encourage and have access to clinicians via email at all times before, during and after their stay. Patient/families have access to resource rooms; this access can be coordinated through case managers or social workers on staff. Weakness: Patients/families do not serve as educators for clinicians or other staff. Domain 8 (Diversity/Disparities) – Strengths: This organization does an excellent job of collecting/measuring data on the community it serves (racial, ethnic, religious and language barriers). Staff is educated, prepared and supported well in its efforts to provide culturally appropriate care. There is always a cultural and/or religious liaison to go to with questions or concerns regarding the proper care and consideration of this organization’s diverse population. Access to interpreters and/or the interpreter phone system is not an issue, as the facility has interpreting staff that speak over 50 languages, including a large percentage of the medical staff being bilingual. Educational materials can be printed out in eight different languages. Weakness: The one area that could use some improvement in this domain is educational
ORGANIZATIONAL LEADERSHIP C158 8 materials being available in more appropriate literacy levels. There is a vast amount of material available to patients/families on just about anything; however, it is hard to understand for a portion of the population served. Domain 9 (Charting/Documentation) – Strengths: Patients/families have access to paper/electronic records. It is easier to access the electronic record then the paper record. Instructions are given to patients/families upon admission, during their stay and on discharge regarding how to access these records. Weakness: Patients/families are not allowed to chart in the electronic system; they can however, take their own notes regarding questions or care. Domain 10 (Care Support) – Strengths: Depending on the staff involved, there is support, disclosure and apology for any errors or harm caused to the patient. Some staff are more willing than others to admit when mistakes are made and apologize. Weakness: Families are actually not allowed onto the units during shift hand-off report. If they are already on the unit, they are actually asked to leave so that hand-off report can be uninterrupted. Family is escorted out of units when rescue attempts are made and cannot activate rapid response systems. Updated medication history is given at every visit, however, there are times when communication with the patient is not possible and their medication history is not followed up on in a timely, consistent manner. Domain 11 (Care) – Strengths: Pain management involves all parties at this facility and communication regarding this remains open, honest and respectful. The nurses do an excellent job of collaborating with the physicians regarding pain management and advocating for their patient if necessary to provide adequate and safe pain relief.
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- Winter '20