Memorial Hospital is an inner city 400 bed academic medical center serving a low-income diverse community. The majority of patients are insured by either Medicare or Medicaid. A recent Joint Commission (JC) inspection of the hospital found major deficiencies in the handling and storing of medications. A report of their findings was submitted to the Chief Executive Officer (CEO) of the hospital citing that on two 20 bed medical-surgical units medications that had expired were mixed in with current medications. The medications with expired use dates were not separated from the good medications.

Upon further inspection the JC team found that the required sign in sheets attesting to the review of all medication dates were signed by the Nurse Managers of these Units. Policy and Procedures (P&P) on the handling and storage of medications were up to date and readily available to all staff. The JC team approved of the P&P but did not find minutes or a sign in sheet showing the training of RN’s, LPN’s, Aides , Residents and Hospitalists who rotated through the Units. The Nurse Managers have been with the hospital an average of ten years and in fact participated in the last JC inspection eight years ago.

The JC gave the hospital one month to submit a corrective action plan or face severe penalties which could include stopping reimbursement from Medicare.

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The CEO hired a consultant Ms. Jones to help develop the corrective action plan. Ms. Jones is a Registered Nurse with years of experience working with hospitals to prepare for JC inspections as well as develop as develop corrective action plans.

Identify the key issues and problems in this case—be specific

What information, data additional resources do you need to help develop the plan;

develop a plan to help them

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