Great Catch winners help YNHH become a high reliability organization

Congratulations to these Great Catch winners for modeling HRO safety behaviors and taking action to improve patient safety.

bulletin

Inpatient

Brittany Douglas, RN, Heart and Vascular Center CICU, was recognized for attention to detail and the use of STAR (stop, think, act, review) when caring for a patient who received intravenous vitamin K for bleeding while in cardiogenic shock. Within an hour, the patient suffered cardiac arrest. Although chest X-rays showed no issues, Douglas also noticed increased swelling in the patient’s neck. The following day, the patient received IV vitamin K again, and experienced similar swelling. After Douglas escalated her concerns and questioned if the symptom was an allergic reaction, it was determined that the patient was allergic to an additive in the medication.

 

bulletin

Allister Hirschman, PA, (second from left) with ED colleagues.


Outpatient 

Allister Hirschman, PA, Emergency Department, was recognized for practicing a questioning attitude and attention to detail while caring for a patient with COVID-19 symptoms. After noting that the patient had a history of prior intubation for a viral illness, Hirschman escalated his concerns to the attending physician. The patient was admitted instead of being discharged, and less than 24 hours later, experienced respiratory issues that required intubation. Thanks to Hirschman’s use of CHAMP behaviors, the patient was saved from a potentially negative outcome.