Accreditation 2023 - Communication

Client Identification by Kim Haley

Throughout the health care industry, the failure to correctly identify patients continues to result in medication errors, transfusion errors, testing errors, wrong person procedures, and the discharge of infants to the wrong families. Fortunately, available interventions and strategies can significantly reduce the risk of patient misidentification. Using person-specific identifiers to confirm that clients receive the service or procedure intended for them can avoid many harmful incidents.

The major areas where patient misidentification can occur include drug administration, phlebotomy, blood transfusions, and surgical interventions. There are several team members caring for each patient, thereby increasing the likelihood of hand-over and other communication problems. Because patient misidentification is identified as a root cause of many errors, this continues to be an accreditation requirement.

The person-specific identifiers used depend on the population service and client preferences. Examples of person specific identifiers include the client’s full name, date of birth, personal identification number, home address (when confirmed by the client or family), or an accurate photograph.

Importantly, the client identification is done in partnership with clients and families by explaining the reason for this safety practice and asking them for the identifiers. When clients and families are not able to provide this information, other sources of identifiers can include wristbands, health records, or government-issued identification. Two identifiers may be taken from the same source to correctly identify the patient.

Regardless of the technology or approach used for accurately identifying patients, careful planning for the processes of care will ensure proper patient identification prior to any medical intervention and provides safer care with significantly fewer errors.

Strategies that are used to ensure proper client identification and safety at PRH include: Click here for the ‘Quick Tip’

• Standardized registration scripting; identification starts at registration. It is the responsibility of the registration staff to verify the identity of the patients every visit at the time of their encounter/admission/appointment.

• Patients receive a wristband every time they are registered. Prior to placing the bracelet on the wrist, the patient is asked #1 their Name and #2 their DOB. The answer is verified on thebracelet and then it is placed on the patient.

• Daily reports of any duplicate profiles are generated and received- any profiles are merged ensuring the continuity of care specific to the identified patient.

• PRH supports the culture of safety and emphasizes the primary responsibility of all health care workers to check the identity of patients and match the correct patients with the correct care (e.g.,laboratory results, specimens, procedures) before that care is administered.

• At least two identifiers (ex. name and date of birth) to verify a patient’s identity upon admission or transfer from another hospital or other care setting and prior to the administration of care are used. A room numbers hould never be used.

• A standard approach to patient identification is used; this includes, white ID bands on which a standardized pattern and specific information (e.g.,name and date of birth, barcoding that links the identified patient to their specific encounter) is written.

• PRH uses a newborn identification system which links the newborn identification and the mother’s identification.

• Automated systems such as, order entry and barcoding have been implemented.

• Color coded wristbands are used for a quick visual identification for; allergies (red) and violence risks (purple).

• Patients are actively encouraged to participate in all stages of the process, by asking open ended identification questions. Ask don’t tell: May I have your date of birth? versus is your date of birth 1January1987?

• Repeated checking and review at all points to prevent automated multiplication of a computer entry error is completed regularly.

Here are some things you can do to ensure patients and families are actively involved in our client identification processes:

1. Educate our patients about the risks related to patient misidentification.

• Remind them how important it is that we repeatedly verify their identity as the health care system is complex and there are multiple people and systems involved in their care. Any error could quickly be replicated and have adverse consequences, their safety is our number one concern.

2. Ask patients or their family members to verify identifying information to confirm that it is correct.

3. Ask patients to identify themselves before receiving any medication and prior to any diagnostic or therapeutic interventions.

4. Encourage patients and their families or surrogates to be active participants in identification, to express concerns about safety and potential errors, and to ask questions about the correctness of their care.

More information on client identification processes, procedures and policies can be found within the policy procedure manual under “Patient Identification and Same Name Alert” and “Newborn Identification”.