Q: Please explain the circumstances around why Gulf Coast decided to investigate epinephrine injection administration.
Terri Lopez: We recently did a quality improvement study on epinephrine injections because a couple of our nurses who work in the procedure room noticed and made a comment about the sudden increase in epinephrine injections.
Q: How was the QI study carried out at the endoscopy center?
TL: Our first step was to develop a quality team. The team pulled clinical documentation to verify whether or not we did indeed have an increase in epinephrine infections, we found that there was definitely an increase. The denter was averaging seven epinephrine injections a year, but we found through the QI study that we had done 23 cases with epinephrine injections up until that point. A process was then implemented to monitor epinephrine injections on a continuous basis.
Q: What changes were implemented?
TL: After we completed this study, our team researched industry standards on when to administer epinephrine injections. The corrective measure we put in place was to first educate physicians and nurses on what the industry standards are, and now those standards were made into our official policy.
Our billers are also instructed to send every medical chart with a bill for an epinephrine injection to our quality committee. If the committee finds that the physician conducted the procedure within the industry standards, then the patient’s record is sent back to the biller for processing. If a patient’s medical record, however, falls outside of the industry standards, we do an educational session with the physician and track the session. Coincidentally, we found out that the increase in epinephrine injections was merely a fluke, and it went back to normal levels soon after we decided to do the study. But by doing the QI study, we now have a measurement to make sure it doesn’t happen again.
Learn more about Gulf Coast Endoscopy Center of Venice.
