Family Notification in Seven Quick and Easy Steps

Seven Steps to Successful Notification is an easy-to-use system based on time-tested tools successfully used by hospitals nationwide. It provides your hospital staff with all of the steps necessary to:

? Identify and locate your unconscious patient's next of kin or surrogate decision maker.

? Improve patient care by locating your patient's medical history, personal physician, and insurance information.

? Provide the facility with a documentation of the steps taken to find the patient's next of kin, to make the notification, and identify the staff members responsible for making it, thereby releasing you from subsequent liability.

? In states with Next of Kin Statutes, provides proof that the facility has met its statutory responsibility.

Let's see the seven steps in action, through the eyes of the nurse manager of Care Central's Trauma Unit, Carolee Cummins.

Carolee comes on duty this morning just as a hit and run is pulling up at the emergency bay. She meets the gurney and runs along side, paying rapt attention to the paramedic's bullet, while she and her staff do their own evaluation. The paramedic's last comment stops her cold. This pretty thirtysomething, woman who is in grave danger of bleeding out, has no identification with her. Carolee starts a John Doe chart for her patient and turns her attention back to the trauma.

1) Patient Status Confirmed

When a patient like this comes in, Carolee is glad that she and her team use the Seven Steps System. She looks down at her chart page and begins the notification process right in the trauma room, by answering the first question. Is the patient unconscious or physically unable to give informed consent? Had her patient been alert and oriented, she would simply have checked the box marked no, skipped the notification section on the chart and proceeded as usual. After the team confirms that the patient is unresponsive to everything but deep pain, Carolee checks "yes" and asks one of the aides to check the waiting room to see if any family members came in with their patient. "No", the aide confirms, "she came in alone". And so the notification and documentation procedure begins.

2) Examine Personal Effects For Emergency Contact NumbersWhen Care Central began to use the Seven Steps, they appointed the nurse manager on duty, as the point person for NOK notifications. So as point person, Carolee begins to look for the young woman's emergency contact numbers or clues to those numbers, by examining her personal effects. Most of the time, Carolee finds the emergency information quite easily, right in her patient's wallet, on a driver's license, emergency contact cards, insurance cards or personal phone books. When she finds what she's looking for, Carolee documents on the chart that the contact has been found, and skips down to Step 5.

In this case her search only takes a moment - the only thing the woman had with her were her house keys. If she had a wallet or a purse, it was destroyed in the accident. Carolee goes through the pockets of her patient's jogging shorts and finds one small clue to her identity - a few message blanks from work that she must have stuffed in her pocket to take care of later. They're all made out to Katherine McCauley. Progress.

If Step 2 had turned up nothing and her patient had still been a Jane Doe, Carolee would have skipped down to Step 7, involving Social Service in her search. But since Carolee's patient now has a name, she goes directly to Step 3.

3) Retrieve Patient's Home Number

Now she'll have to get a bit more creative. As Katherine found out the hard way, life can present major challenges for patients, not to mention an emergency department staff. A quick run to the store without taking your ID, interrupted by a sudden heart attack, can put even the most conscientious person into jeopardy. In upcoming sections of this Kit, you'll find details on traditional and untraditional ways of find that contact information quickly and easily. But for now Carolee, goes through her mental checklist of ways she's found contact information in the past: checking the speed dial of a patient's Cell Phone for numbers labeled "Home" or "work"; the contact pages of a Filofax, or the address book of a PDA. Even a briefcase can contain a patient's