NQF Safe Practices Consensus Evaluation October 2003

1. NQF Safe Practices Consensus Evaluation October 2003 Texas Medical Institute of Technology • Subject Matter Expert Input Instructions: • PROVIDE INFORMATION REQUESTED IN TABLE PROVIDED: • Fill in the sections of the table on slide # 2 with your expert interpretation and answers to the questions in the shaded area. • Slide #4 was provided for overflow information that may not all fit on slide # 2. • USE SLIDE # 3 AS YOUR NQF REFERENCE RESOURCE : • The content has been taken directly from the NQF Safe Practices Consensus Report published May 2003. • PLEASE RETURN THE FORMS BY E-MAIL TO THE LEAD PERSON DEFINED IN THE BOX ABOVE. • IF YOU HAVE ANY ADDITIONAL COMMENTS, PLEASE RECORD THEM IN THE BOX TO THE RIGHT. • IF YOU HAVE ANY QUESTIONS, PLEASE CALL OR E-MAIL THE LEAD OR ASSIST PERSONS FOR THE PRACTICE DESIGNATED ABOVE. • THE LEAD PERSON IS RESPONSIBLE TO COLLECT THE INFORMATION YOU SUBMIT AND THE ASSIST PERSON IS AVAILABLE TO ASSIST YOU AND THE LEAD PERSON. Subject Matter Expert Personal Comments: • Role of the pharmacist in the medication use process should be defined so that all understand duties and expectations.___________________________ • Concern for institutions that do not have 24 hour service. This standard will be difficult to meet and may undermine any implementation of this practice. Must be able to describe a process that includes pharmacists at some point in the process while acknowledging that there are some safeguards that can be implemented in the absence of a pharmacist.___________________________

2. NQF Safe Practice #5: Pharmacists should actively participate in the medication-use process. Fill in the table below. Use slide #4 for overflow information.

3. NQF Safe Practice #5: Pharmacists should actively participate in the medication-use process. Leapfrog Deliverables

4. NQF Safe Practice #5: Pharmacists should actively participate in the medication-use process.

5. NQF Safe Practices Consensus Evaluation October 2003 Texas Medical Institute of Technology • Subject Matter Expert Input Instructions: • PROVIDE INFORMATION REQUESTED IN TABLE PROVIDED: • Fill in the sections of the table on slide # 2 with your expert interpretation and answers to the questions in the shaded area. • Slide #4 was provided for overflow information that may not all fit on slide # 2. • USE SLIDE # 3 AS YOUR NQF REFERENCE RESOURCE : • The content has been taken directly from the NQF Safe Practices Consensus Report published May 2003. • PLEASE RETURN THE FORMS BY E-MAIL TO THE LEAD PERSON DEFINED IN THE BOX ABOVE. • IF YOU HAVE ANY ADDITIONAL COMMENTS, PLEASE RECORD THEM IN THE BOX TO THE RIGHT. • IF YOU HAVE ANY QUESTIONS, PLEASE CALL OR E-MAIL THE LEAD OR ASSIST PERSONS FOR THE PRACTICE DESIGNATED ABOVE. • THE LEAD PERSON IS RESPONSIBLE TO COLLECT THE INFORMATION YOU SUBMIT AND THE ASSIST PERSON IS AVAILABLE TO ASSIST YOU AND THE LEAD PERSON. Subject Matter Expert Personal Comments: • I agree that this safe practice is essential but have not been able to identify the rate of harm associated with verbal orders. ____ • Rather than whenever possible, verbal orders should be reduced to writing at all times in order to ensure that there is accurate documentation. Order should always be read back.__

6. NQF Safe Practice #6: Verbal orders should be recorded whenever possible and immediately read back to the prescriber. Fill in the table below. Use slide #4 for overflow information.

7. NQF Safe Practice #6: Verbal orders should be recorded whenever possible and immediately read back to the prescriber. Leapfrog Deliverables

8. NQF Safe Practice #6: Verbal orders should be recorded whenever possible and immediately read back to the prescriber.

9. NQF Safe Practices Consensus Evaluation October 2003 Texas Medical Institute of Technology • Subject Matter Expert Input Instructions: • PROVIDE INFORMATION REQUESTED IN TABLE PROVIDED: • Fill in the sections of the table on slide # 2 with your expert interpretation and answers to the questions in the shaded area. • Slide #4 was provided for overflow information that may not all fit on slide # 2. • USE SLIDE # 3 AS YOUR NQF REFERENCE RESOURCE : • The content has been taken directly from the NQF Safe Practices Consensus Report published May 2003. • PLEASE RETURN THE FORMS BY E-MAIL TO THE LEAD PERSON DEFINED IN THE BOX ABOVE. • IF YOU HAVE ANY ADDITIONAL COMMENTS, PLEASE RECORD THEM IN THE BOX TO THE RIGHT. • IF YOU HAVE ANY QUESTIONS, PLEASE CALL OR E-MAIL THE LEAD OR ASSIST PERSONS FOR THE PRACTICE DESIGNATED ABOVE. • THE LEAD PERSON IS RESPONSIBLE TO COLLECT THE INFORMATION YOU SUBMIT AND THE ASSIST PERSON IS AVAILABLE TO ASSIST YOU AND THE LEAD PERSON. Subject Matter Expert Personal Comments: • The safe practice should state that abbreviations should be avoided whenever possible and if not, then only approved standardized abbreviations should be used.___________________________ • Implementation is a big challenge as abbreviations shoud be limited not only for medication names and directions, but also for other aspects of communication among providers. • There are those who suggest that there should be a list of unapproved abbreviations. Agree that there should be a list of never to be used. However, this does not prevent clinicians from developing own abbreviations as new medications become available or any other combination of words. These are just as likely to be misinterpreted. There should be a list of abbreviations that can be used and should be standardized throughout health care. One of the nurses at RMF has a book of accepted abbreviations that she uses to review medical records. • Taking a human factors approach: is it not more effective to know what can be used rather than what can not? I realize that the list can be long but there should be little doubt. • From NPSF discussion:Dealing with abbreviations in my facility has been somewhat frustrating. Wehave a list of approved abbreviations which is pages long and nobody paysany attention to. It is revised periodically and folks still use all kindsof abbreviations that are not on the list.

10. NQF Safe Practice #7: Use only standardized abbreviations and dose designations. Fill in the table below. Use slide #4 for overflow information.

11. NQF Safe Practice #7: Use only standardized abbreviations and dose designations. Leapfrog Deliverables

12. NQF Safe Practice #7: Use only standardized abbreviations and dose designations.