vascular access infection prevention
Standardization of Procedures for Safety , Quality and Savings
Creating a safe healthcare environment requires quality , reflected in the level of consistency in the application of evidencebased practices by every clinician .
The goal inherent in any healthcare service is to better the health of patients , usually through treatment and procedures . It is a given that patient safety and quality go hand in hand . But where and how is quality reflected in healthcare practices and how can it be improved , and even guaranteed ? Standardization provides a means to minimize errors , increase patient safety , reduce inconsistency , avoid complication , diminish waste , and even improve the patient experience . When reviewing definitions and applications of standardization , it is evident that instituting this process can result in improvement in healthcare practices at many levels .
Many guidelines and standards have been published , with the intention that they will be applied to patient care to improve and guide practices . Application of these standards from hospital to hospital is inconsistent because healthcare systems pick and choose which guidelines to apply and which ones to ignore . In actual hospital practices , how often are systematic processes for standardization applied to healthcare procedures , and even more importantly , monitored for compliance ? Creating a safe healthcare environment requires quality , reflected in the level of consistency in the application of evidence-based practices by every clinician .
Standardization , according to the Corporate Finance Institute , is the process of creating rules to guide good service and results . Merriam-Webster defines standardizing as a method to bring a process into conformity to ensure consistency and regularity . In an essay for Process Street , Benjamin Brandall says that standardization brings about improvement in quality , productivity , and overall morale . Standardization can be generalized for healthcare as the processes and procedures that allow each patient to receive the same level of care .
The Institute for Healthcare Improvement ( IHI ), in an article by Rozich and associates , describes standardization as a mechanism to improve safety in healthcare . IHI provides more guidance through its published document , “ Four Steps for Developing Reliable Processes ,” in which it describes the institution of reliable systems and standardization as a step to reduce defects , increase consistency , and improve patient outcomes .
With these insights in mind , standardization could be viewed as a method necessary to bring
• about and sustain quality in healthcare .
Application of standardization in procedures requires investigation to pinpoint gaps and inconsistencies in practices . The development of policies and procedures by U . S . hospitals and groups was designed to fulfill procedural standardization but falls short of truly applying the necessary levels of safety , consistency , and quality to every procedure . Most clinicians are required to read policies and procedures during orientation to a facility , but they may never refer to those policies again .
More hospitals are moving to boilerplate policies developed by large organizations such as Lippincott , which may not reflect actual practice and the details necessary to gain the value of standardization .
The basic premise of standardization is establishing a set of steps to direct consistent actions , such as within one procedure . A good example of standardization is in the application of the Central Line Bundle by Peter Pronovost and associates , known as the Michigan Keystone Project .
This initiative implemented a set of five practices , or a bundle , that integrated the Centers for Disease Control and Prevention ( CDC ) guidance into a checklist for insertion of central venous catheters . The bundle first was applied in intensive care areas , and its use later expanded worldwide as a top-level method to ensure patient safety in preventing central line-associated bloodstream infections ( CLABSI ). This simple bundle standardized insertion practices and has contributed to a significant reduction in CLABSIs since 2008 .
Bundles became more popular through support of the IHI and other organizations , which defined a bundle as a small but critical set of processes , determined by Level 1 evidence , applied collectively and reliably as a structured way of performing a process of care to improve patient outcomes .
Bundles are an excellent example of standardization when all components are performed , and a high level of compliance is confirmed through monitoring . According to David Mann , a fixed operations trainer with DLM Solutions , “ You must inspect what you expect .”
An example of identification of gaps in standardized practices is with products such as with needleless connectors . Many facilities utilize multiple brands and types of needleless connectors ,