Setting the Standards- Safeguarding our Patients - IMSN · Setting the Standards-Safeguarding our Patients. ... • Facilitates medication reconciliation for each patient ... •

01.10.2010 www.imsn.ie

June O’Shea and Paul Tighe

Inaugural IMSN Conference 1st Oct 2010 -

‘Networking for safety’

Setting the Standards-Safeguarding our Patients


“A hospital is no place to be sick”Samuel Goldwyn


Outline

• Introduction & background

• JCI accreditation – Who, what & why?

• Outline of JCI standards

• Spin-off from IMSN / JCI synergy

• Future partnerships


Introduction• Private & Public Hospital representation• Medication management experience from

accreditation processes• Networking for safety• National standards

– Pharmacy (Pharmacy Act 2007)– HIQA Draft National Standards for Safer

Better Healthcare (2010)

• Collaborate with HIQA on medication safety standards?


What are standards?

“ the criteria or set of rules that describe the expected levels of clinical and system behaviour as well as courses of action based onresearch and experience”

Davis 1997


What is accreditation?

“a process to provide a visible commitment by an organisation to improve the safety and quality of patient care, ensure a safe care environment and continually work to reduce risks to patients and staff”

Joint Commission


Accreditation Experience

- Pilot site in 2001 for IHSAB- First full survey 2004- 2009 applied for JCI accreditation- 2010 surveyed & accredited

- survey by JCI in 2002 & accredited- 4th survey in 2011


Joint Commission International (JCI)

• US-based non-profit organisation

• Focused on improving safety of patient care& organisation management through provision of accreditation & certification

• Work directly with healthcare organisations to achieve goals of providing quality clinical care and services in safe, efficient & well-managed facilities


Sharing Learning from Accreditation

• 17 Irish JCI accredited organisations– Highest number in EU (59 total)

• All represented at IMSN

• Sharing medication safety initiatives & knowledge of medication safety standards


What is different?

• Role of pharmacy in medication management in organisation

• Proactive identification of risks• Policies • Training• Quality methodology



Overview of JCI standards

Patient centered standards (8)

Healthcare Organisation Management Standards (6)

Focus on patient safety


WHO HIGH 5’s• Concentrated Injectable Medicines

– JCI patient safety goal

• Medication Accuracy at Transitions in Care– JCI standard

• Correct Procedure at the Correct Body Site

• Communication Failures during Patient Handovers

• Addressing Health Care-Associated Infections


JCI Patient Safety Goals(IPSG)

1. Identify Patients Correctly2. Improve Effective Communication3. Improve Safety of High-Alert Medications4. Ensure Correct-Site, Correct-Procedure,

Correct-Patient Surgery5. Reduce Risk of Health Care–Associated

Infections6. Reduce Risk of Patient Harm Resulting

from Falls


JCI Patient Safety Goal 3

• Improve the safe use of high-alert medications

• Concentrated electrolytes

• New 4th edition standards

• High-Alert medications specific to your organisation


IMSN work & JCI Patient Safety Goals

Oral methotrexate safety alertOxycodone alertTransdermal opioid medicationsBest practice guidelines for the safe use of potassiumInsulin best practice guidanceBriefing document on sound alike look alike drugsBriefing document on Vinca alkaloidsIn progress, medication and falls


JCI Medication Management & Use (MMU) standard

MMU 4 Measurable element 6• Initial medication orders compared to the list of medications taken prior to admission, according to the organization’s established process• Facilitates medication reconciliation for each patient

Draft National Standards for Safer Better Healthcare Medication management including safe prescribing & reconciliation (Standard 4.1 Criteria 4.1.8)


“Mistakes are portals of discovery”James Joyce


JCI Standards and medication safety

Standard MMU 7.1 • ‘Medication errors, including near misses are reported

through a process & time frame defined by organisation’

Draft National Standards for Safer Better HealthcareService providers effectively document, report on & respond to safety incidents in a timely manner in line with national legislation, policy, guidelines & guidance. (Standard 4.2 Criteria 4.2.3)


JCI Standards and medication safety

Measurable elements of Standard MMU 7.11. Medication Error & Near Miss defined through a

collaborative process2. Medication Errors & Near Misses reported in a

timely manner using an established process3. Those accountable for taking action are identified4. Organisation uses reporting information to improve

medication use processes


Quality Improvement & Patient Safety (QPS) standard

• Standard QPS.8The organisation uses a defined process for the identification and analysis of near-miss events

• Organisation must track, measure & monitor near miss events

• Draft National Standards for Safer Better Healthcare(Standard 4.2 Criteria 4.2.3 & 4.2.4)


Quality approach

• What is your organisation’s quality methodology?

• RCA and FMEA

• Performance indicators

• Self audit

• Tracer methodology


Setting standards –Does it safeguard patients?

• Learning from Aviation industry• Hygiene standards• Standards for symptomatic breast disease

services• Organisational standards e.g. cardiac

standards – door to cath lab• Performance indicators for medication safety


Strategic Partners

• IMSN sharing & communicating medication safety strategies nationally

• IMSN in unique position to become strategic partner in setting medication safety standards in Ireland

• Precedent in U.S. – www.ismp.org

http://www.ismp.org/



PATIENT


Conclusion

• Specific medication safety standards (as in JCI accreditation scheme) safeguard patients

• IMSN in unique position to assist with national medication safety standards

• “A hospital is a place to be sick”Paul Tighe and June O’Shea


Contact DetailsJune O’SheaPharmacy Manager St.Vincent’s University Hospital

T 01-2774823E [email protected]

Paul TigheDeputy Pharmacy Manager Mater Private Hospital

T (01) 8858532E [email protected]

Documents

Setting the Standards- Safeguarding our Patients - IMSN · Setting the Standards-Safeguarding our Patients. ... • Facilitates medication reconciliation for each patient ... •