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Quality Assurance

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by

Isabel Teo

on 16 July 2014

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Transcript of Quality Assurance

Pathway to Accreditation (8 Steps)
To objectively and systematically
monitor
and
evaluate
the
quality
and
appropriateness
of patient care

To
IMPROVE
patient care by resolving identified problem

- World Health Organization
Quality Assurance (QA)
Joint Commission International (JCI)
Quality Assurance
in Healthcare - JCI

Project by:
Lin Yuda Aiden, Isabel Teo, Zann Yeo,
Toh Ying Xian, Bryan Ang, & Tang Zhi Yin

Joint Commission International
A
nonprofit
organization that
accredits health care organizations and programs
globally.
After hours pharmacy service
Mission of JCI
To c
ontinuously improve
the
safety and quality

of care in the
international community
through the
provision

of
education, advisory
and
international accreditation
services.
Accredited Hospitals in Singapore
John Hopkins Singapore International Medical Centre (2004)
Changi General Hospital (2005)
Institute of Mental Health (2005)
Tan Tock Seng Hospital (2005)
KK Women’s and Children’s Hospital (2005)
National Heart Centre (2005)
Singapore General Hospital (2005)
Raffles Hospital (2008)
Khoo Teck Puat Hospital (2011)
JCI Services
Accreditation
Consultation
Seminars
Academic Courses
Storage of Medicine
The Process
Step 1:
Participate in JCI’s Introduction to Accreditation workshop
Step 2:
Purchase manuals and guides
Step 3:
Attend a practicum
Step 4:
Register with E-App
Step 5:
Step 6:
Step 7:
Step 8:
Establish baseline
Complete phase two of E-App
Experience the survey
Beyond the survey

Preparing for the survey
Be familiar with current standards, policies and procedures
Identify problems or areas to improve on
Hospitals must:
VIDEO!
Hospital Practice
For Hospital Practice:
In a 24 hour pharmacy operation, pharmacy service will be provided by
a pharmacist on duty.


1.
A suitable locked storage cabinet or cart

(e.g. medication night cabinet) will be stocked with a minimum supply of drugs most commonly required for emergency

2. When the pharmacy is closed,
an authorized nurse
will obtain needed drugs from the medication night cabinet. A record will be kept on all withdrawals.


SMALL HOSPITALS PHARMACIES
Withdrawal record includes:
Patient name & location, hospital number where applicable
Complete description of drug product and quantity
Prescriber's name
Name and signature of authorized nurse
Date the drug is removed
Personal Care Practice
Hallway Obstructions
VIDEO!
Hallway Obstructions
Corridor clutter is the
biggest issue
Life Safety Code (LSC).
Building drawings should be constantly
reviewed
and
appropriately update.

According to the Joint Commission:
Helpful tips mentioned by the
Joint Commission
Dead-end corridors of
less than or equal to 50 square feet
can be used for storage.
Hospitals are
allowed to use a patient room
for storage if there is an
automated door closure
and if it is
fully sprinklered.

Hygiene Standards
VIDEO!
Hygiene Standards
Healthcare waste must be
properly managed.
All
medical staff to be educated in
infection control
Mask fitting and PPE
Sterile practice
to be enforced in operating theater
TST*

Fire Safety
VIDEO!
Fire Safety
Purpose of a fire drill is to
test
and
evaluate
the
efficiency, knowledge, and response
of institutional personnel in implementing the f
ire emergency plan.

To provide a
safe, functional and supportive facility.
Key Safety Standards
JCI Accreditation Standards
for Hospitals that apply to safety and emergency planning to deal with fire outbreak are:

Hospitals should
plan
and
implement
a program to ensure that all occupants are safe from fire, smoke, or other emergencies in the facility.


Staff members are required to know
their roles
in the fire safety plan.

Procedures to protect the lives of all patients within the facility involve
five basic steps
for fire emergencies.
Rescue

Alarm

Confine

Extinguish

Relocate

Protection of Patients
Fire Safety Plan
Joint Commission International
Consultation
Workshops and Seminars
Policy Development and Management Workshops
Academic
1) Infection Prevention & Control (IPC) Diploma Program

2) Quality Management & Patient Safety Diploma Program
Beyond accreditation
Standards
All drugs will be stored under
proper conditions
.

The things to take note for storage of drugs are:
Narcotics and controlled drugs substances
are being stored with
proper measures of security
Disinfectants and drugs for external use are
stored separately
from internal and injectable medications.
Drugs are not being
overstocked
Expired drugs
will not be stocked
Drugs which may be required on an urgent or emergency basis are in
adequate and proper supply

Case Study
Other International Accrediting Bodies
Accreditation Canada
The Australian Council on Healthcare Standards or ACHS
QHA Trent Accreditation (based in the United Kingdom)
National Accreditation Board for Hospitals and Healthcare Providers or NABH in India.
Questions???
A hospital wishes to undergo the JCI survey assessment to get accredited. During an observation round by a supervisor, this is what he observed.
Is this good enough or should the hospital do something to improve the current state?

It may be necessary for hospitals to request an equivalency for this if the perimeter walls in these storage locations do not fully extend from floor deck to ceiling deck.
Joint Commission International. (2014, April 1). Joint Commission International Accreditation Standards for Hospitals. Retrieved from http://www.onlinedic.net/docs/JCI_5th_Edition.pdf


Place only
important equipment
in the hallways where needed
Staff to
be more aware
of surroundings
Ensure that routes for evacuation and emergency are
always cleared
Suggestions:
A
fire safety plan
should provide the following

1) Use of alarm

2) Response to alarm

3) Evacuation of patient and staff to a safe area.

4) Emergency phone call to fire department

5) Isolation or extinguishment of fire.
References
Medication Management
Effective
medication management includes a
yearly systems review
of all parts of the organization which includes

inpatient

and
outpatient

basis.
Maintain or further improve the standards
Utilize the services JCI provides
Rowa Vmax
Customized advisory services
to h
elp healthcare organizations to improve

quality
and
patient safety.
Advanstar Communications, Inc. (2011, August 18). Joint Commission's 2010 Report Targets Medication Preparation, Storage, and Security. Retrieved from http://drugtopics.modernmedicine.com/drug-topics/news/modernmedicine/modern-medicine-feature-articles/joint-commissions-2010-report-targe?page=full

The Manitoba Pharmaceutical Association. (2004, June). Hospital Standards of Practice. Retrieved from http://mpha.in1touch.org/uploaded/38/web/documents/Standards-of-Practice-Hospital-09.pdf
Oregon State Fire Marshal. (2013, May). Fire and Life Safety Practices in Hospitals. Retrieved from http://www.oregon.gov/osp/SFM/docs/Fire_Life_Safety/FireLifeSafetyPracticesHospitals.pdf
Tan Tock Seng Hospital. (2013, October 25). Hospitals to Use Robots to Pick and Pack Medicine. Retrieved from http://www.ttsh.com.sg/about-us/newsroom/news/article.aspx?id=5798
Full transcript