Expert answer:Adverse Event Reporting

Answer & Explanation:Read Chapters 5, 6, and 7 in our textbook. After reviewing this week’s required reading, consider the following scenario: You are the lead of the risk management team that has been assigned to evaluate an incident that has occurred. You will be preparing a report for the CEO of the hospital that includes all system failures that contributed to the adverse event as well as utilizing a CQI tool. You will be using the Adverse Event template (Attached)HCA375_Adverse Event Template.doc  to complete the three parts to the assignment. Note: If you have responded substantively to each of the content items within the three parts of the assignment, the paper should be between six and seven pages.Part One: Description of Adverse Event (Complete Part One of the Adverse Event template)Choose an adverse event from the following list:Medication errorPatient fallsPost-operative hemorrhageData – Patient Safety Event For XYZ Hospital for 20XX through 20YY  # of Discharges   # of Surgical Cases   # of Medication Errors   # of Patient Falls   # of Post Operative Hemorrhage   20XX 20YY 20XX 20YY 20XX 20YY 20XX 20YY 20XX 20YYJan  12001400 200  240 300 35038 35 1 3  Feb 1278 1450 213 250 289 370 42 40 1 2 Mar 1389 1540 250 300 300 385 37 45 3 2 Apr 1199 1800 200 245 289 412 36 65 2 3 May 900 1768 159 289 215 404 40 70 1 3 Jun 1000 1690 173 285 215 398 46 65 1 2 Jul 1200 1100 215 200 278 246 50 45 2 1 Aug 1239 978 240 158 301 241 53 40 2 3 Sep 1000 1089 198 200 275 215 48 51 3 2 Oct 789 978 150 248 241 251 38 52 2 1 Nov 980 1000 175 209 230 231 42 47 2 1 Dec 700 980 145 215 200 235 25 43 3 1Note: The number of beds and operating rooms increased effective 1/1/20YY.Describe the adverse event, including who was involved in the event.For your selected adverse event, graph the data for the two years. Analyze the data by determining if the frequency is increasing or decreasing. What factors could be attributed to the change?Discuss the communication techniques/methods utilized to inform the staff of the adverse event.Describe at least two operational or safety processes that might not have been followed that contributed or caused this event to take place. For instance, describe any regulations or procedures that the professional organization and/or accrediting agency measures compliance with the standard.Graph two years of data for your selected adverse event and analyze the data by determining if the frequency is increasing or decreasing.What factors could attribute to the change in data over two years?Summarize the historical and contemporary issues and legal implications related to patient safety in your chosen adverse event.Describe how processes of continuous quality monitoring could impact the adverse event you chose.Part Two: CQI Tool (Complete Part Two of the Adverse Event template)Choose a CQI Tool that best suits your chosen Adverse Event from the following list:FlowchartFishbone Diagram (Cause & Effect)ParetoUse the CQI Tool to illustrate the use of the tool with your chosen adverse event. You will be responsible for creating the CQI Tool, completing the tool, taking a screenshot, and copying/pasting the screenshot under the instructions in Part Two CQI Tool in the Adverse Event template.Part Three: Future Prevention (Complete Part Three of the Adverse Event template) After describing the event in Part One and using a CQI tool in Part Two, apply the PDCA model to summarize the process and steps that your team would recommend to the CEO to prevent this adverse event from reoccurring. Make sure to include who (health care personnel) would be accountable at each step of the process. Complete the Explanation column in Part 3 of the Adverse Event template.It is important to keep in mind that some processes require a checks and balance system. You will need to determine if one of the steps you are recommending would require a checks and balance step and why it is necessary. Paper Requirements: The Paper must be six to seven pages in length (excluding title and references pages) and should demonstrate understanding of the reading assignments, class discussions, your own research, and the application of new knowledge. Excluding your textbook and course readings include a minimum of four scholarly, peer-reviewed sources. Two of these sources must be from the Ashford University Library and must have been published within the past five years. An APA formatted reference page is required. Your responses within the document provided must be substantive, and include complete sentences in paragraph format, including citations per APA format. Refer to the Ashford Writing Center for information on APA guidelines.
hca375_adverse_event_template.doc

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Running Head: TYPE 2 to 3 WORDS OF YOUR TITLE HERE
Title of Paper
Your name
HCA375– Continuous Quality Monitoring and Accreditation
Type Instructor Name Here
Type Date
1
TYPE JUST THE PAPER TITLE HERE
2
HCA375 – WEEK 4 ASSIGNMENT
PART 1 – DESCRIPTION OF ADVERSE EVENT
Refer to the instructions in the Week 4 Assignment of your online course to understand what is expected in each column. This
completed template should be between six to seven pages in length. Include APA citations within the description column
where appropriate. List your references in APA format according to the Ashford Writing Center guidelines on the last page of
this template.
CONTENT
ADVERSE EVENT CHOSEN
DESCRIBE THE EVENT
WHO WAS INVOLVED IN THE
EVENT (Health care Personnel)
COMMUNICATION
TECHNIQUES/METHODS UTILIZED
TO RESOLVE THE PROBLEM
OPERATIONAL OR SAFETY
PROCESSES RECOMMENDED TO
AVOID FUTURE EVENTS FROM
HAPPENING. LIST AT LEAST 2.
HISTORICAL, CONTEMPORARY,
AND LEGAL INFORMATION ABOUT
THE EVENT CHOSEN
APPLYING CONTINUOUS QUALITY
MONITORING – STATE THE
IMPACT OF THIS EVENT FROM THE
ORGANIZATION’S AND PATIENT
PERSPECTIVE
DESCRIPTION
TYPE JUST THE PAPER TITLE HERE
3
WEEK 4 ASSIGNMENT
PART 2 – CQI TOOL
Choose a CQI Tool that best suits your chosen Adverse Event from this list of three:
•
Flowchart
•
Fishbone Diagram (Cause & Effect)
•
Pareto
Use the CQI Tool to illustrate the use of the tool with your chosen Adverse Event. You will be responsible for creating the CQI
Tool, completing the tool, taking a screenshot, and copying/pasting the screenshot into the space below.
TYPE JUST THE PAPER TITLE HERE
4
WEEK 4 ASSIGNMENT
PART 3 – FUTURE PREVENTION
APPLYING PDSA – Worksheet
PHASE
PHASE ACTIVITIES
PLAN
Identify the problem.
What is your objective?
Identify the team members that will
work on the problem.
How would you communicate the plan
to the stakeholders?
What data are you collecting?
Whom are you piloting your plan on?
(You need to select a small group to
pilot your plan on before you
implement fully).
DO
Develop possible solutions to the
problem.
Select one of the possible solutions to
implement in this pilot phase.
What was the result of the pilot?
Detail the method(s) utilized to
communicate the improvement
process.
List observations and note any
problems.
STUDY
Summarize the data collected and
measure if the pilot solution was
effective. Identify any issues that
occurred. Include any communication
issues.
Compare your objective in the Plan
phase to that of the actual pilot result.
Revise plan if needed – describe.
ACT
Implement the plan for improvement.
Describe how you will be continually
monitoring for the improvement plan’s
sustained success.
EXPLANATION
TYPE JUST THE PAPER TITLE HERE
5
References
Excluding your textbook or course readings include a minimum of four scholarly, peer-reviewed sources; two of
which must be from the Ashford University Library that were published within the past five years. All references
must be in APA format according to the Ashford Writing Center.
…
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