ABSTRACT
Empowerment of patients to speak-up during hospitalization is critical for the delivery of safe care. The Veterans Health Administration's (VHA) National Center for Patient Safety has long advocated a systems-based approach to health care delivery. It has often pointed out that the patient is the only component of the health care delivery system that is always present and yet the least likely to be used as a resource. The Daily Plan® is a patient-specific itinerary put into the hands of the patient to inform them of what to expect each day in the hospitaL Using the VA's electronic medical record, cunent provider orders are extracted and displayed in a one-to-two page printed summary. The Daily Plan® includes such items as diagnostic tests, medications, scheduled appointments, diet, etc. Each day the nurse reviews this summary with the patient. The Daily Plan® can be retained by the patient and he/she can share it with family as desired. This process has been pilot tested on several nursing units at VA hospitals to measure the impact on patient safety with evaluations received by both nursing staff and patients. Of the 85 unique nurse shift evaluations, 15% identified at least one enor of omission within their group of patients that shift. Additionally, 12% indicated at least one enor of
commission was identified and corrected. From the 183 anonymous patient evaluations received, 80% reported The Daily Plan® increased their understanding of what was going to happen to them during that day of their hospital stay; 76% indicated it was easier to ask questions; and 72% reported The Daily Plan® improved their satisfaction of the hospital stay. Comments and suggestions to improve The Daily Plan@ were collected and will be used to guide a more userfriendly version. The patient-centered focus of The Daily Plan® strongly demonstrates benefits in patient safety and satisfaction.
