Corrective and preventive action

Recognized principles of quality management include a component for process improvement, comprised largely of corrective and preventive action taken i n response to identified problems. The importance of identifying and invest igating problems has been clearly established in transfusion medicine. Such problems can be identified in the following ways: error, incident, and acc ident reports; adverse reaction reports, customer complaints; process indic ator measurements; results of proficiency testing; and results of internal or external audits, inspections, or assessments. Responses to reported even ts can be remedial, in which the symptom is addressed, or corrective, in wh ich the underlying cause is addressed with the intent to prevent recurrence . If identified problems or their root causes are trended to look for patte rns or problems not yet occurring are anticipated, the action taken is proa ctive and considered preventive. Methods to trend events, monitor processes , and perform root cause analysis are discussed as well as use of the follo wing process improvement 'tools': control charts, flowcharting, the 'repeti tive why', cause-and-effect diagram, and Pareto analysis. (C) 1999 Elsevier Science Ltd. All rights reserved.