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Patient Safety Focus


 Improving Medication Practices

 Improving Emergency Services

 

Improving Medication Practices: The initial focus for improving Patient Safety at HCA was medication practices. The decision to focus on medication practices was based on data from the IOM study showing that medication errors were the most frequent type of medical error occurring in hospitals. Additionally, medication use processes exist in all HCA facilities, making this an issue to which all facilities could contribute. Finally, a good deal of research on medication errors and error prevention existed to inform our work.

Therefore, HCA began an intensive focus on improving medication practices in 2000 believing that this was the area where we would have the greatest impact. Our experience with business function changes, such as shared services, taught us that meaningful improvement happens when effort, expertise, and resources are concentrated on a few important issues.

The recommendations for improving medication use practices have taken two forms:
1. Improving existing practices through implementation of established safety recommendations.
2. Developing new technologies to re-engineer safety into each step of the medication process.

 

Improving Emergency Services: The focus for improving Patient Safety at HCA expanded in 2002 to include Emergency Services. This department was selected for the following reasons:

  • Increased visits to emergency department
    4.9 million visits in 2002, up 6.7 % from 2000
    Up to 40% were non-Obstetric admissions
  • Lowest patient satisfaction scores on surveys
  • Accounts for 14% of all hospital malpractice claims

Recommendations for improving emergency services center around these areas:

  • Patient flow / throughput
    The flow and throughput of patients through the emergency department can be enhanced by use of information technology, strategic planning, and design/construction. This is a key driver of customer satisfaction. HCA is currently conducting various technology pilots, developing emergency department design standards, and heightening the awareness of key elements of patient satisfaction within the emergency department.
  • Outcomes: improving quality and reducing risk
    HCA is focusing on many of the operational issues that affect patient care. Analyzing operational indicators and optimizing patient flow help create an environment to successfully provide effective and efficient patient care. Eliminating bottlenecks and operational inefficiency will improve patient satisfaction and minimize the level of confusion that can affect patient care decisions.
  • Emergency physician relationships
    HCA is working to develop collaborative relationships between its' facilities and emergency physicians. A mutually agreed upon professional services agreement template is available for use by our hospitals. Recognizing the importance of shared goals and risk, dual performance improvement metrics are incorporated into these agreements. In addition, an emergency department medical director job description template is in use to enhance this collaborative relationship and ensure representation of the emergency department with the hospital's medical staff.

 

 

 

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HCA Patient Safety
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Nashville,  TN  37203
Telephone: 615-344-9551