This discussion was created to help you transfer one of theprinciples of quality improvement: “standardization” to a specifictype of health providers using parts of the process that you justread about in the IHI modules. To do this assignment I want you toput yourself in the place of a team of physical therapists (PTs)and administrators who make up the Physical Therapy department in amedium size hospital. The hospital is new and you must come up withpolicies and procedures to keep patients safe and enhance thequality of your services. Inpatient PTs are referred patients aftersurgery or injuries to assess what type of physical rehabilitationthose patients need. They go to the patient’s room and will do anevaluation after receiving information from the written recordabout their surgery or injury. Evaluations are physical movementsthat must be based on accurate information so that patients are notinjured. After evaluations PTs will teach patients exercises andmust have some way to know that the patients can consistently doexercises correctly without injury. They often give writtendirections once they show the patient how they are done.
The physical therapists work 8-5 but the department responds onweekends as well as weekdays so they often have to pass informationon to the PT who works the next day about a particular patient.They also must pass information about the assessment, thetreatment, and patient’s progress on to physicians and nursingstaff through patient records or verbally and this information mustgo to whoever will work with the patient after he/she leaves thehospital. This could be a rehabilitation center, home health careor family members.
Now I would like you to use some of the above details tobrainstorm on how to “standardize” processes in the PT office.
“Standardization” is an important element of qualityimprovement. Standardization basically means that you have aprocedure that is done the same way every time. If a procedure isstandardized and it includes specific elements then it is lesslikely for an error to occur that leaves out those elements. Forinstance, if the procedure to pass medications in a hospitalincludes setting up the meds from a standardized med form, thenchecking the set up meds from the med orders, then bringing themeds to the patient’s room, then checking the patient’s bracelet,asking the patient’s name and explaining what the medication is andwhat it is for before giving those meds to the patient then each ofthese steps is a safeguard against medication errors.
Some professionals use standardized written instructions forpatient care or even standardized diagrams. Others use checkliststhat can be used to establish standardized procedures SBARcommunication is a form of standardizing and briefings anddebriefings can be standardized as well. Standardized writtencommunication that outlines what should be in progress notes isalso common. For instance S.O.A.P. (subjective, objecive,assessment, and plan) notes are used to organize progress notes inmany health settings.
Now, select one of the elements below and create an aimstatement about what is needed, establish measures, and identify achange that uses standardization to accomplish that aim. Rememberto use the information above about the duties of PTs in thissetting to brainstorm your standardized approach. How would youtest if your standardization has worked?
- Who will each PT need to communicate with about patients andwhat standardized ways will that communication occur? (whatinformation should be written and what should be oral—by phone orin person?)
- How can you use standardization to make sure that everyone whois involved knows how to accurately do the exercises?
- How will you encourage the active involvement of patients andtheir families as a patient safety strategy?
In your post for this discussion you must include: your aimstatement applied to one of the three questions above, whatmeasures you will use to show that you have accomplished that aim,the standardized change that you are proposing, and how you willtest the standardized change.
