The Issue of Polypharmacy: Implementing the Nine-Month Quality Improvement Plan

Polypharmacy, described as an individual taking more than four medications, can be concerning with the aging population. Polypharmacy concerns include adverse drug reactions, drug interactions, higher cost, decreased mobility, decreased quality of life and cognition impairment. Those at greater risk of negative polypharmacy consequences include elderly, psychiatric patients, recently hospitalized, individuals with multiple doctors or pharmacies and people with impaired vision or dexterity. There are times that polypharmacy is at times needed to help a person with their diagnosis, an example of this is using multiple medications to treat congestive heart failure which can include digoxin, diuretics, and angiotensin-converting enzyme inhibitors

Shaw, P. & Elliott, C. (2012). Quality and Performance Improvement in Healthcare. 5th Edition. (pgs. 156, 157, [VitalSource Bookshelf version]. Retrieved from

Various internal and external factors influence quality management and outcomes in hospital organizations. One internal factor that affects quality management and outcomes is leadership within the organization. Leadership is important to have successful quality management outcomes because if the leadership does not support it, no change within the organization will be successful. “This commitment must be shared by the board of trustees and all senior clinical and administrative managers and understood that it is a long-term process” (Chassen and Leob, 2011). Leadership is one of the most influential internal parts of the quality management program. Leadership can either help the organization succeed with their support or help the organization fail if they do not support and follow

This quality improvement discussion will review the purpose of quality management in health care industry and why it is needed. Included in this QI report will be an explanation of the

For health care organizations quality data collection is an essential tool used for data collection. The information produced from the data assists the health care organization in other functions such as effective ways to manage and perform decision making for the organization, this includes the strategic planning process. Quality improvement is the method of assessing processes and provides the information necessary to improve services. All of this together allows the health care organization to become a high producing system of

The purpose of quality management in healthcare is a continuous process that improves health care performance and increase customer satisfaction. Within health organizations there are many entities such as pharmacies and clinics all of which need to provide quality services to their patients. Quality improvements are organizational strategies incorporating evidence-based practice to improve healthcare (Huber, 2010). Reviewing why and how the need for quality management in a health care organization will be discussed.

My experience in both my previous career in nursing and human resources has dealt with approaches in quality improvement in patient safety and different metrics in the turning up organizational behavior as well as up swinging the operations of the organizations respectively. We live in a rapidly changing world, and healthcare industry is not exempted from it. Because I will be playing an indispensable role in the future, I am very interested on the concept of quality improvement and what not and identify possible future challenges and draw lessons from healthcare organizations that has spearhead innovative changes to providing healthcare by pursuing the triple dimensions of the improvement of healthcare in general that is Improving the patient experience of care (including quality and satisfaction); Enriching the health of populations; and Reducing the per capita cost of health care.

Quality improvement is a systematic and continuous process which leads to improvements in healthcare services. The health services are then a reflection of the improving health status of a patient population (Health Resources & Services Administration, n.d.). Quality improvement strategies are the actions which a team will take to accomplish the goals of process improvement. The Institute of Medicine (2001) has developed a vision of six aims for improvement in healthcare which include, safe, effective, patient-centered, timely, efficient, and equitable care. Making improvements in these areas will better meet the needs of patients.

3) advocates autonomy and independence of the residents. According to the guideline states that medication review is an evidence-based intervention and this review should be performed regularly (ACSQHC 2009, p. 72). A meta-analysis was conducted in aged care facilities and the relationship polypharmacy and falls, and fall injuries were found out. Residents taking cardiovascular medications, including diuretics, antiarrhythmics, digoxin, have higher fall risks. But, by reviewing their medication, the risks of fall were reduced up to 66% (Baranzini et al. 2009, p. 228). A randomise controlled trial was conducted targeting residents in aged care facilities, and a comparison between medication-reviewed population and non-reviewed population performed. The effectiveness of medication review was statistically confirmed that reviewed population showed 38% lower number of falls than the non-reviewed population (Zermansky et al. 2006, p. 589). Therefore, in aged care facilities, falls are obviously a big problem and often harm the residents. Medication is a major factor for falls because the vast majority of residents are taking multiple medications. However, reviewing their medications, fall risks are significantly reduced. As a nurse, careful observation for the residents and frequent collaboration with pharmacists or doctors should be performed to ensure the residents

Assume that you are a quality officer who is responsible for one (1) of the state’s largest healthcare organizations. You have been told that the quality of patient care has decreased, and you have been assigned a project that is geared toward increasing quality of care for the patients. Your Chief Executive Officer has requested a six to eight page (6-8) summary of your recommended initiatives.

In the article published by Sirkin and Rosner (2009), it was reported that 70% of individuals above the ages of 65 years have hypertension and approximately a third of them fall every year. It was found that hypertension and fall are common in elderly and coexist in most of the cases. It has been thought that the medication that the hypertensive elderly use put them at risks fall. For instance, it has been found that psychotropic agents, antidepressants, hypnotics, anticholinergic and anxiolytics cause falls in many patients. These drugs have been reported to have serious neurological and autonomic effects among the vulnerable individuals (Sirkin & Rosner, 2009). Due to the high correlation between falls and medication, organizations are encouraged to have pharmacy staff provide an ongoing review of patient medication regimens. Through the active participation of nurses, vulnerable patients should be identified and managed according to the required plan.

Quality is an important factor that affects an organization’s service delivery approach or underlying system of care. To achieve a different level of performance and improve quality, an organization’s system needs to change its own delivery system and key processes. The resources (inputs) and activities carried out are addressed together to ensure or improve quality of care. A health service delivery system can be small and simple, such as an immunization clinic or large and complex or a managed care organization. A health care delivery system consists of resources, activities, and results. Activities or processes within a healthcare organization contain focuses on what care is provided and how is done based on the location, time, and patients of the care delivery. Providing services that meet the needs and expectations of patients and their community, including system that affect patient access, care provision that is evidence-based, patient safety, support for patient engagement, coordination of care with other parts of the larger health care system, and cultural competence, including assessing health literacy of patients, patient-centered communication, and linguistically appropriate

Mrs A is a 71 year old widow with CCF and osteoarthritis who has recently been exhibiting quite unusual behaviour. Her daughter is concerned about her mother's ability to remain independent and wishes to pursue nursing home admission arrangements. She fears the development of a dementing illness. Over the last two to three months Mrs A has become confused, easily fatigued and very irritable. She has developed disturbing obsessive/compulsive behaviour constantly complaining that her lace curtains were dirty and required frequent washing. Detailed questioning revealed that she thought they were yellow-green and possibly mouldy. Her prescribed medications are:

Glickman, S., Baggett, K., Krubert, C., Peterson. E., & Schulman, K. (2007). Promoting quality: the health-care organization from a management perspective. International Journal for Quality in Health Care.

Quality is something that every health care agency strives to achieve. The Institute of Medicine (IOM) suggests that health care organizations develop a culture of safety such that an organization's care processes and workforce are focused on improving the reliability and safety of care for patients (Groves, Meisenbach, & Scott-Cawiezell, 2011). In order to address an issue related to health care quality, it is important to look at the frameworks that will analyze an organization and identify opportunities to improve performance. The purpose of this paper is to provide a description of an organization and an analysis of the following: mission, vision and values, strategic plan, goals,