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Stop The Line Infographic
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Stop The Line
What is Stop The Line?
-"Stop The Line" refers to working in a warehouse where big machinery could be potentially dangerous if all safety standards are not being met. There is often times a regimen put in place to stop all operations and "hold the line" on a production line to ensure safety for all of the workers.
What is it?
What does this have to do with healthcare?
-The VHA (Veterans Healthcare Administration) came up with this connection to support staff in always feeling comfortable to speak up if they believe something looks wrong to them. Often times errors could be avoided if an employee felt comfortable to speak up when they weren't sure about something being done while caring for a patient.
Relation to healthcare
Examples
-A patient desperately needs a room but it has not been properly cleaned yet
-The surgeon forgets which side they're operating on and wants to double check before continuing
Examples
-a patient is recieving an IV and it doesn't look properly placed, or there may be an excess amount of blood around the site or in the line
-A part of the doctor's team hears the doctor say something about the patient's care plan, but this was not something the nurse had heard of or read in the patient's report. It is their job to pull the doctor aside and reaffirm with them that they meant to say that. Perhaps they were thinking about another patient, interpereted the patient data wrong, or read the wrong chart on accident
-Someone does not wash their hands before touching a patient
-Unsure if an instrument has been sterilized
3 W's
The VA care team has put together 3 steps for you to make it simple when you want to speak up. The 3 W's are:
-Say what you see
-Say what you are concerned about
-Say what you would like to see happen to ensure the patient's safety
Accidents
Accidents
We know accidents happen, healthcare workers are overworked, underpaid and work long hours. That is why using Stop The Line is crucial for team members to feel comfortable with their fellow staff to speak up and let a coworker know that they aren’t too sure that they’re making the right move for the patient, and perhaps they should get a second opinion.
No Discrimination
I say "No discrimination" to say no matter what rank a staff member may be on, whether it is a nurse, nursing assistant, doctor, janitor, everyone should be treated with the same respect, regardless of their job title. What is most important is keeping the patient safe. Often times, this is what keeps someone on a care team from saying something. Everyone should feel entitled to speak up in the name of safety.
No discrimination!
Time-outs
Stop The Line and Time-outs go hand and hand because they both agree with:
-double checking their notes
-making sure the entire team is on the same page
-help with team bonding
-leaving the floor open to ask questions
-figuring out strategies to making the best forms of communication between staff members
-having emphasis on a RESPECTFUL discussion
-having a shared mental model of what the procedure will look like, this way staff knows what should look right and what may look wrong
Resources
Resources
Graban, M. (2019). “Stop the Line” in a Hospital. https://www.leanblog.org/2009/03/stop-line-in-hospital/
Pellegrini, C. A. (2017). Time-outs and their role in improving safety and quality in surgery. https://bulletin.facs.org/2017/06/time-outs-and-their-role-in-improving-safety-and-quality-in-surgery/
Veterans Health Administration. (2022). Stop the Line for Patient Safety. https://www.patientsafety.va.gov/professionals/stop-the-line.asp