VHA National Center for Patient Safety
The Daily Plain®
This initiative enhances patient safety by involving patients in their care; a single document is provided to them that outlines what can be expected on a specific day of hospitalization.
A facility can customize the document and include a number of items relevant to care:
- Diagnostic tests
The patient is the only component of the health care delivery system that is always present and yet the least likely one to be included as a resource.
Patients and their families want to help ensure safety, however; there has been little professional attention on how best to actively involve patients or how such involvement can affect patient safety.
By importing provider orders into a health summary, patients receive an itinerary for each day in a single printed document. The Daily Plan® is essentially a road map that lets patients see, in black and white, what's going to happen to them on a particular day.
The plan encourages patients and their families to better understand their care; patient involvement is an integral aspect of the program. Patients are encouraged to ask questions if something seems different than planned, which enables them to become more active members of their health care team.
Potential errors can be prevented when nurses and patients review The Daily Plan® together. By doing so, the patient and the health care team are able to recognize and correct any discrepancies. These can include errors of "omission," noticing something missing, or those r of "commission," prevention of a possible medical error, such as in incorrect dose of a medication.
The initial pilot of The Daily Plan® received positive responses from patients and staff during pilot tests, 2007/2008, at five VA facilities. This prompted further attention and NCPS began Phase 2 of the pilot program in 2009. In Phase 2, evaluations were completed by 198 hospitalized patients and 85 nurses.
- Nearly 75% of the patients agreed or strongly agreed that having the plan made it easier for them to ask questions, increased their understanding of their hospital stay, helped them feel more comfortable and provided them with information that helped improve their care.
- 47.5% of the patients reported that either they or their family member found and asked about discrepancy in their planned care. Patients received The Daily Plan® an average of 5 days in the hospital.
- Nurses were asked to reflect upon their assigned patients receiving the plan during their shift and complete a single end-of-shift accumulated evaluation:
- 17.6% of the nurses reported one or more errors/shift were detected
- Nurses found that reviewing The Daily Plan® with their patient was an appropriate use of their time and took approximately 10 minutes or less.