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Related Experiment Videos

A multidisciplinary team approach to reducing medication variance.

Terri A Sim1, Julie Joyner

  • 1Williamsburg Community Hospital, 301 Monticello Ave, Box 8700, Williamsburg, VA, USA. TSIM@williamsburgcommunity.com

The Joint Commission Journal on Quality Improvement
|July 10, 2002
PubMed
Summary

Establishing a nonpunitive reporting system for medication variances doubled patient safety reports. This initiative fostered a culture of open communication and process improvement, enhancing overall medication safety practices.

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Area of Science:

  • Healthcare Quality Improvement
  • Patient Safety Research
  • Medication Safety Management

Background:

  • A multidisciplinary team at Williamsburg Community Hospital addressed medication-related patient safety.
  • Initiatives focused on a nonpunitive reporting environment, collaborative policies, and education.
  • Revising the medication variance reporting policy removed punitive actions, encouraging open reporting.

Purpose of the Study:

  • To foster a nonpunitive environment for reporting medication variances.
  • To improve medication administration practices through collaborative policies and education.
  • To enhance patient safety by increasing the focus on medication safety initiatives.

Main Methods:

  • Revised the medication variance reporting policy to remove corrective actions.

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  • Implemented an extensive educational campaign hospital-wide.
  • Developed a consolidated medication administration policy for nursing, physician, and pharmacy.

    • Main Results:

    • The number of medication variance reports doubled within a 9-month period.
    • A subcommittee was formed to review reports weekly due to increased volume.
    • Quick fixes and immediate successes generated momentum for the initiative.

    Conclusions:

    • The team successfully shifted organizational attitudes towards medication variance reporting.
    • Implementing changes incrementally with early successes sustained team focus.
    • The multidisciplinary approach enabled rapid and effective problem-solving from diverse perspectives.