Nursing home organization

Assume you are a process improvement expert responsible for overseeing process improvement initiatives for a nursing home organization. There are multiple facilities within your region. You have been asked by your CEO to investigate pharmacy errors. You decide to begin by collecting data from Westside Nursing Home. You are given data on both near misses (errors that do not make it to the patient) and actual patient care errors. The trend charts are shown below.

Questions:
1. How might you use the IHI’s framework for Spread be used to reduce errors within the nursing home organization?

What “Changes” will you likely be implementing? Who will be impacted? What is their likely reaction? What barriers will you need to overcome and how might you do so?
Analyze the trend charts. Explain your interpretation, assumptions you are making, and additional data you would want to collect?

 

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