QUALITY ASSURANCE IN HOSPITALS/HEALTHCARE ORGANIZATIONS

The Joint Commission accreditation standards are the basis of an objective evaluation process that can help health care organizations measure, assess and improve performance. The standards concentrate on important patient, individual, or resident care and organization functions that are essential to providing safe, high quality care. The standards set expectations for organization performance that are reasonable, achievable and rational. Each standard is developed with input from healthcare professionals, providers, employers, consumers, and government agencies like the Centers for Medicare & Medicaid Services. New standards are added only if they are in relation to patient safety or quality of care, have a positive impact on health outcomes, meet or surpass law and regulation, and can be accurately and readily measured. The National Patient Safety Goals (NPSGs) have become a critical vocal point by which The Joint Commission promotes and enforces major changes in patient safety and quality of care. The criteria used for determining the value of these goals, and required revisions to them, are based on the merit of their impact, cost, and effectiveness (AHRQ, 2013). Recent changes have focused on preventing hospital-acquired infections and medication errors, in addition to existing goals promoting surgical safety, correct patient identification, communication between staff, and identifying patients at risk for suicide. The most recent update in 2014 added improving the safety of hospital alarm systems as an NPSG. The purpose of the National Hospital Patient Safety Goals is to improve patient safety. The goals focus on problems in health care safety and how to solve them. The National Patient Safety Goals were developed in 2002 to help accredited organizations address specific patient safety issues and are updated yearly. These goals are updated annually and each specifies one or more evidence-based practices with a reputation of decreasing errors while creating a safer patient environment. The first goal is to identify the patients correctly. Most medical facilities use at least two ways to identify patients. Whether it’s giving medicine, taking blood samples or providing a test or treatment, patient identification is must be done and can be a life threatening mistake if not exercised. Second, physicians and staff should practice good communicating skills with their patients. All medical staff in relation to patients should write down and repeat back all verbal or telephone orders and critical test results to make sure everyone is on the same page of music. Always back track yourself with others by evaluating decisions and procedures made before confronting patients and their family members. By doing so will improve the delivery time to get critical and accurate test results to caregivers. Test results should be reported to pertinent personnel and the patient's responsible caregiver as soon as possible to eliminate any confusion. The safe handling and use of medicines is another goal practiced throughout the healthcare industry. Medicines should be labeled or have labels on them in areas where they, along with other supplies, are stored or set up. Extra care and precautions must be taken for certain patients as to what medicine to administer. Record and pass along correct information about a patient’s medicines and initially find out what medicines the patient is taking. It is very important to compare those medicines to new ones prescribed to the patient to avoid harmful interactions which may cause life threatening side effects. It is imperative that he physicians and nurses make sure the patient knows which medicines to take when they are at home. The patient should be reminded to bring their up-to-date list of medicines every time they visit a doctor or medical facility. Health care–associated infections (HAIs) are likely the most common obstacle of hospital care. Some of the most prominent successes in the patient safety field have been achieved in the area of HAI prevention. Physicians and healthcare providers are responsible for protecting their own patients from other infected patients and from hospital staff who may be infected. They must always comply with the practices approved by the Infection Control Committee and if not done are acceptable to stiff fines and/or stripped of their medical license. . Normal day routines such as maintaining hygiene consistent with hospital policies coupled with good nursing practice is imperative for an infection free medical facility. Another procedure required by physicians is the notification of cases of hospital-acquired infection to the staff, as well as the admission of infected patients. Educational methods such as advising patients, visitors and staff on techniques to prevent the transmission of infection will mitigate the spread of infectious diseases. Every medical facility should have protocol in place in case ant staff members become infected. Instituting appropriate treatment standards for any infections they themselves have, and taking steps to prevent such infections being transmitted to other individuals, especially patients. Patient safety programs are broken down into three different stages: identification of the risks and hazards; design, implementation, and evaluation of patient safety practices; and maintaining vigilance to ensure that a safe environment continues and patient safety cultures remain in place (Qual Saf Health Care, 2003). It is important that detection or identification rates are high to avoid unintended risks and hazards not being detected which could have disastrous consequences to all involved. Instead of using one single approach to identify risks and hazards in patient safety, multiple approaches, in collaboration with the three stages listed above, should be used to identify the risks and hazards of healthcare associated injury or harm to patients and staff. The goal of patient safety is to reduce the risk of injury or harm to patients from the structure and process of care. For the overall detection process to be effective it needs to identify not only adverse/ harm events, but no harm and near miss events as well. Surgical errors have received a lot of attention in recent years, compared to other types of medical errors. Ensuring patient safety in the operating room begins before the patient enters the operative suite and continues even after the patient is released and at home or post preventive care. Steps to prevent wrong-site, wrong-person, wrong-procedure errors, or retained foreign objects have been recommended, starts with accurate and balanced communication between the patient, the surgeon(s), and other members of the health care staff (WHO, 2002). Prevention of surgical errors requires the attention of all personnel involved in the patient's care to avoid mistakes such as operating on the wrong body part or even individual. Mistakes can also happen after surgery as well. A patient can take the wrong medicine causing a life threatening allergic reaction or patients can unaware of how to take care of themselves post surgery. Patients have the responsibility of being active in caring for themselves by being an involved and informed member of their health care team.

REFERENCES

AHRQ. (2013). Patient Safety Network. National Patient Safety Goals. http://psnet.ahrq.gov/resource.aspx?resourceID=2230
World Health Organization. (2002). Prevention of hospital-acquired infections. Retrieved on May 12, 2015 from http://www.who.int/csr/resources/publications/whocdscsreph200212.pdf
Quality Safety Health Care. (2003). Organizing patient safety research to identify risks and hazards. Retrieved on May 15, 2015 from http://qualitysafety.bmj.com/content/12/suppl_2/ii2.abstract