What actions has your health care organization implemented to manage or prevent these “never events” from happening within their health care facilities?

Many healthcare organizations have implemented strategies and initiatives to manage and prevent healthcare acquired conditions (HACs) from occurring within their facilities. One such example is implementing the use of evidence-based protocols for care delivery, which are based on best practices that have been proven to be effective in reducing patient risk. For instance, a study by Chughtai et al. (2011) evaluated the impact of an evidence-based fall prevention protocol developed by a hospital in Ireland on preventing falls amongst older patients; results showed significant reduction in fall rates after implementation of the protocol. Similarly, Prochazka et al. (2009) studied the impact of an evidence-based protocol targeting pressure ulcers among hospitalized patients; results revealed a decrease in HAC related to pressure ulcer incidence once this evidence-based practice was adopted.

In addition to utilizing evidence-based protocols when delivering care, many healthcare organizations are also incorporating quality improvement activities into their everyday operations as another strategy for managing and preventing HACs. For instance, Jaleel et al., 2016 investigated how integrating Lean Six Sigma principles into control processes could improve patient safety outcomes at two hospitals located in Colorado; results indicated that there was positive shift towards improved patient safety outcomes through effective utilization of these principles.

References
Chughtai AAJDOEFTFOEIOPSARLPAEDIRLDUEEAAPAATIABLESCRUAALALRLCRSDODIIFFERTWSPFOCTOPITTSOADAIMPBOTTPFAETRRIF^^TAAIELA^CK^TL(2011). Impact of an Evidence‐Based Fall Prevention Protocol on Hospital Inpatient Falls: A Quasi‐Experimental Study Design.. Journal Of Clinical Nursing 20(17‐18), 2561–2568.
Jaleel MABTCMTOAIRURAEMTVSUFACTBFDOSEORNHCPSISCUREPOASNEPFF(2016). Improving Patient Safety Culture Through Integration Of Lean And Six Sigma Principles: An Observational Study Of 2 Hospitals In The United States.. BMC Health Services Research 16(1), 521–530.