Page 223 - Demo

Q Bulletin, Volume 1, No. 32 (Supplement 1), Jan - Dec 202412th National QA Convention, 8 %u2013 10 October 2024QLL-131Reducing Errors in Daily Ward Census Submissions at Hospital Baling, KedahZarina AG1, Azlin Syazwani A1, Ainunnadiah D2, Halimatun Saadiah H3, Halimah N4, Azhani HaliyatiAY2, Selvanaayagam S21 Medical Record Unit, Hospital Baling, Kedah2 Administrative Department, Hospital Baling, Kedah3IT Unit, Hospital Baling, Kedah4Nursing Unit, Hospital Baling, KedahSELECTION OF OPPORTUNITIES FOR IMPROVEMENT:Daily submissions of manual ward census forms (PER-PD103) from the wards to the Medical RecordOffice (MRO) at Hospital Baling, Kedah, contained errors at a rate of two to three censuses per week,impacting data accuracy for national registry entries. This situation subsequently affects the accuracy ofthe bed occupancy rate (BOR), a key metric for hospital performance. Beyond metrics, these errorsimposed undue stress on staff, diverting valuable time from patient care. Therefore, this project aimed toachieve zero errors in daily ward census submissions.KEY MEASURES FOR IMPROVEMENT:Number of daily ward censuses containing errors submitted to the MRO, with the standard set at zero.PROCESS OF GATHERING INFORMATION:A quality improvement study, including verification, strategy implementation, and post-interventionphases, was conducted from August 2023 to February 2024. Data on ward censuses, pre- andpost-remedial, were gathered from departmental records. Interviews and discussions identified issues,while survey questionnaires measured intervention effectiveness.ANALYSIS AND INTERPRETATION:Pre-remedial, up to 15 ward censuses with errors were identified monthly. Content analysis revealed mainerrors including illegible handwriting, transfer errors, miscalculations, and misinterpretations of terms.Non-compliance with the verification step by the ward manager or team leader led to errors beingoverlooked before submission to the MRO. Additionally, conducting the census manually using hardcopyforms resulted in transportation waste.STRATEGIES FOR CHANGE:Revised and standardised work processes, including the addition of verification steps, were implemented.Additionally, an e-census system with real-time data access, incorporating comprehensive guidelines andauto-calculations, was introduced. Roadshows were conducted to facilitate adaptation to these newprocedures.EFFECT OF CHANGE:Post-implementation, error was reduced to zero in January 2024 and one in the subsequent month. Nursesatisfaction increased to 67.7% with the digital e-census, compared to 29.2% with manual processes.THE NEXT STEP:We plan to provide refresher courses and ongoing support to ensure staff proficiency with the e-censussystem, addressing the learning curve experienced during the transition.222 | Page