Identity vigilance and adverse events
Healthcare facilities are subject to an increasing demand for care, with strained resources, exposing patients and healthcare professionals to various risks, particularly the risk of identity errors. However, the correct identification of a patient is a key factor in ensuring their safety throughout their healthcare journey.
Both users and healthcare professionals are not always aware of the risks generated by imperfect identification. Indeed, in the care pathway, patient identification generally takes the form of a simple discussion: reception at the emergency or admissions department, reception in the operating room, etc. These moments appear to have no critical character, yet they are. This unperceived criticality is an additional risk factor for identity vigilance errors.
Let's give some examples from the Patient Safety Database or the press to illustrate:
- Mrs. and Mr. X are admitted to the emergency room following a traffic accident. They each require a transfusion. Mrs. X will mistakenly receive the blood products intended for Mr. X.
- A patient admitted to the emergency department for headaches, registered under the wrong name, died of meningitis after being unable to respond to a call for her name (which was the wrong one).(Patient dies at Lariboisière hospital: investigation confirms malfunctions in emergency department)
- Performance of a posthectomy on a child undergoing tonsillectomy in the operating room, following a misidentification while being stretchered to the operating room.
Incorrect identification can also lead to other undesirable events: delays in care, diagnostic errors, therapeutic errors, incorrect exchange of information between professionals, recording of health data in a file that is not that of the user concerned (collision), creation of several files for the same user, or even billing errors*.
To improve patient safety, the identification process has become a key element in the deployment of national health policies.
Since January 1, 2021, it has become essential that a user be identified in the same way by all healthcare professionals who share data concerning them. Thus, the obligation of referencing by the national health identifier (INS) has been put in place, reinforcing the principle of identity vigilance.
Identiovigilance, an institutional commitment!
Proper patient identification is the first step in a process that extends throughout their care by the various healthcare professionals involved.
With this in mind, the principle of identity vigilance has been reinforced in recent years. Thus, the Ministry of Health and Solidarity defines identity vigilance as a set of measures implemented to ensure the reliability of user identification and to secure their health data at all stages of their care.
Identitovigilance concerns the understanding and respect by all actors of the identification rules as well as the management of risks related to the errors encountered.
Therefore, all healthcare professionals, regardless of their specialties, location, or mode of practice, must now employ best practices for identification in order to secure the sharing of health information and to guarantee patient safety.
In its previous V2010 and V2014 certifications, the Haute Autorité de Santé had already defined the criterion "Identification of the patient at all stages of their care" as a priority enforceable practice.
To summarize, in order to guarantee patient safety and avoid adverse events, healthcare professionals must be trained in these reliability measures to enable patient identification at all stages of the care process and before any decision or act of care concerning the patient(s).
TheSafeTeam Academy and the principle of identitovigilance
SafeTeam Academy has made identity vigilance a recurring theme in each of its video simulations, whether it involves benevolent care in nursing homes, imaging procedures, or surgical procedures. These modules have been designed to support caregivers and provide them with the tools necessary to ensure the reliability of care, particularly with regard to identity vigilance.
These modules question healthcare professionals about their practices and lead them to constantly verify the identity of patients through video immersions featuring simulated care situations.
The concept of identity vigilance can also be applied to caregivers in order to improve the patient experience. We will return to this subject in another article, dedicated to nominative caps also discussed by the children of the factor (Human Factors in Health).
Afun clinical case to finish with
To conclude this article on a note of humor and identitovigilance, we invite you to watch the following animated clinical case, taken from feedback from the Patient Safety Database.
If you too would like to play your part in improving the reliability of care within your facilities, opt for SafeTeam Academy training courses and contact us to find out more: contact@safeteam.academy
*https://esante.gouv.fr/sites/default/files/media_entity/documents/RNIV%201%20Principes%20communs_1.pdf
