942-9530 Fax (602) [email protected]