1. Module 10 Event Disclosure, Grievance and Use of Cyracom & VRI

2. PART 1
Event Disclosure

3. Event Reporting
Intended to promote a safe and healthful environment for patients, visitor, employees, medical staff and volunteers.
Prompt reporting provides a mechanism to improve quality of care by preventing similar events and identifying opportunities.

4. Event Reporting
An event report must be generated for any unanticipated happening that is not consistent with the routine care of a patient and/or the routine operation of the facility.
Examples – falls, medication related(wrong dose), IV (wrong solution), pressure ulcer and loss of property.

5. Event Reporting
iVOS Event Reporting System (ERS) is located in the following:
Clinical Tunnel
Starfish Folder
A paper Event Report for may be used and must be delivered to the Risk Management or Patient Relations Departments.

6. iVOS Reporting

7. Safe Harbor Provision
All events must be reported immediately. If any employee completes and submits an event report within 48 hours of becoming aware of the event, there will be no disciplinary action taken; however, additional education or training for the involved individual may be required, if warranted under all the circumstances.
An event report must be submitted by an employee involved in an event even if another employee has previously submitted a report of the event. This safe harbor provision does not apply to action or requirements of regulatory bodies.

8. Safe Harbor Provision
Safe Harbor provision does not apply to protect any individual if:
The acts or omissions of the reporting employee , giving rise to the event, are the result of criminal activity or activity outside an employee’s job description or license.
Action demonstrates a willful reckless disregard for the safety of patients, employees, medical staff or visitors.
It is clear that an employee can’t practice in a safe manner, after having been provided appropriate education.
At the time of the event the employee was under the influence of alcohol or illegal drug use.

9. Safe Harbor Provision
The determination as to whether the reporting of an event is exempt from the safe harbor under one of these exceptions will be made in accordance with appropriate human resource policies and procedures with input from hospital leadership and Dignity Health Legal Department.

10. Disclosure Reporting
Disclosure -Communication to patients or families of information regarding test, treatment or surgical intervention.
Unanticipated Outcome/Event-An adverse result that differs from what was anticipated to be the result of a treatment or procedure.

11. Disclosure Reporting
Take necessary action to mitigate the harm to the individual that may be caused by the unanticipated outcome.
It is the responsibility of all employees and physicians to report any unanticipated outcome immediately to their immediate supervisor and the facility Risk Manager.
Complete an event report.
Participate in any investigation (as directed) initiated to determine the cause of the event that may prevent future like occurrences.

12. Disclosure Reporting
Once it has been determined that an unanticipated outcome has occurred disclosure is necessary to patient or representative.
The treating Physician, Risk Manager and Director/Manager will determine the appropriate time for disclosure.
All three individuals or designees will participate in the disclosure.
Only these individuals or designees are allowed to disclose information regarding the event.

13. Part 2
GRIEVANCE

14. Grievance
A patient grievance is a formal or informal written or verbal complaint (when the verbal complaint about patient care is not resolved at the time of the complaint by staff present) by a patient, or the patient’s representative, regarding the patient’s care, abuse or neglect.

15. Your Responsibility Resolve the issue – Service Recovery
File an iVOS Event Report in the Event Reporting System (ERS) - Location: Clinical Tunnel
If unresolved - Contact your Director/Manager or House Supervisor
If unresolved - Provide a grievance form located in forms fast (section Patient Rights)

16. Grievance Committee
CHSB Board of Directors is responsible for the effective operation of the Grievance Process.
All grievances are reviewed by the Grievance Committee.
Grievance Committee Members are: Hospital President, VPs Nursing, NCU/BHS, Directors of Patient Relations/Risk Management, Quality, Medical Staff, Education, Medical Imaging & Patient Accounts.
Final outcomes of a grievance is submitted to patient and/or patient’s representative.

17. Part 3
USE OF CYRACOM

18. Interpreter Phone Use of Cyracom Phone
Available on all patient’s rooms
Remember to include interpreter’s ID number in patient’s notes

19. Video Remote Interpretation (VRI)
Video Remote Interpretion (VRI) is a videotelecommunication service that uses devices such as web cameras or videophones to provide sign language or spoken language interpretation through a remote or offsite interpreter.

20. The VRI Machine
The Video Remote Interpretion (VRI) equipment is located in the House Supervisor’s office. This will be checked out using the staff’s name, patient name, department/unit and date. The date when the machine was returned should be documented as well.

21. Connecting the Machine to the Internet
Two ways to connect to the internet:
Use BLUE Ethernet cord to plug into an ORANGE data jack at your location
Use the hospital Wi-Fi (all settings have already been established for you but you may need to turn on the Wi-Fi).

22. VRI Service When first turning on the laptop, the first screen will be
to enter “CHSB” and then “Centerdrive”
Click on the CyraCom icon on the desktop located at the upper left side. Please note if an error screen shows regarding website options, choose … to continue. This should take you to the next screen; if not, then try using the BLUE ethernet cord.
It will ask for a username. Type the letter “V” and it should auto-populate the full username including the password.

23. VRI Service – cont’d Click on Video Remote Interpretation link.
The next screen will have “American Sign Language” defaulted. Press the “Start Session” underneath the video screen.

24. VRI Service – cont’d
The screen will move to the middle, take this time to enlarge the screen to full screen. You can do this by hovering over the bottom right corner of the video screen and choosing the “arrows out” icon.
The service should connect with a video interpreter within 5 minutes.

25. Troubleshooting
If logged out of the CyraCom website, use the username Get the password from the Risk Management/Patient Relations office.
All other issues should be directed to the House Supervisor or IT (David Aldrete).

26. VRI Proper Etiquette
When in need of spoken language interpretation, over-the-phone (OPI) should be the first choice for any non-ASL (American Sign Language) service needs.
Regardless of the situation, always offer to provide a qualified medical interpreter to the patient and/or family members. Cyracom spoken language interpeter is also available through the spectralink by dialing “HELP”.
Although unnecessary, it is recommended for the provider to introduce themselves to the interpreter. (Example: “Hello interpreter, my name is Nurse Smith at Best Hospital in New York City”)
Give one sentence summary to the interpreter. (Example: “The patient is in for surgery and we are going to be asking some general questions.”)

27. VRI Proper Etiquette – cont’d
Adjust the camera/cart/screen so the interpreter has a clean view of the patient and the patient can see the interpreter. Stand to the side or behind. (Provider does not need to see the interpreter or vice versa).
When speaking to the patient, look directly at the patient (even if the patient’s eyes are fixed on the computer screen or elsewhere).
Speak in the first person. (Example: “Mr. Jones, we are going to ask you a few questions before the surgery”).
Do not turn your back on the patient when speaking to them.

28. Questions?