Medical Staff Bylaws - Arkansas Children's Hospital

President for Medical Administration, Safety, and Improvement, the Nursing QualityImprovement/Accreditation Director, the Chair of the organization-wide Quality and Safety Council, theVice President of Clinical Services, a Pharmacy representative, Vice President of Operations, QualityImprovement Director, a parent representative, the Radiation Safety Officer, the Chair of the TransfusionCommittee, and a representative of the Office of General Counsel as a non-voting member (for advisoryonly). The Chief Quality Officer, or designee, will serve as chairperson.2. Function: The Quality and Patient Safety Committee is chartered jointly by theBoard Services and Quality Committee and the Medical Staff Executive Committee to oversee the ACHcommitment to patient care quality and patient safety across the clinical enterprise. As such,deliberations and findings of the committee are protected under the appropriate Arkansas statutes.Through its deliberations and activities, the committee will:d. Set the quality and patient safety agenda for the ACH clinical enterprise.e. Promote quality and patient safety initiatives in patient care areas and across theclinical enterprise.f. Ensure that quality and safety standards are being met across the clinicalenterprise.This will be accomplished through:Safety Goals6) Compliance with The Joint Commission standards and National Patient7) Review of quality and safety activities, including but not limited toa) Infection Controlb) Transfusionc) Radiation Safetyd) Escalation of Caree) Multi-institutional collaboratives/initiatives8) Review of clinical policies and procedures relevant to quality and patientsafety.9) Review of quality and safety performance indicators and metrics forclinical practice.10) Oversight of all other clinical and administrative activities as they affectquality and patient safety. For example,a) Medical equipment and supply purchase and careb) Pharmacy and medical safetyc) In-hospital of transport of patients86