Managing an Effective Quality Assurance Research Paper

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Reports from medical center services and committees concerning patient incidents are used to develop appropriate interventions.

Trended data of patient incidents can point to shift and date where most incidents occur.

Desired Outcome

A 50% reduction in the number medication errors of all types over the next 12 months.

Goals and Objectives to Facilitate Outcome

The overarching goal of this program would be to reduce the number of medication errors in general and among those wards/shifts with the highest numbers of medication errors over the past 12 months. The objectives in support of this goal include:

1. Developing awareness campaign materials such as locally prepared newsletter articles, posters and brochures concerning the goal to reduce medication errors.

2. Conduct a medication error theme seminar that provides basic guidelines for avoiding medication errors (the "5 Ps").

Translation of Goals and Objectives into Policies and Procedures

The above-described goals and objectives would be codified in a center memorandum, signed by the director.

Relevant Professional Standards

This program is congruent with VA professional standards for patient care. In this regard, Jorm and Dunbar (2009) emphasize that, "In a patient-centered health system the views, experiences and rights of the patient drive the way that care is delivered. There is now an increasing emphasis on patient-centeredness as an essential characteristic of safe and high quality care" (p. 390). The initiative also encourages the use of the new Electronic Patient Event Report (ePER) system introduced by the VA in January 2013. According to the VA, "The ability for doctors, social workers, ward staff, and administrators to report events provides the opportunity to improve care for our Veterans" (Tillman, 2013, para. 3).

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Explanation Concerning How the Proposed Resolution Upholds the Organization's Mission and Values and Improves the Culture and Climate

The initiative described herein is completely congruent with the VA's stated mission which is taken from President Abraham Lincoln's Second Inaugural Address: "To care for him who shall have borne the battle, his widow and his orphans." To raising awareness of the need to reduce patient incidents in general and medication errors in general, the program also improves the culture and climate of the individual medical centers administering the initiative.

Conclusion

Tertiary healthcare facilities are replete with patient interactions that can result in patient incidents, including falls and medication errors. By keeping track of these events and identifying patterns of occurrence, quality assurance professionals can help improve the quality of care being delivered to veteran patients in VA healthcare facilities. Because the information is frequently sensitive and can have implications for career development for the individuals involved, it is vitally important that any such initiative be implemented and administered in a thoughtful fashion that ensures anonymity in aggregated data analyses. In sum, quality assurance professionals have a number of useful tools at their disposal, including chart and peer review as well as patient incident reporting systems that can identify opportunities for improving patient care......

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