A Quality Improvement Initiative for Strengthening Prescription Writing Practices Among Medical Interns at Healthcare Facilities of Delhi

Background: Prescription errors, often leading to inadequate treatment and adverse effects, are a global concern. In Delhi, a significant percentage of prescriptions have been found to be irrational, highlighting the need for improved prescription writing practices. Objective: This study aims to evaluate and enhance the prescription writing practices of medical interns at healthcare facilities in Delhi through a Quality Improvement (QI) initiative. Methods: The study was conducted over three weeks at three Rural/Urban Health Training Centres under the Department of Community Medicine of a Medical College in Delhi. A total of 50 prescriptions written by interns were audited using a standardized checklist. The QI intervention included training sessions on prescription writing, supervision by junior residents, and the use of checklists. The interventions were developed and tested through repeated Plan-Do-Study-Act (PDSA) cycles. Results: Baseline prescription audits revealed a mean prescription score of 11.88 ± 2.44 with an average of 2.63 ± 1.25 drugs prescribed per prescription. Significant improvements were observed in the mean scores reaching 15.90 ± 2.29 after the final intervention, which was statistically significant (p-value = 0.000). The number of drugs prescribed per prescription decreased, and the proportion of prescriptions with a presumptive diagnosis and appropriate antibiotic use increased. Conclusion: The QI interventions significantly improved the prescription writing practices of medical interns, reducing prescription errors and enhancing patient care. Refresher training and supervision are essential to sustain these improvements.