• Zach Johnson

Q15 Safety Checks // Goals + Performance Indicators

Continuing on our Q15 (safety check) deep dive series. In this post we will cover the goals of Q15 safety checks and the attributes we see in high performing teams. See our first post "What is a Q15 Safety Check?" here.

The mission of our company is to improve patient safety in behavioral healthcare facilities. As part of our work, we have hundreds of conversations, visits, and partnerships with inpatient psych, addiction treatment, and skilled nursing teams around the country. We hope to provide context (industry-wide and nation-wide) so that you may more effectively evaluate and improve your safety practices.


*** Transparency Notice: VisibleHand provides safety solutions/products related to the topics addressed (and we would love to talk with you about them). However, there are many safety improvements that can be made without the use of VisibleHand products or services, so we hope that you will read on regardless of your interest in our Digital Q15 & Proximity tools. ***

Goals of Q15 checks:

- Safety; for patients and caregivers.

- Accountability; to ensure the care team is following treatment guidelines.

- Collaboration; to ensure patient information is shared across the care team.

- Legal Protection; for caregivers and the healthcare organization from legal liability if accused of negligence/abuse/etc.


Attributes of highly compliant teams:

Clear directive

- Management communicates & supports that Q15s are the #1 priority for the responsible caregiver. (ie. patient requests that come up during Q15 rounds should be attended to by another team member or completed between rounds - but should not distract from compliant Q15 checks)

Measurement

- Many management teams can only give “best guess” approximations of their Q15 compliance. (80%? 90%?) However, in our experience, on-time in-person Q15 checks happen closer to ~60% of the time. Incorporating unit or individual-level performance on a shared bulletin board can boost performance.

Feedback loops

- Managers that can identify and quickly follow-up with high performing and low performing caregivers correct mistakes & patterns sooner. Some teams do periodic video audits to check caregiver compliance. While better than nothing, these audits are typically infrequent and/or only used when there is a suspected issue. (reactive vs. proactive)

Incentives & Penalties

- Some teams have a 1 strike policy whereby caregivers need to be dismissed if they do not conduct their checks. This can lead to a cycle where management teams with staffing issues may ‘ignore’ poor performance due to the difficulty in replacing team members.

- We see higher sustained compliance on teams where high performers are recognized and poor performers are identified and assigned corrective action plans.

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