Patient Safety and Medical Errors - Essay Example

Patient Safety and Medical Errors Introduction Patient safety has remained one of the major concerns in hospitals across the globe as a result of the injuries and deaths caused by mistakes and errors committed by healthcare workers. Patients in a hospital trust the qualification of the hospital workers and therefore believe in their ability to deliver them from the health condition they are suffering form. The issue of patient safety concerns all hospital workers including the doctors, the nurses who care for the patients, accuracy of drug prescription and dosage from the pharmacist, great care and protocol abiding by social workers and dietician among others (Nieva and Sorra, 2003). Failure by this group to follow due process or any negligent behaviour increases the risks of the patients and compromises their safety. Patient safety is considered as a wide area that has grown out of the current use of technology and the development of different medical approaches in healthcare. According to the global nursing association, patient safety has no financial needs as it involves the commitment of the healthcare professionals and the provision of quality services to the patients (Stern, 2008). Impacts of medical error on patient’s health Medical errors do occur in hospital setting as a result of professional negligence or omission which could have been avoided thus affecting the healing process of the patient. In medical history, the medical errors and their impacts on patients recovery has been documented beginning from the time of Socrates. However, most professional healthcare workers lack information on the impacts of the errors they commit and these results into misreporting or lack of reporting all together, an event that has led to the death and chronic injury of patients (Leape and Berwick, 2005). A number of studies have indicated the prevalence of medical errors in the health system across the globe, affecting developed and developing countries alike. In Australia, the medical errors documented in one year caused more than 18,000 deaths that could have been avoided and prevented. In the United States, the number was high, standing at over 44,000 in one particular year. The number of injuries remains high though their accuracy is doubtable due to lack of documented information on the same at any particular time (Nieva and Sorra, 2003). The cost of medical errors on patients can be categorized into human and economic costs and this provides a description of human life lost or the number of adverse effects caused on the health of the patient. According to the Australian patient safety foundation, the South Australia cost has experienced an increased cost of claim and insurance associated to medical negligence and errors suits (AHRQ, 2001). The state health assurance agency paid over $18 million to patients who claimed compensation following the complications they developed as a result of the negligence. The national health service of the United Kingdom pays an estimated £400 million to different claimants every year, further demonstrating the economic cost of medical negligence. According to the united state agency of healthcare research and quality, avoiding medical errors and negligence can save the country up to $8.8 million in setting clinical negligence cases (Leape and Berwick, 2005). Though research has focused on the economic pains of these errors, the human costs further strengthen the need to develop an error free medical system. Loss independence and decreased productivity are some of the devastating impacts of medical errors on patients and their families. Most careers have been shattered and dreams affects after a medical error caused incapacitation thus affecting the economic engagement of the affected parties (Johnstone and Kanitsaki, 2006). In the development of proper quality assurance in hospital and the elimination of medical errors, safety management models must be developed to guide all the employees in the organization. A number of widely accepted medical practices exist but each institution can develop an internal approach based on the nature of services they specialize in and the qualification of the staffs (Perry, 2002). Safety management approaches also differs depending on the policies adopted by countries and their levels of economic development and growth. In Finland for example, the government launched the finish patient safety strategy in 2009 that was used for the development of patient quality protocols up to 2013 (Nieva and Sorra, 2003). In this strategic plan, the finish government planned to achieve a common culture of patient safety across its hospitals and medical facilities in the country. Based on the broad principles of this strategy, the ideologies of patient safety falls under the area of quality and risk management, which needs a multi approach to achieve its objectives? This strategy highlights the development of safety culture which promotes the provision of safe care and accurate treatment to patients (Truog, Browning, Johnson & Gallagher, 2010). The health professionals involved in the caring of patients must also take responsibility for their actions and any omissions and errors that may arise from the work. This strategy highlighted the need for Management Corporation in the development of safe environments (Patel, 2008). Improving patient safety As part of quality assurance and risk management, patient safety must be consistently improved in line with emerging approaches adopted by governments to reduce medical errors in hospital and home care. At this stage, the approaches adopted to ensure patient safety and how different governments and hospitals have approached patient care in the recent past will be discussed (Michell, Rosenorn-Lanng, Gulliver & Currie, 2013). Donabedian adopted a way of measuring healthcare 40 years ago in which he proposed the use of the available structures, processes and outcomes to evaluate its effectiveness (Leape and Berwick, 2005). Through the structures, the accessibility of the health system and the new approaches adopted to improve quality could be improved. Through outcomes, the positive benefits of quality controls and management in the hospital can be evaluated and witnessed, further demonstrated the benefits of quality control in healthcare and reduction of medical errors (Nieva and Sorra, 2003). In this approach, the error which compromises the safety of patients is critically analysed and approaches to improve its negative impacts on the wellbeing of the patient determined. In this system, organization develops quality control approaches that are focused on the relationship between the patients and the machines used in the care and treatment (Newhouse & Poe, 2005). The benefits of this approach led to its adoption by the joint commission on the accreditation of healthcare organization which allowed hospitals to adopt it the investigation of the adverse effects that can be witnessed in patients. The ability of the root cause analysis approach to build a working relationship between patients and physicians has been attributed as one of its main advantage. Through this approach, healthcare professionals are also able to learn how to control and avoid medical errors that may be detrimental to the health of the patient. This approach also has the ability to determine system flows in health facilities and develop correction approaches, further reducing the occurrence of such errors in hospitals. The failure mode and effect analysis is the second approach that health facilities can adopt to improve patient’s safety and avoid medical errors. In this approach, the individual components of failure are used to determine the effectiveness of the safety program in the facility. Through this, the flaws that exist which give room for the continued errors and omissions which threatens the life of patients is determined (Medicine, 2000). To succeed with this approach, healthcare facilities must adopt a step by step process in implementing it which will ensure that all healthcare professionals in the facility understand it applications and ensure strict adherence to the protocol. First, each facility must develop a process flow diagram to act as a guide to the healthcare professionals in the event of an error or omission that may affect the health of the patients (Shaw, 2000). Through the development of this step, the process retraction and simulation can be achieved which is helpful in determining the source of the error. Failures in healthcare quality affect healthcare provision and the extent of this impact must be evaluated for the centre to be well placed to tackle system errors and omissions especially with machine assisted patients. Apart from the use of strategies and models to improve healthcare quality in hospitals, other professional and relationship based approaches can be used that can eliminate the presence of errors and reduce its impacts on the health of the patients. Lack of proper communication in hospitals has been attributed to increased occurrence of omissions and errors as professional’s acts on assumptions as opposed to communicated reasons. To improve the quality of healthcare within health facilities, proper communication channels must be adopted to reduce the occurrence of misinterpretation in hospitals (Tutuncu and Erbil 2006). In most cases, clinicians and nurses have prescribed antibiotics to patients who have a history of allergy towards the same due to poor communication among the staff themselves and with the patient. By clearly highlighting the roles of every employee in a medical team, responsibility and owning up is improved and this assists in the development of a committed team that understands their personal roles (Shaw, 2000). Patient safety and total quality management With the increasing prominence placed on health safety and the development of error proof systems, total quality management has been incorporated into organizations to reflect the success in witnessed in corporate applications. Total quality management is an approach that seeks to develop an effective system that ensures the provision of high standard services and a reduction of errors at a reduced cost. Implementing safety measures in hospitals is costly and this has pushed different organizations to adopt cheaper yet effective approaches which are achievable through the adoption of TQM. The issue of quality assurance and control in hospital can be traced to the time of Florence Nightangles when she worked on the Crimean war. The presence in variation of approaches adopted towards a similar medical condition creates the connection between patient safety and total quality management. The approaches adopted for patients with recorded allergy to antibiotics have been associated with the safety complaints in most hospitals making the development of a common approach important. Such an approach will follow the stand goals of total quality management to achieve a system that is error free but cost effective. Through the development of proper total quality management approaches, Tutuncu (2007) argues that a culture of patient safety is developed in health facilities. Health facilities develop approaches and procedures for verifying the routines adopted in medical practice. Through total Quality management, consistency is achieved and this is the current crave in most healthcare facilities which seek to develop error proof systems (Kalra, 2011). Previous approaches on the mitigation of medical errors and the improvement on patient safety have focused on individual responsibilities and errors and this has done little to change the situation. With total quality management, safety control moves from being individual based to focusing on systems and errors committed as a result of the flaws in the system. The paradigm change that has led to a change in focus from individual sources of error to system sources of era makes total quality management the best approach in the development of an environment that ensures patient safety (Singer, Gaba and Geppert, 2003). As the nature of competition in hospitals increases, the nature and quality of services offered makes total quality management the best option to increase satisfaction and improve the healthcare provision to patients. While patient safety is not a static phenomenon but a continually changing process that requires incorporation of new ideas, total quality management provides the options that can be employed to achieve these goals (Baker & Norton, 2001). The success of any organization program is dependent upon the ability of the leaders to create a working team that has the ability to create coherence and the spirit of togetherness. This is even more essential in a situation where the organization seeks to introduce more customer cantered approaches in conducting business. As all departments in the organization are needed to ensure that the new approach to customers succeed, all departments and units in the organization must work together, guided by a common goal and the need for a common result (Lim, 2004). Teamwork is defined as the ability of members of an organization to pull their strengths and personal attributes together to ensure that the organization achieves its objective timely and with ease. Through well-coordinated teamwork approach, efficiency in an organization is enhanced and this enables the members of the organization to achieve their tasks with much ease as compared to an environment devoid of teamwork (Wong, 2004). In total quality management, different categories of teams are used with each playing a distinct from the other and assisting in ensuring that the final goal of the organization is achieved. The first team that plays the key fundamental role is the problem solving team that is made of the managers, supervisors and a few representatives of the employees. This team holds regular meetings in which they brainstorm on the best approaches to improve the quality of services offered in the organization and improve productivity. Within emirates airline, such a team has played a major role in the development of more pragmatic and customer based policies that have improved service delivery and customer satisfaction at the company (Sexton, Thomas and Helmreich, 2000). Once these policies and changes aimed at improving quality service delivery are implemented, the natural team assumes the major role of implementation. This team is critical in understanding what the organization seeks to achieve through introducing the new approaches and how much they are expected to input to ensure that all these succeeds. As a result, the success of total quality management in an organization is influenced largely by the input and the attitudes of the natural teams towards it. This can be improved through proper leadership that aims at coaching the employees and ensuring that the new goal of the organization is not pushed into their throats but tailored for their understanding (Kohn, Corrigan and Donaldson, 2000). The virtual teams develop the best digital approaches that Emirates can adopt to ensure that its total quality management plans succeeds at all times. Through this team, the organization has the ability to map the areas within the airline that if changed or modified can improve the nature of service offered in line with TQM. To ensure continuity at the airline among its different subsidiaries across the world, the virtual team within the TQM liaises with other teams across the world to ensure they develop a coherent approach. This is especially essential because the nature of services offered by emirates airline is not measured based on the Dubai results but across the world (Encinosa and Hellinger, 2008). Total quality management is responsible for the development of a positive safety climate and culture that involves the participation of the leadership of the hospital and the healthcare professionals involved in decision making and policy formulation. According to Sexton, Thomas and Helmreich, (2000), an environment that is characterized by safety culture is founded on proper communication approaches that emphasize the need to adopt proper reporting approaches. This explains the intensified research by different stakeholders within the healthcare sector to understand the relationship between patient safety and quality management in hospitals. Importance of total quality management in healthcare systems In a business setup, a scenario of seller and buyer exist whose relationship is influenced by the quality of services offered by the seller and the satisfaction of the buyer. In a healthcare facility, changes have created a scenario where the doctor is viewed as the seller while the patient is buyer with a relationship that is influenced by the quality of services offered and the satisfaction of the buyer. Total quality management provides room for the elimination of repetitive processes that are associated with omissions and errors that compromise the quality of healthcare. The cost of wasteful process is also eliminated within the hospital settings if total quality management is adopted and safety of patients given more prominence (Tutuncu and Erbil, 2006). With the eight principles of total quality management, safety measures and controls can be effectively developed in hospitals. The principle of customer focused organization when developed in hospitals ensures that patients are treated as valuable members of the organization whose satisfaction remain fundamental. As a result, the provision of quality services ceases to be an issue of privilege but an entitlement as satisfaction guarantees continuity (Baker & Norton, 2002). Total quality management has the principle of leadership that seeks to ensure that the top management of the hospital works towards ensuring that policies implemented places patient safety as a priority. By establishing a unity of purpose in the leadership, a healthcare facility can develop a collaborative approach to achieving quality service provision and the elimination of errors that are detrimental to the health of the patients (Singer and Tucker, 2004). Total quality management works towards the development of employee participation and involvement all healthcare workers, a process that will be helpful in ensuring that all doctors and clinicians understands what is expected of them and work towards achieving them. In most instances, lack of proper involvement of all professionals involved in patient care has been attributed to the occurrence of errors and omissions which have affected the health of the patient. As the person in charge of caring for the patient, the nurse must have access to clear and direct instructions on medication and care as provided by the medical doctor. This is improved and enhanced in situations where involvement is enhanced and doctors work together to ensure that the medication accurate and drug hyperactivity is attained (Tutuncu, Kucukusta, Akman, 2007). In professional model of quality assurance, responsibility for a mistake committed is blamed on an individual or professional who commits the mistake as opposed to the system that the professional was operating in. Total quality management as demonstrated in other parts of the paper is system based and lays blame and responsibility of omission on the system as opposed to the individuals. While making quality control decisions on the organization, the management must involve clinicians who are tasked with the implementation of the decisions made. In clinical profession, autonomy is critical and the use of total quality management is used to increase the autonomy of the professionals (Debra & Drapper, 2008). References Tutuncu, O., Kucukusta, D., Akman, A. et al. (2007). “The Role of Patient Safety Climate on Quality Management System: Perceptions of Nurses”. 51st European Organization for Quality Annual Congress, Prague, Czech Republic. Tutuncu, O. and Erbil H. (2006). 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