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PI.3.20: Proactively dealing with high-risk, low-volume procedures to increase safety

Accreditation Connection, June 20, 2008

PI.3.20 requires an ongoing and proactive process for seeking out the causes of—and identifying methods for the prevention of—adverse effects to increase patient safety. PI.3.20 applies preventive, proactive patient safety tactics rather than reactive actions taken only after an error or adverse event has occurred. High-risk, high-volume, problem-prone, and low-volume processes should be evaluated.

The high-risk, low-volume processes are my favorite to review.

For example, look at the recently published Sentinel Event Alert on pediatric medication errors. We have always known this is an area of difficulty. Pediatrics, outside of specialty or children’s hospitals, does not make up a large percentage of the patient population, especially when it comes to dealing with medication. In psychiatric facilities, pediatric and adolescent care may make up a small percentage. You must identify the risks here. It’s a very patient- and age-specific population.

When looking for low-volume, high-risk procedures, take your cue from the emergency department (ED).The ED and other areas of the hospital use certain procedures constantly and others very rarely.

Editor’s note: This feature explores problematic Joint Commission standards with expert advice from BOJ advisors. This month, Elizabeth Di Giacomo-Geffers, RN, MPH, CNAA, BC, a healthcare consultant in Trabuco Canyon, CA, discusses PI.3.20.

Access the full story in the June issue of Briefings on The Joint Commission. Access is free for BOJ subscribers; nonsubscribers can purchase a copy of the story for $10 by clicking here.

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