Use of total quality management techniques to improve compliance with a medication use indicator.

Total quality management techniques were used to lay the groundwork for and to implement procedural changes designed to improve compliance with the Joint Commission on Accreditation of Healthcare Organizations' medication use indicator for ordering and administering presurgical antibiotics. The effect of these procedural changes on patient outcomes (i.e., postsurgical infection rates and length of hospitalization) is described. In a study to assess compliance, 57 (30 percent) of 40 control patients received a presurgical antibiotic within 1 hour of incision compared with 65 (52 percent) of 126 study group patients, and 83 (44 percent) of the control group received a presurgical antibiotic within 2 hours of incision compared with 88 (70 percent) of 126 study group patients. Postsurgical infection rates and length of hospitalization were not significantly different (p = .407 and p = .885, respectively).