Quality improvement in medication administration - Research Paper Example

Medication administration forms the key performance improvement area in Carlinville Area Hospital as strategy of alleviating liabilities and costs that may arise due to lapses in drug administration. Medication administration is one of the sensitive areas in public health that is highly controlled by a number of statutes both federal and state (Blegen & Hughes, 2009). It is important that healthcare practitioners observe stringent measures when administering drugs in order to avoid ligations associated with negligence and incompetency. In fact, the law is very clear on the issues related to drug administration and incase Carlinville Area Hospital will fail to institute proper performance measures, it will be virtually impossible to avoid problems associated with poor drug administration. Instilling quality improvement in medication administration will ensure that Carlinville Area Hospital upholds all the stipulated guidelines, policies, and procedures relating to nationwide drug administration. A number of methodologies are available to healthcare providers that can effectively be used to integrated quality improvement into performance measurements. The key methodologies include but not limited to Six Sigma, Lean Production System, and Root cause analysis (Hughes, 2008). These methods are important for ensure that organization operations are streamlined enough to meet the performance measures instituted by the organizations. It is also evident that these methods allows for flexible monitoring of organization activities to allow for speedy corrective measures in case of deviation. Starting with the Six Sigma, this is improvement method focuses on eliminating waste by continuous improvement, monitoring and designing of process without jeopardizing satisfaction. Process capabilities act as the performance measure considering that the method employs comparison technique in the sense that the process before improvement is compared to the process capability after quality improvement. According to Hughes (2008), notable advantages in this method include ability to reduce variations as well as to improve outcomes for a variety of processes. Root Cause Analysis (RCA) is also another significant method of improving quality in a hospital setup, it involves formalized investigation, and problem solving approached aimed at uncovering what might have caused an event as well as the events that were intercepted. Root Cause Analysis plays a significant role in helping individuals pinpoint trends as well as assess risk to be applied in case of suspected human. RCA is often based on the assumption that systems rather than personal factors are probably the root cause of most problems (Hughes, 2008). Unlike other improvement methodologies, RCA is a reactive technique that starts to operate once an event has occurred, illustrating the sequence of events leading to the specified event and above all addressing the root causes for proper examination of the event. Notable advantages of Root Cause Analysis include highly significant in assessing reported errors. It can be used to suggest system changes whenever the need arises. Lean productions system has been utilized successful to integrate quality improvement and performance measures in number of organizations, healthcare not left behind. Lean production system has highly been used to remove inefficiencies in organization systems that may lead to wastes (Hughes, 2008). Customer needs are the focus of this method as it aims at removing activities considered non-value-added to improve processes. This methodology depends a lot on the root cause analysis in its effort to improve processes considering that RCA has the ability to investigate errors. Hughes (2008) asserts that Lean production method only comes in to improve quality and prevent future occurrence of identified errors through RCA. Lean production method is considered advantageous for producing results in an objective and concise manner. Additionally this methodology is highly applicable in removing inefficiencies in the processes. Electronic Medical Record (EMR) also referred to as Electronic Health Record (EHR) refers to an automated medical record used in a hospital setting for easier storage, retrieval, and modification of patients data. According to Payton and Tan (2010) EMR are widely used across the globe by different healthcare providers ranging from small scale to large scale. It is obvious that Carlinville Area Hospital values Software and Information systems for daily transaction records relating to medication administration thus the need for Electronic Medical Record (EMR). Electronic medical record is such an important tool to the Carlinville Area Hospital to the extent that its absence can be a big blow to the entire hospital with respect to effectiveness of medication administration. Electronic medical record will certainly ensure that Carlinville Area Hospital persistently enjoys proper management of organization records regarding medication safety and error prevention. Through its every day undertaking the hospital has to handle a wide variety of overwhelming medication data that must be stored, for later retrieval as per the healthcare needs of the patient. Besides using EMR to handle medication records Carlinville Area Hospital can still use the information system in managing a number of hospital data ranging from patient records such as daily admission and discharge data. Other information that can be managed by the EMR include supervisory data, drug stock-out data, appointment, staff availability, in patient records which involve bed capacity and duration of stay as well as vital hospital information relating to facilities and equipments. Ensuring the quality and effectiveness of Electronic medical record translates to a number of benefits to Carlinville Area Hospital ranging from determination of information requirement, effective and timely production of reports, and ease of documentation of vital organization records relating to medication administration. Additionally, EMR is also going to ensure that there is fast dissemination of information to users especially the management and physicians for quick decision-making. Above all the hospital will enjoy fast and ease gathering, processing, and monitoring of information owing to an effectively performing EMR. Electronic medical record plays a significant role of curbing inefficiencies and costs associated with poor storage of data, which can be understood, inform of delay in retrieval and loss of important records (Payton & Tan, 2010). It is obvious that if EMR is not incorporated in management of the Carlinville Area Hospital then operation efficiency will be forfeited thus poor service delivery and quality in terms of medication administration. Payton and Tan (2010) state that Decision Support System (DSS) is computerized information system that supports decision-making undertakings in business setup. Decision-making Support Systems are of wide variety and are often designed according to the type of business environment. For instance, a DSS for manufacturing organization will be very different for a banking institution. It is noteworthy that DSS are normally interactive in nature considering that they give decision makers and opportunity to gather, process and suggest solutions to the issue at hand thus speeding up the decision making process. Decision Making Support system used specifically in hospital setup is referred to as Clinical Decision Making Support System (CDSS). Gorman (2001) acknowledges that just like any other DSS, Clinical Decision Making Support System (CDSS) are interactive in the sense that it can influence the decision of the clinician with respect to patient diagnosis. CDSS are of two type Knowledge-Based and Non-Knowledge Based CDSS and both play a critical role in assisting the physician come up with quick decision about the patient diagnosis. DSS has widely been utilized for its ability to produce new evidence that supports a particular decision, automate decision-making process, increase decision making speed as well as problem solving. Clinical Decision Support System can widely be applied in administration of medication in a hospital setup such as Carlinville Area Hospital to reduce errors associated with dispensing of drugs. For instance, CDSS can easily advice the clinician of the drugs to dispense incase the patient is one particular drugs or under specified condition (Gorman, 2001). CDSS can also be effective in promoting effective administration of drugs by promoting appropriate clinical coding and documentation of drugs thus avoiding problems associated with improper labeling of drugs. Additionally, CDSS will help the clinicians of Carlinville Area Hospital to track drug orders to ensure that drugs do not land in the wrong hands. Computerized physician order entry (CPOE) refers to an electronic process of entering physician orders and instructions relating to radiology results, medication, laboratory tests, and x-ray examinations instead of using paper chart (Payton & Tan, 2010). In other words, CPOE is a computer-based system that allows medical practitioners to issue instruction and orders to other divisions in the hospital with which the patient is dealing with and they may include laboratory, or pharmacy. With the new trend in technology software developers saw the need to end tradition methods of issuing orders which involved use of verbal communication or hand-written. In the recent past, several damages used to occur in hospitals owing to traditional ways of issuing instructions. However, with the present CPOE system in place very few problems can befall patients. It is noteworthy that CPOE can effectively be used to prevent medication errors associated with issuing hand written as well as verbally communicated which are in most cases illegible or misinterpreted in a hospital setting such as of Carlinville Area Hospital (Payton & Tan, 2010). The hospital - of Carlinville Area Hospital will take advantage of CPOE to curb delays associated with issuing medication instructions to the relevant authority. Benchmarks and milestones are highly significant tools in a quality improvement effort. Any organization including Carlinville Area Hospital needs benchmarks and milestones in their quality improvement efforts. Without the benchmarks an organization will not b e able to understand its strategic direction towards quality improvement in their outcomes and processes. Benchmarks and milestones refers to ways that hospitals and doctors use to analyze data both internally and in comparison to the data recoded by other hospitals. For instance, a Carlinville Area Hospital will use benchmarks and milestones as tool of improving quality by comparing its performance data against best performance in the industry in terms of outcomes and processes. Quality indicators on the other hand refer to the standards, norms, qualitative as well as quantitative measures used in determining the level of quality achieved. Benchmarks and milestones are important for establishing the baseline for various targets against which quality indicators can be used to measure the degree of adherences to such baseline targets. Carlinville Area Hospital will use its quality indicators to measure the level of quality achieved with respect to standards or measures set by best performers in the health industry. The first benchmark to be used by Carlinville Area Hospital includes the number of reported drug error cases per category. This benchmark will be used to compare the number of patient injuries as result of specific medication error against the reported case in other regional hospitals. The second benchmark includes the number of patients who stated that the medical practitioners explained to them about medicine issued to them before it is administered to them. The third benchmark to be used by Carlinville Area Hospital involves the number of patients who reported that all drugs to be delivered to them were well explained before the delivery. The information gathered from the patients of Carlinville Area Hospital will be compared against the national averages collected and represented in measurable forms. Quality healthcare is one of the major priorities of federal government especially the Department of Health and Human Services (HHS) (NQF, 2011). Besides the HHS the Centers for Medicare & Medicaid Services (CMS) has always upheld the issue of quality healthcare by implementing a number of healthcare initiatives aimed at promoting top quality healthcare for all the beneficiaries of Medicare. One of the healthcare initiatives by the federal health system involves putting in place a number of quality measures that are widely recognized nationally. Performance and Quality measures refers to tools that assists organizations to measure healthcare outcomes, processes or organization systems associated with quality healthcare goals (NQF, 2011). It is noteworthy that missions, vision and strategic plan always outline the short term as well as long term goals and objectives of the company and as such performance and quality measures may be used to measure systems, processes and outcomes associated organization goals and objectives both long and short term. It is obvious that organization needs performance and quality measures to track their efforts towards specified goals. The quality measures are going to assist Carlinville Area Hospital measure all the organization processes, systems and outcomes that linked to the healthcare quality goals and objectives contained in the mission, vision, and strategic plans of the hospital. The key healthcare quality goals contained in the mission, vision and strategic plans of Carlinville Area Hospital include effective, efficient, patient centered, safe and timely healthcare. References Blegen, M & Hughes, R. (2009). Medication Administration Safety. U.S. National Library of Medicine. Retrieved October 15, 2011 from: http://www.ncbi.nlm.nih.gov/books/NBK2656/ Gorman, P. (2001). Clinical Decision Support Systems for the Practice of Evidence-based Medicine. Journal of the American Medical Informatics Association, 8(6): 527–534. Hughes, R. (2008). Tools and Strategies for Quality Improvement and Patient Safety. Retrieved October 15 2011 from: http://www.ahrq.gov/qual/nurseshdbk/docs/HughesR_QMBMP.pdf National Quality Forum (NQF). (2011). HHS Performance Measurement. Retrieved October 15 2011 from: http://www.qualityforum.org/About_NQF/HHS_Performance_Measurement.aspx Payton, F & Tan, J. (2010). Adaptive health management information systems: concepts, cases, and practical applications. Massachusetts: Jones & Bartlett Publishers. Read More