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You are the Quality Assurance Manager at Viking Hospital in Ft Bend, Indiana. It is a 547 bed facility. There is

a 92-bed psychiatric practice and a 60-bed rehabilitation facility. We have a 5-story office building connected to the facility. Management has identified some areas of the hospital that have impacted the quality of care being provided. Your department has been charged to identify the best QI approach to address these issues. This is what you know so far:

  1. In the pharmacy department, we have recorded, over a 60-day period, lost charged totaling $20,000. Manager blaming it on nursing staff paper work;
  2. There were other lost charges, not yet quantified, resulting from other recording errors;
  3. There was evidence that the ancillary services were not ensuring that patient information was being entered into the charts - this impacts billing and patient discharges;
  4. A new approach was approved that would increase the number of OB/Gyn patients. It was embraced by the doctors and patients. However, the nursing staff and anesthesiologists opposed it. This caused some of the nursing staff to resign. Another nursing manager was put in-charge to implement the change. An issue came up with regard to charges. Each unit had separate charges. This resulted in duplicate and missed charges.
  5. The current practice is to send placentas to the lab for analysis for normal deliveries. This costs us 200.00. The medical staff do not believe this is necessary nor know why it was being done. It is not part of today's standards.
  6. There has been an increase in the cost of inpatient drugs. We are spending roughly $1.5 million dollars per year.

What would be your recommendation on how to resolve these quality issues to be presented to senior management. 

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