Free Essay

Improving Quality of Care

In: Science

Submitted By kokonaye
Words 1344
Pages 6
Annually, millions of Americans receive high-quality health care that restores their health to the best it can be and allows them to carry on functioning in society at their optimum best. Unfortunately this story does not resonate with some Americans who are far from happy about the level of care they received while sick. Quality problems are present in wide variation across board when talking delivery of health care services, in some instance, the issue could be with underutilization of a particular service, and other instances may include misuse of service which is generally preceded at onset by prior unacceptable level of errors. The purpose of this paper is to highlight medication errors as a health care safety issue. One solution involving automation would be explored since it has long been recognized as an important factor in reducing human errors in work processes. It is crucial to showcase this because numerous studies have substantiated the positive effects of health IT on quality and safety improvements, Slovenky & Menachemi (2011).
A safety Initiative
With new tools provided by the Affordable Care Act, hospitals can now aggressively implement programs with sole aim of assisting in the reduction of preventable errors. The act provides hospitals with incentives to improve the quality of health care, and provide real assistance to medical professionals, to support their efforts to reduce harm, McKinney & Zigmond (2011). The government predicted that this could save 60,000 lives over the next three years and potentially save up to $50 billion in Medicare bill. The federal government is encouraging providers to adopt and effectively use electronic health record (EHR) systems, Heubusch (2011). The goal in the development and use of EHR’s is to enable effective and measurable improvements in the health of individuals and fully involve them in the process.
Reasons for the Initiative The Institute of Medicine (1999), defines a medical error as "the failure to complete a planned action as intended or the use of a wrong plan to achieve an aim". An adverse event is defined as "an injury caused by medical management rather than by the underlying disease or condition of the patient". One of the reasons why the EHR initiative was developed was because it became apparent that about 80 percent of serious medical errors was due to miscommunication between caregivers when a patient is transferred or handed off, American college of Surgeons (2011). Complete and accurate information is of utmost importance in health care, providers will be in a better position to manage and advocate for patients when they have access to a patient’s entire complete and accurate health history, in effect, better access to information. Complete and accurate electronic health information will facilitate the ability of multi-dimensional teams to diagnose and treat patients.
It is reported that there are between 44,000 and 98,000 individuals who die every year in hospitals due to preventable medical errors, Medscape (2011). As earlier mentioned, there are several ways in the ‘medication use processes’ where errors can occur. These include; prescribing, documenting, transcribing, dispensing, administering, and monitoring. Prevention of medication errors has therefore become a high priority worldwide. There is mounting evidence that systems that use information technology (IT), such as computerized physician order entry, automated dispensing cabinets, bedside bar-coded medication administration, and electronic medication reconciliation, are key components of strategies to prevent medication errors, Agrawal (2009).
Strengths and Limitations of the Initiative
Strengths: Hospitals with automated notes and records, order entry, and clinical decision support have fewer complications, lower mortality rates, and lower costs, Amarasingham et al (2009). IT systems have also been reported to have the potential to save up to $88 billion over 10 years in costs in the USA. Clinical decision making is a complex process that depends on human ability to provide undivided attention and to memorize, recall, and synthesize huge amounts of data – all vulnerable areas. IT systems can improve access to pieces of information, organize them, and identify links between them. Clinicians often ‘know’ the information (such as a patient's allergies, a drug recall warning, or a drug–drug interaction) but forget to consider it at the time of prescribing. IT systems are effective in bridging this ‘knowing–doing’ gap, by presenting the relevant information to the clinician at the time of decision making, Pfeffer & Sutton (2000).
Limitations: With growing recognition that many inpatient medication errors occur at care transition points, reconciliation of medication lists during admission, transfer and discharge is an important step in improving safety. Computerized Physician Order Entry (CPOE) systems are effective in reducing errors during prescribing; however, a CPOE system cannot detect an error if the physician does not remember to prescribe a medication that the patient was taking at home. Another concern that has been raised by evidence of the potential negative consequences of IT systems on patient safety is that IT systems can adversely affect clinical care by generating more work or new work for clinicians, causing workflow problems, or even generating new kinds of errors, Koppel et al (2005). The current approach to IT standardization and certification is focused on the functionality of the system, but does not address its implementation or usability by clinicians.
Role of Nursing Nursing as a profession has a long history of regarding patient safety as a primary precept of the profession. Nurses have 2 roles in medication error prevention, first they must check to see that other healthcare providers have not made any errors in any part of the medication order chain; next they must ensure that they themselves do not make an error. Ordering or prescribing the wrong drug, dosage, or route contributes to 48% of medication errors. Nurses intercept 48% of these types of ordering errors. Transcription errors account for 11% of all errors, of which 23% are intercepted by nurses. Dispensing errors comprise 14% of all medication errors; however, nurses intercept 37% of them. Overall, nurses intercept 58% of all medication errors. Administration errors account for 28% of all errors, Medscape (2006).
Quality healthcare depends on the availability of quality data, Ahima(2007). IT systems are key components of a multifaceted strategy to prevent medication errors and improve patient safety. However, we need to be mindful of their potential to affect clinical workflow adversely, with attendant complications. Improving standardization and certification of the design and implementation of such systems should help. In addition, creating an economic and policy environment conducive to the financial goals of hospitals and physicians will facilitate wider adoption. Nurses can take a more prospective, risk-reduction approach to medical errors (Wolf, 1989). Adoption of appropriate technology blended with a confidential error reporting system that protects the professional interests of nurses will be effective in reducing, preventing and correcting medical errors.

Agrawal, A (2009). Medication Errors: Prevention using information technology
Systems. Retrieved from
AHIMA (2007) Assessing and Improving EHR Data Quality Journal of AHIMA (78) 3.
Amarasingham. R., Ptantinga.,L., Diener-West M., Gaskin.D(2009) Clinical Information
Technologies and Inpatient Outcomes: a Multiple Hospital Study. Arch Intern Med 169: 108 114.
American College of Surgeons (2011) ‘TJC Tackles Miscommunication among
Caregivers’. Bulletin of the American College of Surgeons (1) 96.
Heubusch, K (2011) Advancing Quality and Patient Safety Initiatives. Retrieved from Koppel. R., Metlay.J., Cohen.A., Abaluck. B., Localio. A., Kimmel. S., Strom. (2005). Role of Computerized Physician order entry systems in facilitating Medication errors. JAMA 293: 1197- 1203.
Medscape (2006). Medication Error Prevention for Healthcare Providers. Retrieved from
McKinney. M,. Zigmond. J(2011) HHS Launches $1 Billion Patient – Safety initiative.
Retrieved from
Pfeffer. J., Sutton. R (2000). The Knowing – Doing Gap: How Smart Companies Turn Knowledge into Action. Boston, MA: Harvard Business School Press: 2000.
Slovenky, D., Menachemi, N (2011). How Information Technology can Improve Safety:
Error reduction in Health Care: A Systems Approach to Improving Patient Safety,
3rd Edition. San Francisco. CA, Jossey –Bass.
Wolf. Z (1989) Medication Errors & Nursing Responsibility. Holistic Nursing Practice.
4(1) 8- 17.

Similar Documents

Free Essay

Quality Improvement in Primary Care

... | |Quality Improvement in Primary Care | | | | | | | | With the movement to advance quality care and the improvement of health care outcomes, organizations have increasingly implemented quality improvement (QI) initiatives to meet requirements. Quality Improvement refers to activities aimed at improving performance and is an approach to the continuous study and improvement of the processes of providing services to meet the needs of the individual and others. Engaging primary care practices in quality improvement activities is essential to achieving improvements in health care such as the triple aim. In an effort to create a high-value health care system the focus on improving the performance and safety of primary care is a must. The objective of......

Words: 436 - Pages: 2

Premium Essay

Quality Improvement Part Ii

...Running head: QUALITY IMPROVEMENT PLAN PART II Quality Improvement Plan Part II Cheryl Wright University of Phoenix HCS 588 Cynthia Hughes July 16, 2012 Quality Improvement Plan Part II Quality improvement is a hospitals process to advance the quality of care and outcomes for patients using an explicit set of philosophies and procedures (Walker, 2012). This paper attempts to describe some of the areas of potential advances for quality improvement at Washington County Regional Medical Center (WCRMC) nursing unit. One principle of quality improvement is measurement, which is the collection of data to improve patient care. Using these measurements and tools can help leaders understand the direction of quality in the organization. Areas of Potential Improvement for the Organization. The areas of consideration for improvement at WCRMC are emergency room wait times and discharge instructions. Both of these improvement areas have financial and influence for the health care organization. Emergency room wait times can reduce the market share and financial stability of the health care organization. Discharge instruction if given appropriately by the nursing staff can reduce the readmission rate for WCRMC, along with financial gain and improve the satisfaction of the patient experience. These are just of couple of measures WCRMC can use to align the mission of the organization and the commitment of improving performance. There are several models and......

Words: 1382 - Pages: 6

Premium Essay

Improving Quality Healthcare

...Improving Quality of Care Ottawa University Abstract Assessing and improving quality health care in the United States is a high priority in this day and age of health care. As health care providers we have an obligation to serve as leaders and visionaries and actively demonstrate and document the advances to patient-centered care. Many agencies and organizations have developed initiatives to advance patient care through quality improvement measures and patient safety programs. Evaluating quality health care is important for consumer, providers and society. Developing a quality measure of health care is an important objective for organizations that value health care quality. Improving Quality of Care The continuing growth of technology in healthcare is ground breaking at this time. With the advancements in technology and health care, there has become a rift between providers and patients. Patients want the best quality care from the health care system. Despite this justifiably positive view that, overall, quality of care is high in this country, many factors point to the fact that the quality of care is declining. It is believed that patient-physician relationships are not as strong as they once were, causing distrust and uncertainty. The health care field is ever changing and health care providers need to stay current on those changes, both now and in the future. Quality patient care will greatly remain impacted from the health care provider shortages and in return...

Words: 2258 - Pages: 10

Premium Essay

Strategy for Improving Healthcare Delivery

...STRATEGY FOR IMPROVING HEALTHCARE DELIVERY AND ORGANIZATION PERFORMANCE The present report is focused on identifying strategies for defining, measuring, and improving performance of the healthcare delivery system in any organization. The scope of the report is kept limited to the frontline health service delivery system like hospitals and clinics which directly interacts with patients. The main objective of the report is to identify important determinants of organizational performance in healthcare and to present examples of solutions which can improve its functioning and performance. Identifying present performance: Before formatting future strategy for any organization, it is important to evaluate its present performance. It is important for any organization to deliver healthcare of high quality, high efficiency, easy accessibility, and easy utility; to be considered as a high performance organization. Additionally, the high performance organization must be open to enable learning and to have well planned strategies to access support from different parts of the society to attain sustainability. Thus section discusses the six main outcomes required by high performance organization which are quality, efficiency, utilization, access, learning, and sustainability. 1. Quality: Research on the clinical quality of the healthcare is as old as the healthcare delivery system itself. The researchers identify clinical quality as safe and medically appropriate healthcare.......

Words: 3736 - Pages: 15

Premium Essay

Regulatory Agency

...Policy Primary Care Improvement Quality and Equality About UsBoard of TrusteesStaffPresident's MessageJobsHistory & FundersDirectionsFAQs About CHCS Slide Deck_Dec_2010 (229K) Medicaid Fact Sheet (44K) About CHCS Fact Sheet (61K) Download Adobe Acrobat Reader to read PDF files. Our Mission The Center for Health Care Strategies (CHCS) is a nonprofit health policy resource center dedicated to improving health care quality for low-income children and adults, people with chronic illnesses and disabilities, frail elders, and racially and ethnically diverse populations experiencing disparities in care. We work with state and federal agencies, health plans, providers, and consumer groups to develop innovative programs that better serve people with complex and high-cost health care needs. Our Priorities Enhancing access to coverage and services. Under health care reform, Medicaid is poised to serve more than a quarter of all Americans. CHCS is helping states and health plans to understand the care needs of the Medicaid expansion population and streamline linkages between Medicaid and the insurance exchanges. Improving quality and reducing racial and ethnic disparities. Medicaid currently serves more than 60 million Americans including a significant portion in racial and ethnic minority populations. Quality outcomes in Medicaid are significantly lower than in commercial insurance. CHCS is working to close the gap by improving the quality of care......

Words: 508 - Pages: 3

Premium Essay

What Can Be Done to Improve Access to Healthcare

...improving Quality and Value in the U.S. Health Care System August 2009 Preamble The Bipartisan Policy Center (BPC) is a public policy advocacy organization founded by former U.S. Senate Majority Leaders Howard Baker, Tom Daschle, Bob Dole, and George Mitchell. Its mission is to develop and promote solutions that can attract the public support and political momentum to achieve real progress. The BPC acts as an incubator for policy efforts that engage top political figures, advocates, academics, and business leaders in the art of principled compromise. This report is part of a series commissioned by the BPC to advance the substantive work of the Leaders’ Project on the State of American Health Care. It is intended to explore policy trade-offs and analyze the major decisions involved in improving health care delivery, and discuss them in the broader context of health reform. It does not necessarily reflect the views or opinions of Senators Baker, Daschle, and Dole or the BPC’s Board of Directors. The Leaders’ Project was launched in March 2008. Co-Directed by Mark B. McClellan and Chris Jennings, its mission is (1) to create a bipartisan plan for health reform that can be used to transform the U.S. health care system, and (2) to demonstrate that health reform is an achievable political reality. Over the course of the project, Senators Baker, Daschle, and Dole hosted public policy forums across the country, and orchestrated a targeted outreach campaign to...

Words: 35073 - Pages: 141

Premium Essay

Explain the Roles and Responsibilities of Two Overarching Health Organisations and care in England, making sure people have the support, care and treatment they require, with the compassion, respect and dignity they deserve. Their responsibilities include: * They lead across health and care by creating national policies and legislations, providing long-term goals to meet current and future problems/challenges, putting health and care at the core of the government and being global leader in health and care policy * They support the integrity of the system by providing funding, assuring the delivery and continuity of services and accounting to Parliament in a way that represents the best interests of the patient, public and taxpayer. * They support innovation and improvement by supporting research and technology, promoting honesty, openness and transparency, and teaching a culture that values compassion, dignity and the highest quality of care above everything Above all, DH encourages staff in every health and care organisation to understand and learn from people’s experience of health and care and to apply this to all their tasks. Their priorities are: * Living and ageing well: helping individuals live healthier lives and making the UK a great place to be and to grow old in * Preventing diseases and poor health, improving care for individuals over the age of 75, improving social care, integrating health and care and improving care for people with dementia * Caring better: raising standards in health and care,......

Words: 575 - Pages: 3

Premium Essay

Cost and Quality Analysis

...Running head: COST AND QUALITY ANALYSIS Healthcare cost and quality Grand Canyon University July 24th, 2012 Ethics, Policy, and Finance in the Health Care System Sally L. Clark A challenge that the healthcare nation is facing is to provide the quality of care that is expected and obtain low healthcare cost. Working hand in hand with the private sector and government is in hopes of improving the quality of care that each patient deserves and maintaining the cost so that research can continue. The purpose of this paper is to look into relationships between healthcare cost and quality healthcare. Differences in HealthCare Cost and Quality Working in the healthcare system, you often wonder if the nation works on quality of care or do they work more on cost of healthcare. Quality of care is an important role in achieving the best healthcare. Cost of healthcare is based on incentives that support the effectiveness while curving the spending growth (MacReady, 2012). Reform needs to be provided a baseline in evaluating healthcare delivery systems for a broader success of payments and delivery models with payment providers (2012, p.2). Sometimes higher cost effects quality of care. Some decisions need to be made that may affect the “clinical and fiscal health of the nation” (2012 p.1). Differentiating Roles and Major Activities Public and Private agencies plays an important role on how healthcare is delivered. The Commonwealth Fund...

Words: 1228 - Pages: 5

Premium Essay

Concepts Analysis Paper

...University March 10, 2014 The concept of Quality has a close relation with nursing practices. Higher quality healthcare is the common goal of all healthcare team and improving healthcare quality has become the common focal point of all healthcare organization. Quality has become an important issue for healthcare facilities facing a changing of healthcare environment (Tsai, & Wu, 2013). Quality is derived from the Latin “quails” and is defined as essential character of nature…an inherent or distinguishable attribute or property, a character “trait” and is defined as superiority of kind and degree or grade of excellent (Wicks, & Roethlein, 2009). Every quality expert defines quality somewhat differentially, and there are a variety of perspectives than can be taken in defining quality. The most widely concept of quality is the Industrial Organization Society (IOS) definition as “the degree to wish a set of inherent characteristics fulfill requirements” (Wicks, & Roethlein, 2009, p. 85). The psychological concept is closely aligned with the dictionary definition when quality relates to logic: “quality is the positive or negative character of a proposition” (The Merriam-Webster Dictionary, 2014). Quality is a set of characteristics or properties, as supported by the multidimensional definitions of quality. Quality can focus on excellence or can be viewed as the degree of a services attained (Golder, Mitra, & Moorman, 2012). Quality is perhaps the most......

Words: 2863 - Pages: 12

Premium Essay


...Key Features of the Affordable Care Act By Year On March 23, 2010, President Obama signed the Affordable Care Act. The law puts in place comprehensive health insurance reforms that will roll out over four years and beyond. Use the links below to learn about what’s changing and when: OVERVIEW OF THE HEALTH CARE LAW 2010: A new Patient's Bill of Rights goes into effect, protecting consumers from the worst abuses of the insurance industry. Cost-free preventive services begin for many Americans. See More 2010 Changes. 2011: People with Medicare can get key preventive services for free, and also receive a 50% discount on brand-name drugs in the Medicare “donut hole.” See More 2011 Changes. 2012: Accountable Care Organizations and other programs help doctors and health care providers work together to deliver better care. See More 2012 Changes. 2013: Open enrollment in the Health Insurance Marketplace begins on October 1st. See More 2013 Changes. 2014: All Americans will have access to affordable health insurance options. The Marketplace allows individuals and small businesses to compare health plans on a level playing field. Middle and low-income families will get tax credits that cover a significant portion of the cost of coverage. And the Medicaid program will be expanded to cover more low-income Americans. All together, these reforms mean that millions of people who were previously uninsured will gain coverage, thanks to the Affordable Care Act. See More 2014......

Words: 3433 - Pages: 14

Premium Essay

Foundations Paper Hsm/260

...organization that is direct focus on health care issues. The foundation support public agencies, universities and public charities that fall under tax exempt sec. 501 (c) (3) of the Internal revenue code. The mission of the Robert Wood Johnson Foundation is to improve the health and health care of all Americans. Their goal is clear: To help our society transform itself for the better. The foundation does numerous projects throughout it organization. Every year the foundation gives out approximately 1,000 grants totaling hundreds of millions of dollars to hospitals and research institutes. The RWJF (Robert wood Johnson Foundation) does provide annual reports containing its complete list of grants awarded each year. You have the ability to apply for multiple grants at one time as long as it for different projects. You do have to submit an application form in for applying for certain grants. The entire process can take anywhere from four to seven months before it’s approved.       Clinical Scholars is one of the most successful foundation programs. It provided young physicians the opportunity to study on non-clinical topics such as management and economics. They have a unique capability and responsibility to confront the most pressing health and health care problems threatening our society. Their efforts focus on improving both the health of everyone in America, and their health care—how it's delivered, how it's paid for, and......

Words: 897 - Pages: 4

Premium Essay

Hsc 451

...Risk Management Summary HCS 451 March 20, 2011 Risk Management Summary The purpose of risk management is an important aspect of health care industry in United States and throughout the world. The risk management in health care organization considers patients safety, quality assurance and patient’s rights as well as employees rights. The Joint Commission, which accredits and certifies more than 17,000 health care organizations and programs in the United States, defines risk management in health care as "clinical and administrative activities, undertaken to identify, evaluate, and reduce the risk of injury to patients, staff, and visitors and the risk of loss to the organization itself” (Miller, 2010). The Children Hospital Central California commits to patient safety therefore safety depends on creating processes to anticipate errors and prevent them before they cause harm.  The primary goal of their Patient Safety Program is to ensure that all care is safe, effective, patient-centered, timely, efficient, and equitable.  The hospital vision is to sustain involvement of everyone at Children's Hospital Central California, which will develop into a national innovator and leader in delivering safe patient care. Care proudly recognize by patients, parents, peers, and the community. At children’s hospital, the key steps in identifying and managing risk are to practice safety regularly. Numerous of initiatives are structure around the Joint Commission’s National Patient......

Words: 744 - Pages: 3

Premium Essay

Care Delivery Model

...Patient-Centered Care Delivery Model, a Multidisciplinary Team Approach NR532 Healthcare Operational Planning and Management Patient-Centered Care Delivery Model, a Multidisciplinary Team Approach Increased emphasis from the Institute Of Medicine (IOM) and the Patient Protection and Affordable Care Act (PPACA) on improving quality, safety and reducing care cost has brought forth challenges among hospital executives (Cama, 2009). Nurse executives must develop low cost, innovative and effective ways to deliver patient care. The focus of this manuscript is to develop and implement a care delivery model emphasized in a patient-centered care delivery model using multidisciplinary team approach. Patient-centered Care Delivery Model According to the Institute of Health Improvement (IHI), “patient-centered family care is care through a patient’s experience that is coordinated, informed and grounded in respectful interactions with providers that are consistent with the patient’s values, expectations and care decisions” (Balik, 2011). Evidence-based practice has drastically increased this past decade with one of its cornerstones being “patient-centered care and nursing being at the frontline to lead this change. Professional nurses are prepared to effectively lead the healthcare team to achieve patient and organizational goals. Patients are unique in every facet of their needs and therefor multiple disciplines are critical to best deliver patient-centered outcome (Cama,......

Words: 1281 - Pages: 6

Premium Essay

Evolution of Health Care Information Systems

...Evolution of Health Care Information Systems Looking back twenty 1990’s and now in 2010 health care has changed extremely. Health Insurance Portability and Accountability Act (HIPAA) did not exist until 1996. HIPAA made it possible for everyone to qualify for health insurance and setting privacy and they established health information standards and regulation. Veterans Health Administration’s (VHA) had a reputation of poor quality of care and the 90’s were the beginning of a major transformation of VHA that was aimed at improving the efficiency and quality of care that was being provided to their patients. Capability to do data analysis in 1990 was impossible most of the data was collected and stored in a room untouched. Advanced in technology made it possible to do research and do data analysis. The advantages in technology are beneficent to health care information in providing electronic medical records, medical billing, telemedicine and teleradiology. Evolution of Health Care Information Systems Compare/contrast of either health care facility or physician’s office operation with the same 20 years prior To look back twenty years ago in the 1990’s and now in 2010 health care has changed tremendously. In the 1990’s Health Insurance Portability and Accountability Act (HIPAA) did not exist. Prior to HIPAA, which was passed in 1996, there were no regulations or standards for health care delivery in making it more efficient for patients. ......

Words: 1641 - Pages: 7

Premium Essay

Hospital Assessment

...Risk and Quality Management Assessment Summary Beverly L. Rivera HCS/451 April 1, 2015 Kevin Stevens Risk and Quality Management Assessment Summary The healthcare industry is growing rapidly with significant changes directing new trends and advance technology for the future. Within recent years, the shift from manual medical records to electronic medical records allows individuals to be an active participant in direct control of their health care. As these changes continue to increase, the risk and quality departments within health care organizations has an enormous duty to enhance the quality of care for its internal and external customers. Gwinnett Medical Center is one of many healthcare organizations that embraces change along with enhancing the quality of care their patients receive. The executive summary assessment will describe details of Gwinnett Medical Center, the risk, and quality management department policies, and how the risk and quality management determines the quality outcome for the goals the hospitals. Gwinnett Medical Center Gwinnett Medical Center (GMC), also known as Gwinnett Hospital System, Inc. (GHS), was established in the early 70s and is a not-for-profit health care network. The hospital is a 553-bed facility, which includes 464-inpatient and 89-skilled licensed nursing and long-term facility. Gwinnett Medical Center has two acute-care hospitals, and facilities in different cities and the metro Atlanta area. The facility in......

Words: 2174 - Pages: 9