The Walworth County Patient Safety Council – Aurora Health Care

Consisting of 11 patients and 12 healthcare providers – all residents  of Walworth County, Wisconsin – this council may be the first model that  brings patients and providers together to develop strategies for improving  medication safety in their community.  From the initial design stages  to the implementation of the tools, the council applied a grassroots/public  health approach to build this program as a community effort.

Assisting the Council in accomplishing its goals were two additional unique  partners: Consumers Advancing Patient Safety (CAPS), a consumer-led nonprofit  organization which advocates consumers as partners in the safety movement and  envisions global healthcare systems that are safe, compassionate and just;  and Midwest Airlines (Milwaukee, WI), know for their outstanding safety record  and excellent consumer-focused service.  CAPS guided the development of  the council and used a similar model to engage consumers with the Patients  for Patient Safety initiative as part of the World Health Organization’s  (WHO) World Alliance for Patient Safety.  Midwest Airlines shared their  expertise in consumer relations and shifting an organization toward a culture  of safety.

The Patient Safety Council met monthly since November 2005.  Their work  was targeted toward persons 55 years and older, who are among the most vulnerable  to medication safety issues due to chronic medical conditions, multiple medications  and multiple healthcare providers.  During each meeting, patients/caregivers,  nurses, physicians and pharmacists worked together, breaking down barriers  between patients and their healthcare providers and identifying strategies  to help themselves and others prevent adverse outcomes and medication errors.  In  a very short time, the Council determined communication as key to ensuring  safe medication use.  This translated to a need for effective strategies  that will empower patients to become active partners in their care as well  as assist patients, families and healthcare providers in clearly communicating  with one another.

The Council created several interventions to improve medication safety for  individuals 55 years and older.  A medication bag, in which to easily  carry all of a patient’s medications to healthcare appointments, was  identified as a vital communication tool.  The patients and healthcare  providers on the council were instrumental in evaluating multiple features – such  as bag size, handle design, and closure mechanisms – in order to ensure  that the selected medication bag meets the needs of individuals 55 years and  older.  A personal medication list for the patient to complete and bring  to healthcare appointments was also created as a tool to improve communication.  Through  presentations at a variety of community groups, such as the Rotary Club, informal  social gatherings, professional meetings and home visits, more than 300 county  residents provided feedback regarding the bag and list.  Since September  2006, 16,000 medication lists and 7,300 medication bags have been distributed  throughout the county.  Over 80 community education programs have been  conducted with 2,300 patient and community participants. 

Simultaneously, strategies directed at healthcare providers were being implemented.  Clinic  chart forms were evaluated to identify optimum format for documentation of  a patient’s medications.  An electronic medical record system will  be implemented in the Walworth County Aurora Health Care clinics this summer.  Clinic  process flow was improved to allow more time for medication review. 

Two project toolkits will be available this summer.  The first toolkit  will outline the steps to developing and implementing a patient advisory council.  The  second toolkit will contain the patient and healthcare provider tools to improve  medication safety.  In collaboration with the Agency for Healthcare Research  and Quality (AHRQ) and CAPS, the toolkits will be disseminated widely and will  be hosted on the CAPS website. 

For more information, contact the Principal Investigator: Kathryn Leonhardt,  MD, MPH (Kathryn.Leonhardt@aurora.org).