The NC Hospital Performance Report

The North Carolina Center for Hospital Quality and Patient Safety (NC Quality Center) has aligned its efforts to be consistent with a national initiative called the Hospital Quality Alliance (HQA). HQA is a national public-private collaboration to encourage hospitals to voluntarily collect and report hospital quality performance information. Hospitals across the country have been providing information through the HQA initiative since October 2003.

Quality Process Measures

Quality of hospital care can take on many meanings. It may mean that there was a successful outcome (e.g., a patient survived a heart attack or was cured of pneumonia) or it may mean that a patient was satisfied with their stay in the hospital and that they thought they were treated well. Process measures are another way to measure quality of care. A process measure determines if a patient was given a needed medicine, treatment, or diagnostic test at the right time. Through extensive research, national guidelines have been established for the recommended care of patients with various medical conditions. Common medical conditions that have been broadly studied are heart attacks, heart failure, pneumonia and surgical care. It is very common for adults to be in the hospital to receive treatment for one of these reasons. Getting the recommended care means you are more likely to have better outcomes.

Patient Safety

A hospital patient should expect that the medications received in the hospital will be exactly what the doctor ordered. With innovative bar-coding technology, Bedside Medication Verification (BMV), Granville Health System patients can be confident that the medications they receive will be accurate, every time.

The process involves a caregiver scanning the patient’s identification arm band and then scanning the medication prior to giving it to the patient. BMV allows caregivers to utilize bar code scanning technology to confirm patient identity and medication information against data readily available via an electronic Medication Administration Record (eMAR). Immediate access to a patient’s current pertinent results and medication administration information greatly reduces preventable medication errors. The use of bar code scanning increases accuracy and efficiency of caregivers completing medication administration records, providing physicians faster and easier access to critical information to manage patient care.

In November, Granville Medical Center began using the Bedside Medication Verification system to administer medications to inpatients on the Obstetrics (OB) unit. The system will be implemented in the Medical, Surgical and Intensive Care Units during December 2011.

“BMV provides another layer of safety for the patient in regard to medication administration. The security of scanning (bar coding) the drug to the patient is an important step toward safety,” said Maria Calloway, former GHS Chief Nursing Officer.

Each patient’s medication dosage is also bar-coded in the hospital pharmacy. The system also checks potency dates and possible drug interactions with multiple prescriptions. If one of the qualifying factors does not match, several warnings appear on the computer screen to alert the nurse or therapist to double check, verify and/or call the physician before administering the medication.

The BMV system works in combination with software developed by Medical Information Technology, Inc. (MEDITECH), a software and service company specializing in health care information systems technology for hospitals and health systems.

The hospital has been using Meditech's electronic charting since 1997. Hospital staff can easily access patients’ medical records by computer, including physicians’ reports, nursing notes, lab results, radiology results, and other test results. Physicians can also view the records from their offices as well as from hospital computers. Designed to be the next component following electronic charting, eMAR will give physicians and caregivers the ability to electronically view the medication documentation in addition to other medical records.

The implementation of BMV and eMAR helps Granville Health System support the medical community as it integrates into its planned complete electronic medical record and patient centered health care. In addition, the program ensures patient safety by following the “Five Rights” of medication management: Right Patient, Right Medication, Right Dosage, Right Route and Right Time.

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