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A qualitative analysis of medication use variance reports
David M Krol1, Lisa Stump, Diane Collins
1Department of Pediatrics, and Principal, Center for Oral Health Policy, School of Dental and Oral Surgery, Columbia University, 622 West 168th Street VC4-402, New York, NY 10032, USA. dmk2004@columbia.edu
The Joint Commission Journal on Quality Improvement
|June 18, 2002
Summary
A qualitative analysis strategy using a multidisciplinary team identified new medication use variance patterns. This approach enhances patient safety by uncovering preventable errors and improving medication safety efforts.
Area of Science:
- Healthcare Quality Improvement
- Patient Safety Research
- Medication Safety Analysis
Background:
- A large hospital implemented a process change using qualitative data analysis to enhance medication use safety.
- The study aimed to develop a strategy for analyzing qualitative data to identify and prevent previously unclassified medication use variances.
- A multidisciplinary team was involved to improve the quality and effectiveness of the analysis approach.
Purpose of the Study:
- To design and implement a qualitative data analysis strategy for medication use variance.
- To uncover and classify previously unrecognized patterns of medication use variance.
- To identify opportunities for intervention and prevention of medication use errors.
Main Methods:
- Qualitative analysis of 264 medication use variance, incident, and event reports from April to June 2000.
- A five-member multidisciplinary team (pharmacist, nurses, physicians) conducted independent qualitative analysis and coding.
- An iterative consensus process was used to develop and refine a coding framework until no new domains were identified.
Main Results:
- Ten general medication use variance domains were identified.
- Twenty-one subdomains within these general domains were further determined.
- The qualitative approach successfully uncovered new variance patterns.
Conclusions:
- Employing a multidisciplinary team and a qualitative analysis strategy significantly improved patient safety initiatives.
- This approach led to the discovery of novel variance domains, causes, and intervention opportunities for preventing medication use variances.
- The qualitative analytic approach is versatile, adaptable, dynamic, and superior to strictly quantitative methods for medication use variance analysis.