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Quality assurance in an acute geriatric ward
1Department of Elderly Care, Basingstoke District Hospital, Hampshire, UK.
Quality Assurance in Health Care : the Official Journal of the International Society for Quality Assurance in Health Care
|January 1, 1991
Summary
Implementing a problem-oriented patient record system improved geriatric care by enhancing team communication and modifying prescribing behavior, leading to safer discharges and reduced medication costs.
Area of Science:
- Geriatric Medicine
- Healthcare Management
- Patient Records Systems
Background:
- Traditional separate professional records in geriatric wards can lead to fragmented patient information.
- Implementing a unified, problem-oriented approach is crucial for improving interdisciplinary care coordination.
Purpose of the Study:
- To evaluate the impact of a multi-disciplinary problem-oriented patient record system on a geriatric ward.
- To assess changes in documentation, goal achievement, patient functional status, and medication costs.
Main Methods:
- Introduction of a multi-disciplinary problem-oriented patient record system on a 24-bed geriatric ward.
- Utilized a Master Problem List with care plans, goal setting, and achievement analysis.
- Doctors justified medication and radiological investigations; audit indicators were developed.
Main Results:
- 34% of patient records showed at least one unmet goal; 45% missed review dates.
- 20% of patients had lower functional status at discharge.
- Medication cost per patient decreased by 10.8% compared to the previous year, while a similar ward saw a 6.7% increase.
Conclusions:
- The problem-oriented patient record approach enhanced team communication and assured safer patient discharges.
- Prescribing behavior was modified, leading to significant cost savings in medication.
- This system demonstrates a viable strategy for improving efficiency and patient outcomes in geriatric care.