Global journal on quality and safety in healthcare最新文献

{"title":"Assessment of Knowledge About Patient Safety Concepts Among Medical and Pharmacy Students.","authors":"Areeg Abumostafa,&nbsp;Fadwa Abu Mostafa,&nbsp;Khaled Al-Kattan,&nbsp;Rana Alkateb,&nbsp;Aljohara Alayesh,&nbsp;Fatima Adem,&nbsp;Nada Salaas,&nbsp;Omar M Zeitouni,&nbsp;Mohamad S Alabdaljabar,&nbsp;Zarin Chowdhury","doi":"10.36401/JQSH-20-26","DOIUrl":"https://doi.org/10.36401/JQSH-20-26","url":null,"abstract":"<p><strong>Introduction: </strong>Patient safety is a central principle of healthcare professional practice that requires a significant consideration within the teaching curricula; however, there is a lack of special courses that focus on patient safety concepts in an integrated way in many countries. This study aims to assess the knowledge of medical and pharmacy students regarding patient safety concepts.</p><p><strong>Methods: </strong>A cross-sectional study was conducted at Alfaisal University during the 2018-2019 school year. A survey consisting of 15 questions was designed with the help of the quality and patient safety department at King Faisal Specialist Hospital and Research Centre, Riyadh (KFSHRC). The survey was validated and then electronically distributed to all students enrolled in the College of Medicine and College of Pharmacy.</p><p><strong>Results: </strong>A total of 304 (22%) of 1368 students completed the survey. The survey revealed that 51% of students had an acceptable understanding of the types of human error; however, 53% of students had little knowledge about the factors that lead to these errors and 61% did not know how to report an error. Many students (41%) reported being directly involved in an unsafe situation that may cause patient harm, such as a healthcare-related error, adverse event, or inconsistent care. Most students (90%) agreed that hiding errors to avoid further implications is unethical and reporting errors is the responsibility of every healthcare provider.</p><p><strong>Conclusion: </strong>Most Alfaisal University students understand the significance of patient safety education and understand the types of human errors, yet the causes of errors and the protocols for reporting them were not well understood by most students.</p>","PeriodicalId":73170,"journal":{"name":"Global journal on quality and safety in healthcare","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10228988/pdf/i2589-9449-4-2-53.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9922652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Value of New Fields in the Medical Record for Quality Improvement.","authors":"Theodore Poufos,&nbsp;Georgios Rigakos,&nbsp;Stefanos Labropoulos,&nbsp;Kalliopi Stathaki,&nbsp;Ioanna Theodorakopoulou,&nbsp;Lina Hadjiyassemi,&nbsp;Effrosyni Vlachou,&nbsp;Olympia Spyri,&nbsp;Ioanna Prasini,&nbsp;Evangelia Razis","doi":"10.36401/JQSH-20-37","DOIUrl":"https://doi.org/10.36401/JQSH-20-37","url":null,"abstract":"<p><strong>Introduction: </strong>Quality in healthcare delivery is important for the safety and experience of patients with cancer. Effective documentation is an integral component of quality improvment, and accurate documentation can be affected by prompts in the medical record, potentially improving quality of services.</p><p><strong>Methods: </strong>The Contemporary Oncology Team (COT) is a Greek private oncology practice that participated in the American Society of Clinical Oncology's (ASCO's) Quality in Oncology Practice Initiative (QOPI). Between 2014 and 2019, COT implemented changes in its paper patient medical record, in order to improve quality of care and documentation. Fields regarding pain, emotional well-being and psychosocial assessment, discussions with the patient and consent about treatment and disease, medication details and cumulative dose, treatment goals, side-effect grading, pregnancy screening, treatment adherence and anticipated duration were added. In this report, we present the association of these improvements with COT performance in QOPI.</p><p><strong>Results: </strong>Pain and emotional well-being assessment and documentation were significantly improved by the development of a structured patient follow-up form. In contrast, the assessment of fertility issues, tobacco use, and the documentation of treatment plan and intent did not present a drastic change, because COT performance was already above QOPI average.</p><p><strong>Conclusion: </strong>A thorough reform of COT paper medical record according to QOPI standards improved QOPI scores, but more importantly effected a shift in the team's culture to safer and more standardized quality based care.</p>","PeriodicalId":73170,"journal":{"name":"Global journal on quality and safety in healthcare","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10228984/pdf/i2589-9449-4-2-65.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9939381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to COVID-19 Pandemic: Managing Inpatient Pharmacy Services at King Abdulaziz Medical City - Jeddah.","authors":"Ali F Alwadie,&nbsp;Hani S Alhamdan,&nbsp;Anjum Naeem,&nbsp;Abdullah M Alzahrani,&nbsp;Khalid Albogami","doi":"10.36401/JQSH-20-31","DOIUrl":"https://doi.org/10.36401/JQSH-20-31","url":null,"abstract":"<p><p>Since early December 2019, the coronavirus disease 2019 (COVID-19) has been relentlessly spread worldwide and has hit the healthcare systems with terrible force. Pharmacists play a vital role in the healthcare system in providing medicines, therapeutics, vaccines, clinical services, and other pharmaceutical care services to patients. Therefore, to ensure all these services continued at King Abdulaziz Medical City - Jeddah during the COVID-19 pandemic, the Department of Pharmaceutical Care initiated a departmental crisis preparedness plan, as a part of general hospital preparedness plan. It started with adjusting medication dosing time, instituting a daily medication refill process, working remotely, expanding the use of automation, and modifying employee schedules. Other actions included the following: handling drug shortages, placing restrictions on some medications, using personal protective equipment, changing routine practices of pharmacy aides, revising the medication delivery process, starting a contingency training program, and restricting pneumatic tube operation. We took guidance from the Ministry of Health, our own institute's experience, World Health Organization recommendations, updated scientific research, and the American Society of Health-System Pharmacists regulatory updates. This article aims to describe how health services, policies, and systems were applied and adapted to address a specific problem while maintaining all pharmacy employees' safety. This article reviews the inpatient pharmacy's particular needs and responses to these needs to meet the COVID-19 pandemic challenges.</p>","PeriodicalId":73170,"journal":{"name":"Global journal on quality and safety in healthcare","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10228989/pdf/i2589-9449-4-2-77.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9939380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using Intern-Led Quality Improvement to Reduce Readmissions for Specialty Service Patients Within an Academic Medical Center.","authors":"Alfeil Felipe,&nbsp;Anu Vats,&nbsp;Andressa Sleiman,&nbsp;Brian Tran,&nbsp;Miis Akel,&nbsp;Omri Chia,&nbsp;Jeannette M Hester,&nbsp;Daniel J Hoh,&nbsp;Katharina M Busl,&nbsp;Jacqueline Baron-Lee","doi":"10.36401/JQSH-20-38","DOIUrl":"https://doi.org/10.36401/JQSH-20-38","url":null,"abstract":"<p><strong>Introduction: </strong>Postdischarge patient calls are an effective intervention to decrease unplanned readmissions. Despite its efficacy, calls are time consuming and compete with other clinical obligations. The purpose of this study was to evaluate the viability of intern-led quality improvement (QI) on conducting initial postdischarge calls to filter patients who require clinical or nurse follow-up.</p><p><strong>Methods: </strong>QI interns from an academic medical center's QI program completed postdischarge patient calls within 72 hours of patient discharge from a neurosurgery service between June 2018 and July 2019. QI interns filtered patients who required follow-up calls from a clinical service or nurse department. The departments called patients within 48 hours of requests. Unplanned readmission rate was compared between the cohort of patients who requested and received a follow-up call versus a cohort of patients who requested and did not receive a follow-up call (control).</p><p><strong>Results: </strong>QI interns completed 83.8% postdischarge patient calls within 72 hours of discharge. Reasons for unsuccessful calls included patient unresponsiveness (74.6%), wrong phone number on file (13.9%), and request to be called at a different time (11.5%). Nurses completed 57.2% follow-up requests within the targeted 48 hours and completed remaining requests within 7 days. QI intern postdischarge follow-up calls, in conjunction with nurse follow-up intervention, showed a significant (risk ratio = -3.31, <i>p</i> = 0.012) preventive effect on unplanned readmission rate.</p><p><strong>Conclusions: </strong>QI interns are a viable alternative to nurses to conduct the first contact of postdischarge patient follow-up calls. This system of QI interns filtering calls to the correct clinical service or nurse department increased postdischarge patient follow-up calls success rate and decreased readmission rates.</p>","PeriodicalId":73170,"journal":{"name":"Global journal on quality and safety in healthcare","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10228986/pdf/i2589-9449-4-2-70.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9939383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perception of Hospital Accreditation Impact among Quality Management Professionals in India: A Survey-Based Multicenter Study.","authors":"Lallu Joseph,&nbsp;Vijay Agarwal,&nbsp;Umashankar Raju,&nbsp;Arun Mavaji,&nbsp;Princy Rajkumar","doi":"10.36401/JQSH-20-44","DOIUrl":"https://doi.org/10.36401/JQSH-20-44","url":null,"abstract":"<p><strong>Introduction: </strong>Accreditation ensures the standard of healthcare, yet accreditation effects on service quality are much debated. Some perceive it as improving quality and organizational performance, whereas others see it as overly bureaucratic and time-consuming, so adding it has limited advantage. The aim of the present study was to understand the perception of hospital staff working in quality management (i.e., doctors, nurses, and administrators) on accreditation, and determine whether years of accreditation have had any impact on their perception.</p><p><strong>Methods: </strong>This was a cross-sectional, descriptive, data-based study initiated by the Consortium of Accredited Healthcare Organizations. It consisted of primary data obtained in form of responses to a 30-item questionnaire and collected from 415 respondents. A probability (<i>p</i>) value of less than 0.05 was considered statistically significant.</p><p><strong>Results: </strong>For all 30 items, a significantly greater number of participants had a favorable response (<i>p</i> < 0.001). A greater number of administrators, as compared with doctors and nurses, responded positively on the impact of accreditation (<i>p</i> < 0.05). Participants from hospitals with 1-4 years of accreditation, as compared with participants from hospitals with 4-12 years of accreditation, gave a favorable response (<i>p</i> < 0.05).</p><p><strong>Conclusion: </strong>One of the most important hurdles to implementing accreditation programs is the dilemma of healthcare professionals, especially senior hospital staff, regarding the positive impact of accreditation. The need to educate healthcare professionals about the potential benefits of accreditation, which should resolve any cynical attitude of healthcare professionals towards accreditation, is of utmost importance.</p>","PeriodicalId":73170,"journal":{"name":"Global journal on quality and safety in healthcare","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10228987/pdf/i2589-9449-4-2-58.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9939382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reducing Nonsentinel Harm Events due to Medication Errors by Using Mini-Root Cause Analysis and Action.","authors":"Ghada Hussain Al Mardawi,&nbsp;Rajkumar Rajendram,&nbsp;Souzan Mohammed Alowesie,&nbsp;Mufareh Alkatheri","doi":"10.36401/JQSH-20-25","DOIUrl":"https://doi.org/10.36401/JQSH-20-25","url":null,"abstract":"<p><strong>Introduction: </strong>A full root cause analysis (RCA) such as that required following a sentinel event is time-consuming, labor-intensive, and expensive. This quality improvement project used a similar but abbreviated process (mini-RCA and action; mini-RCA²) in response to medication errors that caused less serious harm.</p><p><strong>Methods: </strong>In 2018, all medication errors that caused harm due to system failures but were not sentinel events were investigated by mini-RCA². The incidence of similar medication errors reported in the year before and in the year after the introduction of mini-RCA² was compared to determine the impact of this intervention. Similar events were identified by searching the safety reporting system database for reported medication errors by drug name (e.g., Humate® P) and/or event type (e.g., prescribing error-omission of a patient's home medications on admission to hospital). The time and labor costs of this intervention were estimated.</p><p><strong>Results: </strong>Seven medication errors were investigated by mini-RCA². More than 48 members of staff from 11 clinical and nonclinical departments contributed to the identification of 39 system failures and made 42 recommendations, of which 22 (52%) were implemented. This reduced the recurrence of reports of similar events from 35 (0.57%) to 21 (0.36%). Although this 0.21% absolute decrease did not achieve statistical significance, recurrence of similar harm events was reduced from 7 (0.11%) to 0 (<i>p</i> = 0.016). Benefits were greatest when the mini-RCA² recommendations were fully implemented. This reduced the recurrence of similar events from 9 (0.21%) to 0 (<i>p</i> = 0.007). A total of 251 hours (mean ± SD, 35.9 ± 16.6 hours) were required for this intervention. The associated labor cost was Saudi Arabia Riyal (SAR) 34,181 (US $8256; mean SAR ± SD, 4883 ± 1302 [mean US $ ± SD, $2102 ± $561]).</p><p><strong>Conclusion: </strong>The use of mini-RCA² to review medication errors provided a structured process to manage reported events, monitor the implementation of recommendations, and assess the effectiveness of implemented actions. The use of this rapid process to investigate errors that cause harm but are not sentinel events reduced recurrence of similar medication errors. Although the time and cost required for this intervention is not insignificant, the cumulative benefit to patients, healthcare professionals, and the organization are greater.</p>","PeriodicalId":73170,"journal":{"name":"Global journal on quality and safety in healthcare","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10229010/pdf/i2589-9449-4-1-27.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9565441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reducing Medication Harms: Thoughts and Strategies.","authors":"Inês Ribeiro-Vaz,&nbsp;Renato Ferreira-da-Silva","doi":"10.36401/JQSH-20-X8","DOIUrl":"https://doi.org/10.36401/JQSH-20-X8","url":null,"abstract":"","PeriodicalId":73170,"journal":{"name":"Global journal on quality and safety in healthcare","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10229005/pdf/i2589-9449-4-1-1.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9565445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of a National Accreditation Program on Patient Safety Culture in a Tertiary Hospital: Pre- and Post-Evaluation Study.","authors":"Khaled Al-Surimi,&nbsp;Shahenaz Najjar,&nbsp;Abdulrazak Al Quidaihi,&nbsp;Emad Masuadi","doi":"10.36401/JQSH-20-30","DOIUrl":"https://doi.org/10.36401/JQSH-20-30","url":null,"abstract":"<p><strong>Introduction: </strong>The objective of this study was to assess the effectiveness of the Saudi national accreditation program on patient safety culture in a secondary-tertiary public hospital in Saudi Arabia.</p><p><strong>Methods: </strong>Three hundred health professionals were randomly selected to participate in a survey. The survey was used in three phases: baseline, before accreditation, and after accreditation. Primary and secondary outcome measures were teamwork within hospital units, feedback and communication about errors, hospital handoffs and transitions, overall perceptions of safety, frequency of event reporting, and perception of patient safety grade.</p><p><strong>Results: </strong>The survey response rate was 100%. A statistically significant impact of accreditation was found for teamwork within hospital units, feedback and communication about errors, and hospital handoffs and transitions (<i>p</i> = 0.002, 0.009, and 0.010, respectively). Ordinal logistic regression confirmed that the accreditation program had a significant effect on overall perceptions of safety (odds ratio [OR] [1.42-13.56], <i>p</i> = 0.010), frequency of event reporting (OR [0.91-7.96], <i>p</i> = 0.073), and staff awareness of grading safety culture (OR [0.02-0.70]) and reporting behavior (OR 0.10 [0.03-0.37]).</p><p><strong>Conclusion: </strong>The Saudi national accreditation program had a significant positive impact on some patient safety culture dimensions and outcomes. These findings provide local empirical evidence on the benefits of implementing national accreditation programs. Further research on a larger scale is highly recommended.</p>","PeriodicalId":73170,"journal":{"name":"Global journal on quality and safety in healthcare","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10229006/pdf/i2589-9449-4-1-18.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9565436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reducing the Length of Stay by Enhancing the Patient Discharge Process: Using Quality Improvement Tools to Optimize Hospital Efficiency.","authors":"Yacoub Abuzied,&nbsp;Hassan Maymani,&nbsp;Basim AlMatouq,&nbsp;Oweida AlDosary","doi":"10.36401/JQSH-20-27","DOIUrl":"https://doi.org/10.36401/JQSH-20-27","url":null,"abstract":"<p><strong>Introduction: </strong>Delays in the discharging process can affect hospital efficiency. Improving patient flow in acute care hospitals is an essential issue that hospital management and research aim to achieve. Admission volume and LOS for hospitalized patients in the medical specialties department was examined at a tertiary care center in Riyadh, Saudi Arabia, to explore practical approaches to reduce the LOS. We aimed to identify and manage reasons for the delay in discharging patients from the medical specialties department at a tertiary care center in Saudi Arabia.</p><p><strong>Methods: </strong>Admission and discharge data for hospitalized patients were collected from 2016-2018. In 2017, a FOCUS (find, organize, clarify, understand, select)-PDSA (plan, do, study, act) quality improvement method was used to improve the discharge processes, with specific measurable targets per year. The number of readmissions and mortality rates decreased significantly after the intervention was implemented, suggesting an improvement in the quality of treatment and the process of admission and discharge.</p><p><strong>Results: </strong>Despite gradual increases in admissions from 2016 to 2018, the mean LOS decreased significantly between 2016 and 2018, from 9.16 to 7.47 days (<i>p</i> < 0.001). The number of readmissions and mortality rates decreased after the intervention was implemented in 2017, suggesting an improvement in the process of admission and discharge.</p><p><strong>Conclusion: </strong>The LOS can be reduced by implementing a quality improvement intervention, driven by a multidisciplinary committee involving healthcare personnel, to facilitate the optimal discharge mechanism through available hospital resources and services.</p>","PeriodicalId":73170,"journal":{"name":"Global journal on quality and safety in healthcare","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10229011/pdf/i2589-9449-4-1-44.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9558564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Testing of Defects per Million Medication Orders as a SMART Indicator for Monitoring Medication Safety in Admission and Discharge Orders.","authors":"Eman Kamal,&nbsp;P J Parameaswari","doi":"10.36401/JQSH-20-32","DOIUrl":"https://doi.org/10.36401/JQSH-20-32","url":null,"abstract":"<p><strong>Introduction: </strong>The study investigated the use of defects per million medication orders (DPMMO) as a SMART (specific, measurable, achievable, realistic, and timely) indicator for monitoring medication safety in admission and discharge orders. The study aimed to develop and test a new indicator as an investigator of medication safety.</p><p><strong>Methods: </strong>The study was conducted in 2018 at King Saud Medical City in Riyadh City in Saudi Arabia. A retrospective cross-sectional design was used. The research sample had 292 patients. The selected medication orders included two types of medication orders (admission and discharge order). After sufficient data had been gathered from the hospitals, a statistical analysis was carried out.</p><p><strong>Results: </strong>Analysis of admission and discharge orders indicated that defects per million opportunities (DPMO) and DPMMO count were slightly low, while the sigma level for admission orders was slightly high. Thus, the admission order process was slightly better than the discharge order process.</p><p><strong>Conclusion: </strong>The DPMMO indicator could serve as a SMART indicator of medical safety. It can be used as a standardized indicator in any healthcare facility, which serves as a recommendation guide in monitoring and evaluating healthcare processes or systems that affect the safety and outcomes of patients.</p>","PeriodicalId":73170,"journal":{"name":"Global journal on quality and safety in healthcare","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10229007/pdf/i2589-9449-4-1-11.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9565440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}