By Sheena Chung and Natalie Tynan-Baldassarra
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Patient identification errors are not uncommon in busy healthcare settings. If two patients have similar names, there is a potential for misidentification, potentially resulting in significant harm to the patient. At Women’s College Hospital, we pride ourselves on providing safe care to our patients and have defined processes to minimize the risks of patient misidentification.
Client/patient identification is a fundamental step in the healthcare process that involves the use of at least two (2) client/patient-specific identifiers to adequately confirm their identity. Identification must be done at the first point of entry (check-in) in the hospital as well as prior to providing any service, medication, treatment, or procedure. Client identification is also a Required Organizational Practice of Accreditation Canada.
Positive identification of patients ensures that the right patient is matched to the right service, treatment, procedure, medication to ensure the highest level of patient safety for every encounter. Proper client/patient identification can help to minimize preventable allergic or adverse reactions, delays in care, duplicated work, privacy breaches, wrong-person procedures, documentation in the wrong patient record, and other errors. Click here for the QTip.
At Women’s College Hospital, person-specific identifiers for both in-person as well as virtual care. In virtual care (i.e., telephone and video appointments), confirmed identification should be documented in the electronic patient record.
At least two of the following approved identifiers must be confirmed in order to correctly identify a client/patient:
- Patient’s full name, i.e., their first AND last name
- Patient’s full date of birth
- Hospital medical record number (MRN)
- Validated health card number (for example, OHIP)
- Valid photo identification
It should be noted that the patient’s room, bed, or station number is NOT an approved identifier.
At check-in, the patient’s health card is typically requested as well as one other identifier (e.g., the patient’s date of birth). For healthcare providers, usually the client’s/patient’s full name and date of birth is requested prior to initiating care or treatment. In circumstances where an identifier cannot be confirmed, additional identifiers from the approved list can be used until the patient’s identity can be established. If correct client/patient identification cannot be confirmed, your manager or supervisor can be engaged to help address the situation.
For high-risk areas that involve invasive procedures, such as surgery and blood transfusions, an identification band with at least 3 identifiers, i.e., MRN, full name, and date of birth, is given to patients and worn throughout their hospital stay.
Ask! Don’t tell!
When verifying a patient’s identity, ask the client/patient to state the information instead of confirming it. For example, “Please state your first and last name and date of birth” is the correct procedure, while “Is your name Jane Doe and date of birth is January 1, 1966?” is incorrect. Asking clients/patients to confirm what is being said to them is problematic due to potential distractions, similar sounding names, hearing challenges, and inherent bias such as the tendency for people to assume the information relayed is what they expect it to be. The “Ask! Don’t tell!” approach is much more reliable.
Working with patients:
At WCH, Experience Advisors are client/patients, their care partners, and community members who work with the hospital by sharing their lived experiences and providing input on various initiatives and programs. When reviewing the process for Client Identification at WCH, Experience Advisors felt that patients might be uncomfortable being asked to prove their identity multiple times. Experience Advisors suggest engaging patients in the client/patient identification process is the key to partnering for patient safety. Experience Advisors relayed that sharing the purpose of client/patient identification need not be long or complex. WCH staff can start the dialogue with “For your safety, please tell me your…” or “Just to ensure that I have the correct chart pulled up for you…” before verifying a patient’s identification.
To learn more about the process for ensuring correct identification you can read the policy document 2.50.001- Patient Identification
To learn more about Accreditation, visit the Accreditation Intranet Hub.