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Intervention

Intervention is the most difficult quality control task. Interventions must occur when the input data deviate from the quality control standards. The magnitude of the intervention may range from the issuance of a simple memo to the emergency suspension of medical staff privileges. In the first case, the intervention by memo will have few repercussions. In the second case, however, the intervention could create both medical care and administrative problems. The wide range of severity of the potential problems that accompany various interventions demands that the consequences be evaluated as part of the preventive law checkup. It is important not to overreact to perceived threats; but, if the failure to intervene could result in injury to a patient, the political consequences of intervention become much less important. It is more important to prevent patient injuries than to avoid administrative controversies. Once a health care provider becomes aware of a quality control problem, there is a duty to intervene. The breach of this duty may create legal liability if an injury results from the problem.

There must be careful documentation of the rationale for all interventions. While it is preferable that this documentation of the rationale for all interventions. While it is preferable that this documentation be completed before the intervention, it can be done later if time is of the essence to prevent a patient injury.

If an intervention is to be effective, it must be timely, specific, directed at the source of the problem, and backed by sufficient authority to accomplish the necessary changes. These considerations must be assessed when evaluating the effectiveness of a quality control program. The most common problems arise from the inability of administrative or nursing personnel to institute interventions that require the exercise of medical judgment. The need for medical staff cooperation in interventions requires that the medical staff committees be integrated into the quality control program.


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