A Safety Score Improvement Plan for Cleveland Clinic Cancer Center


ASafety Score Improvement Plan for Cleveland Clinic Cancer Center

Developmentof a Safety Score Improvement Plan

Thissafety score improvement plan is designed for the Cleveland ClinicCancer Care Unit located at 9500 Euclid Avenue in Ohio. This planseeks to revolutionize patient safety at Cleveland by reorganizingsafety policies and procedures in the Cancer Care Unit in the nextfour years. The objective of the program will be to achieve an 80%reduction in medical errors reported at the cancer care unit. Thisplan will identify the areas that need improvement, and proposesafety and quality safeguards that will be implemented in order toreduce harm presented to the patients by medical errors in theinstitution.

PatientSafety Issues

Thepressing patient safety issues at the Cleveland Clinic Cancer UnitMedical Errors. This issue is specific to the Cancer Care Unit wheredifferent patients with different types of cancers are taken care of.Medication errors have been reported to result from: confusion inmedication with similar packaging and names, non-commonly prescribedmedication, commonly prescribed medication but the patients areallergic, and medication that requires testing to ensure therapeuticlevels are maintained. Consequently, administration of the wrongdose, wrong medication, or through the wrong route have beenminimally reported. To minimize medical errors in the unit, the planrecommends reorganization of the prescribing, transcribing,dispensing, administration, and monitoring of the medicationadministration process.

Effectof Nursing Leadership in driving needed changes

Nursesmake a critical difference every day in the lives of their patientsand patient’s families. In fact, Medication administration is theresponsibility of nurses in most of the healthcare settings.Naturally, nurses are leaders and by using their expert knowledge,they manage and meet patient care needs at different levels. Thus,the effect of nursing leadership in driving change is widelyrecognized in many healthcare institutions. Most of the contemporaryhealth institutions recognize the without leadership, theorganization’s objectives might not be fully achieved. The proposedhealth specifics will directly affect nursing operations. Thus, theirsuccessful implementation will call for transformational nursingleadership. For instance, working with nurses to assess medicalsafety will be critical since nurses are directly involved in theadministration of medication (Kelly, 2011).

Justas the demand for nursing leadership is a necessity, so is the needfor well-established communication channels among the differentstakeholders. For the safety of patients at the Cancer Unit to beoptimized, the communication between nurses, physicians, doctors,patients, and other stakeholders is important. Of course, changingthe healthcare culture in the Cancer Unit to become patient-centricwill be a tough decision. However, transforming it will be vitalsince the unit cares for some of the most vulnerable population inthe society.

HowCurrent Policies and Procedures Affect the Safety Issue

Patientsafety is at the heart of the current policies and procedures ofCleveland Clinic Cancer Unit. The unit has remained committed toreducing avoidable harm and has focused on the improvement ofmedicines safety to reduce medical errors. Consistent with thesegoals, the purpose of this safety scores improvement plan is toachieve an 80% potential harm reduction rate. The plan is athree-year project, which is expected to begin in November 2016. Thecurrent safety policies are loose at the Error-Prone Processes ofmedical administration. Thus, there is a need for policy update toengage all the areas that involve patient safety in the cancer unit(Kelly 2011).

Strategyfor Collecting Information about the Safety Concern

Datacollection is a common activity in many healthcare institutions:nevertheless, the data collected in most of these institutions haslittle impact on their planning. Like many other healthcareinstitutions, the Cleveland Clinic faces major challenges whencollecting performance data from patients, staff, or other types ofenrollees. With this understanding in mind, this plan proposes directmethods of data collection such as direct observation, filling ofquestionnaires, and staff surveys. Consequently, widely establishedestimation methods can equally be used to supplement direct effortsof data collection. Special interest will be given to the Error-ProneProcesses of medical administration. For successful adoption of anyof the proposed data collection methods, the involvement of allstakeholders is very critical.

RecommendingEvidence-Based Strategy to Improve Safety Issue

Medicationsafety is a major area of concern in many hospitals. Unfortunately,recent literature reviews suggest that there is little evidence tosupport the specific base innervations. The recommended actiondepends on each of the identified causes of medical errors.Generally, there will be introduction of medical calculationworksheets, medication safety education program. Consequently, theprogram proposes the Plan-Do-Study-Act cycles accompanied by multiplesystem changes, which will be designed to help improve the safety ofmedical administration. Other strategies will include the developmentof preprinted labels for common drugs, standardizing administrationof drugs and updating the existing Intranet-based drug informationdatabase. Some of the system focused strategies include decreasingworkloads, RN independent double-checks, and improving safetyclimates. Recommended process focused action include reducinginterruption during medical administration and monitoring patientresponse to medication.

Planfor Implementing Recommendation and Monitoring outcomes

Forsuccessful implementation of this plan, a wide range of stakeholderswill be actively engaged. Of major concern in the implementation ofthis plan will be the staff and patients since the engagement ofthese parties transforms the quality of care. Furthermore, thedeterioration of patient health in the Cancer Care Center Unit hasbeen directly linked to poor stakeholder engagement. Under the newstrategy, patient safety briefing, incidence reporting, and voluntaryreporting will be encouraged to help in the process of monitoring theprogram outcomes. With these strategies, it is highly anticipatedthat the general safety of patients at the cancer care center willimprove significantly.

QualityIndicators to be Used

Themain quality indicates will be reduced case of medical errors.Positive results from data analysis will also be an indication thatthe program has had a positive impact on the safety of the patients.


Outcomeswill be monitored through constant quality audits, medical reviewsand assessing the general impact of the program. Negative reviews,reduced quality of care, and increased complaints from patients willindicate unsuccessful efforts. Voluntary reporting will also beencouraged.

Policiesand Procedures

Theexisting policies and procedures will not be changed but will bestrengthened. The purpose of the program is not to change the policy,but to improve the quality of care through adherence andstrengthening of the existing policies and procedures.

WhetherNursing Staff Will need Training

Theproposed strategies require constant Nursing training. Furthermore, anursing training program is part of the recommended actions.


Kelly,P. (2011). NursingLeadership &amp Management.New York: Cengage Learning