MINNESOTA
MAY 2017
PHYSICIAN
THE INDEPENDENT MEDICAL BUSINESS JOURNAL
Volume XXXI, No. 2
Quality improvement Deconstructing the PDCA model BY RAHUL KORANNE, MD, MBA, FACP
T
he U.S. health care industry is working at a breakneck pace to understand and control the drivers of the rising per capita cost of care, while improving the quality and experience of care we provide to individual patients and large populations (IHI triple aim). More recently, the medical industry has started addressing the goal of reducing burnout in health care staff as well (the expanded quadruple aim). Clinician exposure to quality improvement (QI) models is likely to increase and providers are sure to be called on to engage in these efforts. It is imperative that frontline clinicians understand the basic premise and structure of QI efforts and become familiar with them.
Off-label prescribing An increasingly common practice
One widely used QI model is the Plan-DoCheck-Adjust (PDCA) cycle, which was created by Walter Shewhart and Dr. W. Edwards Deming and became popular across the globe in the 1950s. This model consists of four steps: Quality improvement to page 184
BY JASON VARIN, PHARMD; CLHC SLFS*; AND ILO LEPPIK, MD
I
n 1937 the pharmaceutical manufacturer, S. E. Massengill Company, produced a sulfonamide antibacterial preparation that used diethylene glycol as a solvent. “Elixir Sulfanilamide� was believed to be responsible for over 100 deaths and many more non-fatal poisonings. The following year, the Federal Food, Drug, and Cosmetic Act (FDCA) was passed. While it has been amended many times over the years, the intent of the FDCA regarding pharmaceuticals has been to ensure the efficacy and safety of medications prior to widespread use. Off-label prescribing to page 164