Five questions assess quality improvement in ICU safety
The quality improvement project at the Veterans Affairs Ann Arbor (MI) Healthcare System (VAAAHS) was prompted by a serious medical error, but the process improvement team realized that the occurrence of sentinel events was not a good way to measure success. Instead, they came up with five questions that they ask regularly to determine how well the project is working.
Marcia Piotrowski, RN, MS, clinical risk manager in the office of the chief of staff, says the answers to these questions are combined with hard data about compliance with the specific safety standards on the checklist designed by the team. These are the five questions:
- Have there been recurrences of the same type of medication error involving nonsecure medications on carts, which led to the original sentinel event?
- Have there been similar medication errors?
- Have patient deaths or cases of permanent morbidity linked to safety deficits occurred since the inception of the program?
- Have staff been able to transfer their learning and experience about a specific problem to the general concept of creating a safe environment instead of solely focusing on discrete safety elements?
- Do staff attitudes regarding the occurrence of errors differ as compared with before the program’s inception?
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