Research Paper on "Managing an Effective Quality Assurance Program"

Research Paper 4 pages (1092 words) Sources: 4

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Managing an Effective Quality Assurance Program at a VA Medical Center

Today, the Department of Veterans Affairs (VA) operates a system of 167 medical centers across the country that provides tertiary healthcare services to eligible veteran patients. Each of these medical centers has a quality assurance service that is responsible for identifying opportunities for improving patient care through a rigorous patient incident reporting system. The results of these monitoring activities are reported at the medical center level, as well as regionally and nationally. By analyzing this aggregated data, quality assurance services can help reduce the incidence of serious patient incidents such as medication errors, patient falls and patient abuse. This paper provides a description of a quality assurance services in a VA medical center from a systems theory perspective. A summary of the research and important findings concerning using a systems theory approach to reducing patient incidents are provided in the conclusion.

Review and Discussion

A wide range of events qualify for a patient incident report in the VA healthcare system, including patient falls (without and with injury), medication errors (without and with injury) and surgical misadventures. Other events such as fires and patient abuse are also reportable. In all cases, the patient incident data is trended locally and forwarded to regional offices and ultimately VA Central Office to national comparisons. When patient events are sufficiently serious, they may warrant peer review and adverse personnel actions can result from these reviews. An open system concept of this process is set forth in Table 1 belo

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Table 1

Open System Concept of Department of Veterans Affairs Peer Review

Concept

Definition

Application to Large-Scale Organization

Application to the Nursing Services Delivery Theory

Inputs

Incident reports of medication errors, especially those sufficiently severe to trigger a peer-review.

In any VA healthcare setting, incident reports can be generated by anyone.

In the nursing services, these inputs typically involve medication errors or patient abuse cases.

Throughput

Computer-based reporting system is available that allows for the reporting of all types of incidents (i.e., fall, medication error, fire, etc.) which are then trended by ward and shift, and weighted by patient days of care.

Results of incident analyses are reported in the medical center's weekly QA report and discussed by all medical center committees as the data relates to them.

Various initiatives have been used to reduce patient incidents; for example, posters reminding nurses about eliminating medication errors resulted in a 30% reduction.

Output

The patient incident data is transmitted to a regional office and subsequently VA Central Office in Washington, DC for aggregation and further analysis.

All VA medical centers receive aggregated reports concerning their patient incident reporting regimens and where they stand compared to all other VA medical centers. A single event can include more than one type of patient incident (Walshe & Boaden, 2006).

Patient incidents are inevitable but steps can be taken to reduce them. In one medical center, the decision was made to reduce the number of falls a patient experienced to just one to qualify for fall prevention protocols.

Systems as cycles of events

Patient incident reporting is an ongoing program.

Renewal is generated through internal audits as well as Joint Commission reviews.

Outputs: reduction in patient incidents

Activities: Accreditation achieved

Negative feedback

Trended analyses of patient… READ MORE

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Quoted Instructions for "Managing an Effective Quality Assurance Program" Assignment:

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On this paper, please use Headings and separate sections of main posts. Also make sure to follow the instructions below and also include a reference page

Application: Systems Theory

As noted in the Learning Resources, systems theory provides a meaningful and beneficial means of examining challenges in health care organizations. To do this effectively, however, it is essential to assess all system components, as some may be relatively healthy while others are problematic.

For this Assignment, you apply systems theory to the examination of a problem in a department or a unit within a health care organization. (Note: You may use the same problem you identified for the Discussion as long as it meets the criteria for this assignment.)

To prepare:

Review the Meyer article, *****Nursing Services Delivery Theory: An Open System Approach,***** in this week*****s Learning Resources. Focus especially on the information presented in Table 1 (p. 2831) and Figure 2 (p. 2833).

Reflect on your organization or one with which you are familiar. Within a particular department or unit in this organization, identify a problem the staff is encountering.

Using Table 1 in the Meyer article as a guide, analyze the department or unit, identifying inputs, throughput, output, cycles of events, and negative feedback. Consider whether the problem you have selected relates to input, throughput, output, cycles of events, and/or negative feedback.

Think about how you could address the problem: Consider what a desired outcome would be, then formulate related goals and objectives, and translate those goals into policies and procedures.

Research professional standards that are pertinent to your identified problem.

Reflect on the organization*****s mission statement and values. In addition, consider how addressing this problem would uphold the mission and values, while improving the organizational culture and climate. (Depending on the organization you have selected, you may have explored these in the Week 1 Discussion.)

To complete:

Write a 3- to 5-page paper that addresses the following:

Describe a department or unit within a health care organization using systems theory terminology. Include a description of inputs, throughput, output, cycles of events, and negative feedback.

Describe the problem you identified within the department or unit using an open- systems approach, and state where the problem exists using the systems theory model (input, throughput, output, cycles of events, or negative feedback).

Based on this information, explain how you would address the problem as follows:

Formulate a desired outcome.

Identify goals and objectives that would facilitate that outcome.

Translate those goals and objectives into policies and procedures for the department or unit.

Describe relevant professional standards.

Explain how your proposed resolution to the problem would uphold the organization*****s mission and values and improve the culture and climate.

This Assignment is due by Day 7 of Week 3.

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