You are the Risk Manager of your hospital and you have just been alerted that an

Question

You are the Risk Manager of your hospital and you have just been alerted that an inpatient was mistakenly given the wrong medication. The error was discovered soon after the administration of the drug and an antidote was given the patient. The patient will be fine.

Answer the following questions:

What steps, if any, should you immediately take?

What structures and processes within the organization should be examined?

What improvements could be made to prevent such an accident from recurring?

How would you ensure that such accidents are identified, tracked and monitored on an ongoing basis?

Explanation / Answer

Risk management in hospital: The risk management is systematic process of identifying, evaluating and addressing potential and actual risk

Steps followed for prevention of potential risk

1. Identification of situations in hospital that could cause financial risk

2. Evaluatiin of incident report for atleast six month with available data and compare the data with other hospital that could predict potential risk.

3. Elimination of needless procedures that could create a problem

4. Transfer of liabilities through hold harmless between drug and equipment manufacturers

5. Implementation of risk coverage through best among the commercial,capitative and self insurance. Further hospital should hold in hospital grivience cell and collection of data with negative outcomes

Structure and process:

Since risk management is the process of controlling

incidents which are inconsistent with the normal practice and

activities of the hospital, incident reporting becomes the

foundation stone of a sound system of managing risks.

Incident reporting process is designed to accomplish the

following tasks

1. Identifying and detecting risks.

2. Assigning values to risks.

3. Anticipating losses.

4. Deciding upon objective steps to minimize the impact

on the patient and the hospital.

Improvements for support in retarding further compliance issues: 1.Computerised prescribing, bar-code technology to assist dispensing and drug administration, smart pumps for administering parenteral drugs and automated dispensers are some of the technologies widely used.

2.Computerised Decision Support Systems (CDSS) integrated with CPOE have helped to reduce prescribing errors further 3. The Prescribing Information and Communications Systems (PICS) is an evolving system developed in Birmingham, England

4.Bar-codes have been used in the medication use process to assist dispensing and drug administration errors, and to improve patient identification. Bar-code Assisted Drug Dispensing (BCDD) systems can improve the accuracy and timing of in-patient dispensing and reduce wrong drug, wrong dose and wrong timing errors in the pharmacy . Use of Bar-code Assisted Medication Administration (BCMA) systems can significantly reduce drug administration errors .Non-timing drug administration errors were reduced from 11.5% to 6.8%

Identification and tracking:

Implementation of vigilance department that monitor and allocate tracking number based on the criticality of the situation happens in the organization's and filing RCA root cause analysis and CAPA corrective and preventive action.

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