Dr. Babineau

Patient Safety Questions
Rhode Island Hospital

Through the end of November, site visitors were able to ask Timothy Babineau, MD, president and CEO of Rhode Island Hospital, questions about patient safety. Questions are no longer being accepted, but feel free to contact us with any inquiries or comments.

Below is a list of questions that were posed, followed by Dr. Babineau's answer.

Related Information

Recent Questions and Answers

Question about medical education by Toni M. Lebel on 11/10/09 at 11:29 a.m.
Please tell me where I can find policies pertaining to the availability of a fully licensed physician for your medical students and patients. Though both the medical and patient communities may benefit from being served by a 'teaching facility’, teaching typically should involve some form of "teaching" and "supervision". The total medical care of any patient in your facility should not rest upon any student or limited licensed physician. For any student to inform a patient that it does, due to the time of night, or for any other reason, is completely inappropriate and very concerning. Patient safety and medical care should never be compromised in an acute care facility, due to the hour of the day. Especially within an acute care facility. I would appreciate any help in finding these policies pertaining to my concerns.
  Living and learning together by Dr. Babineau on 11/16/09 at 11:20 a.m.
Physicians are in-house caring for patients 24 hours a day. As the major Brown teaching hospital, we train the next generation of physicians and surgeons in Rhode Island, through clinical care and teaching. Medical students are supervised by many layers of physicians, including residents, fellows and attending physicians. Students are here to learn and are supervised at all times; they cannot order medications or procedures. Residents and fellows (physicians who have graduated from medical school and are gaining advanced training in their specialty areas) are always supervised by attending physicians, according to our Graduate Medical Education policy on supervision. Even if she/he is not at the bedside, the attending physician is responsible for the care provided and is involved in making clinical decisions throughout the day and night.

If you have questions about your hospital care, ask your nurse or physician. Our patient advocates also can help at 401-444-5817. If you have concerns about a resident or fellow, contact Dr. Staci Fischer at 401-444-8450 or sfischer@lifespan.org. In addition, we have a non-emergency patient safety hotline, 401-444-SAFE (7233) or 4SAFE@lifespan.org.


 
Question about magnet status by Sue on 11/3/09 at 1:49 p.m.
In light of the recent trouble, is there any consideration for achieving Magnet designation? It seems that empowered nurses could have helped avoid all the surgical errors.
  Moving toward our goal by Dr. Babineau on 11/4/09 at 11:20 a.m.
Over the past year we’ve started putting in place the structure to move the department of nursing toward Magnet status. We’re aligning our nursing philosophy and our policies, procedures and practices, both clinical and management, with Magnet standards. We continuously monitor our performance according to those standards. We have excellent nurses and widespread support throughout the organization, including from senior management, to pursue the goal which we expect will take us several more years to achieve.		  

Response to pharmacy intiatives by konradcrabtree via Twitter on 11/3/09 at 11:35 a.m.
Major safety push in pharmacy in last few years around sterile compounding in IV room: USP 797. How is hospital addressing?
  Working nationally and locally by Dr. Babineau on 11/4/09 at 2:11 p.m.
Rhode Island Hospital fully supports the efforts that have been made nationally to improve sterile drug compounding in hospitals—in fact most of these practices have been in place at this hospital for many years. Construction has also begun on a new state-of-the-art clean room for sterile drug preparation that is expected to be complete in the next month.		  

Subglottic secretion drainage by Yolande Muoio on 10/29/09 at 1:37 p.m.
There seems to be some controversy surrounding the research as to whether or not the use of subglottic secretion drainage is effective in preventing ventilator-associated pneumonia. I was curious as to whether or not Rhode Island Hospital supports this intervention and if so, has the hospital seen a decrease in hospital acquired pneumonia?
  Collaborating for better care by Dr. Babineau on 10/30/09 at 8:41 a.m.
Rhode Island Hospital belongs to the ICU Collaborative, which includes all adult intensive care units in Rhode Island. For the past five years, this group has worked to share best practices to improve outcomes for critically ill patients. The collaborative, as a group, looked at subglottic secretion drainage and decided not to support its use in the state at this time. The collaborative has shown a 21 percent reduction in ventilator-associated pneumonia and a 62 percent reduction in central line-associated blood stream infections compared to a 2008 baseline. Sepsis mortality at 27.6 percent is lower than the national average of 28.6 percent. RI is the only state to have unanimous voluntary participation in such an initiative. This is just one of our patient safety and quality efforts.		  

Gallbladder surgery by ferdie on 10/28/09 at 10:13 a.m.
I was in the hospital for gallbladder surgery a few years ago, and the doctor did a great job-- I was back at work in a week and a half with no problem. Hearing about the surgery error makes me wonder whether I should consider another hospital if I have to have surgery again.
  Your confidence is not misplaced by Dr. Babineau on 10/28/09 at 11:48 a.m.
Let me assure you that your confidence in this hospital is not misplaced. We perform about 25,000 surgeries annually and in each case, the physician is a competent and caring professional; the OR team is highly trained and all work hard for the best possible outcome for the patient. We don’t want a single medical error to happen—ever. That’s why we have processes in place to prevent them, such as timeouts, marking the site, and many others. Until the Department of Health and our own internal investigation are complete, I can’t tell you with certainty that we know the root cause of the error. However, when the cause has been determined, please believe me that we will do our utmost to make sure it doesn’t happen again. We understand how distressing a medical error is for the patient and the patient’s loved ones, just as we know how traumatic medical errors are for the physician and staff.		  

Medical errors by bigk076 on 10/28/09 at 9:55 a.m.
These medical errors always seem to happen at Rhode Island Hospital. Maybe we should be learning what other hospitals do?
  We are sharing information by Dr. Babineau on 10/28/09 at 10:45 a.m.
Having worked at hospitals in Massachusetts and Maryland, I know that the problem of medical errors is a priority at every hospital, which is why hospitals are sharing information about medical errors as well as processes they’ve put in place to prevent future errors. At Rhode Island Hospital, we have embraced a culture of transparency: when a medical error occurs, we report it immediately, investigate it thoroughly, report our findings and the solution that will prevent future errors. Other hospitals across the country are doing the same—for example, some hospitals do so in Massachusetts, a state that reported 24 wrong site surgeries in 2008. Thanks to the culture of transparency, we are getting closer and closer to preventing medical errors from reaching the patient. However, no hospital is there yet.		  

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