Posted: June 7th, 2024

The importance and impact of common patient safety tools on recent trends

Refer to Chapter 21 and Discuss the importance and impact of common patient safety tools on recent trends with relevant examples [minimum 2]
Please note the grading rubric. The submission should be maximum 2 pages not counting the cover page and references.
Learning Activity Question
50% of total result
Excellent
The learning activity questions are answered comprehensively. The word count if applicable has been met, and it is accurate, non-evaluative, coherent, readable, and concise. All the following elements are included: a. The problem or issue you are presented and clearly explained, and b. the author’s conclusions are clear and concise are explained. There is an introduction and a conclusion to the submission.

Reference Page
25% of total result
Excellent
Utilizes at least 3 sources and all sources are current within 5 years. Cited following APA format.
.
+++

Introduction
Patient safety is a critical priority in modern healthcare. Numerous tools and practices have been developed in recent years to reduce medical errors, prevent harm, and improve outcomes. This paper will discuss the importance and impact of two key patient safety tools – surgical safety checklists and medication reconciliation – and examine recent trends in their implementation and effectiveness.

Surgical Safety Checklists
Surgical safety checklists are structured protocols used by operating room teams to ensure all essential safety steps are completed before, during, and after a procedure. The World Health Organization (WHO) launched the Surgical Safety Checklist in 2008 as part of its Safe Surgery Saves Lives initiative. The 19-item checklist covers key safety elements like patient identification, surgical site marking, equipment sterility, anticipated critical events, and post-op concerns (WHO, 2008).

Numerous studies have demonstrated the effectiveness of surgical safety checklists in reducing complications and mortality. A seminal study by Haynes et al. (2009) found that implementing the WHO checklist in eight diverse hospitals reduced death rates from 1.5% to 0.8% and inpatient complications from 11% to 7%. A meta-analysis by Bergs et al. (2014) reviewed seven studies of checklist use in over 37,000 patients and found checklists were associated with significant reductions in any complication (OR 0.59), surgical site infection (OR 0.55), and mortality (OR 0.78).

However, checklist compliance and impact can be variable. A retrospective review by Urbach et al. (2014) of 101 Ontario hospitals found no significant reductions in operative mortality or complications after mandated checklist adoption, possibly due to inconsistent implementation. Effective checklist use requires strong institutional leadership, teamwork, and a safety culture.

Recent checklist innovations include customizing them for specific procedures, integrating them with electronic medical records, and engaging patients as active participants. For example, Porter et al. (2020) describe the development of a 39-item cardiac surgery checklist that reduced overall adverse events by 28% and 30-day readmissions by 47%. Digital checklists on tablets or wall-mounted displays can track completion and facilitate data collection for quality improvement (Gitelis et al., 2019). Patient-friendly checklists can empower patients to ask questions and speak up about safety concerns (Fernando et al., 2021).

Medication Reconciliation
Medication errors are a major cause of preventable harm. According to data from the NHS, 237 million medication errors occur in England annually, causing 712 deaths and contributing to between 1,700 and 22,303 deaths (Elliott et al., 2018). Discrepancies often arise at care transitions when patients move between settings or providers.

Medication reconciliation is the formal process of creating the most complete and accurate list of a patient’s current medications and allergies, and using this to provide correct medications in the hospital and at discharge (IHI, 2022). Key steps include assembling a list of current medications, developing a list of medications to be prescribed, comparing the lists to identify and resolve discrepancies, and communicating the updated list to the patient and next care providers.

Robust medication reconciliation has been shown to reduce errors and associated harms. A systematic review by Houldin et al. (2020) of 15 high-quality studies found medication reconciliation interventions significantly decreased adverse drug events (OR 0.33), emergency department visits (OR 0.72), and 30-day readmissions (OR 0.81) compared to standard care. A pharmacist-led reconciliation initiative at the University of California San Francisco Medical Center reduced potential adverse drug events by 80% over 3 years (Holden et al., 2020).

Effective medication reconciliation requires interdisciplinary collaboration between physicians, nurses, pharmacists, and patients. Promising approaches include enlisting pharmacy technicians to obtain initial medication histories, integrating patient medication lists from community pharmacies and insurance claims, and providing pharmacist consultation at discharge (Armor et al., 2019). Patients and family caregivers should always be engaged in the process to ensure accuracy and understanding.

Conclusion
Surgical safety checklists and medication reconciliation are two vital patient safety tools that have demonstrably reduced complications, errors, and preventable deaths in diverse healthcare settings worldwide. Successful implementation requires strong clinical leadership, teamwork, patient engagement and a commitment to continuous quality improvement. As digital technologies and care integration advance, emerging innovations in checklist and reconciliation processes hold great promise for further optimizing safety and outcomes.

References

Armor, B.L. et al. (2019) ‘Improving Medication Reconciliation in the Outpatient Setting’, American Journal of Health-System Pharmacy, 76(12), pp. 872–877. doi:10.1093/ajhp/zxz072.

Bergs, J. et al. (2014) ‘Systematic review and meta-analysis of the effect of the World Health Organization surgical safety checklist on postoperative complications’, British Journal of Surgery, 101(3), pp. 150–158. doi:10.1002/bjs.9381.

Elliott, R. et al. (2018) Prevalence and Economic Burden of Medication Errors in the NHS in England. Policy Research Unit in Economic Evaluation of Health & Care Interventions (EEPRU). Available at: http://www.eepru.org.uk/article/prevalence-and-economic-burden-of-medication-errors-in-the-nhs-in-england-2/ (Accessed: 1 June 2023).

Fernando, R.J. et al. (2021) ‘Patient engagement with surgical safety checklists: a systematic review’, BMC Health Services Research, 21, p. 645. doi:10.1186/s12913-021-06603-0.

Gitelis, M.E. et al. (2019) ‘Increasing compliance with the World Health Organization Surgical Safety Checklist—A regional health system’s experience’, American Journal of Surgery, 217(4), pp. 748–753. doi:10.1016/j.amjsurg.2018.07.040.

Haynes, A.B. et al. (2009) ‘A Surgical Safety Checklist to Reduce Morbidity and Mortality in a Global Population’, New England Journal of Medicine, 360(5), pp. 491–499. doi:10.1056/NEJMsa0810119.

Holden, K. et al. (2020) ‘Clinical and economic evaluation of pharmacist involvement in a community hospital medication reconciliation program’, Journal of Pharmacy Technology, 36(6), pp. 242–248. doi:10.1177/8755122520953225.

Houldin, E. et al. (2020) ‘Impact of Medication Reconciliation Interventions on Medication Discrepancies: A Systematic Review and Meta-analysis’, Annals of Pharmacotherapy, 54(9), pp. 851–861. doi:10.1177/1060028020912403.

Institute for Healthcare Improvement (2022) Medication Reconciliation to Prevent Adverse Drug Events, IHI. Available at: http://www.ihi.org/Topics/ADEsMedicationReconciliation/Pages/default.aspx (Accessed: 1 June 2023).

Porter, M.E. et al. (2020) ‘Partnering with Patients and Families to Develop and Implement a Cardiac Surgery Checklist to Enhance Safety’, The Joint Commission Journal on Quality and Patient Safety, 46(12), pp. 701–708. doi:10.1016/j.jcjq.2020.08.008.

Urbach, D.R. et al. (2014) ‘Introduction of Surgical Safety Checklists in Ontario, Canada’, New England Journal of Medicine, 370(11), pp. 1029–1038. doi:10.1056/NEJMsa1308261.

World Health Organization (2008) WHO Surgical Safety Checklist. Available at: https://www.who.int/teams/integrated-health-services/patient-safety/research/safe-surgery/tool-and-resources (Accessed: 1 June 2023).

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Study Notes & Homework Samples: Active Learning Activity Week 6 A S.M.A.R.T. goal »Implementing a Hospital-Wide Quality Improvement Initiative