Adverse Events in Hospitals and Their Potential Solutions - Essay Example

ADVERSE EVENTS IN HOSPITALS AND THEIR POTENTIAL SOLUTIONS IDENTIFICATION AND CRITICAL ANALYSIS OF FACTORS SURROUNDING ADVERSE EVENTS IN HOSPITALS AND THEIR POTENTIAL SOLUTIONS BASED ON LITERATURE 15th May, 2012 The provision of effective health care services in hospitals is becoming an increasingly complex issue, since most clinical research findings have been focusing on new techniques of diagnosis and treatment without a consideration on improved operating systems. However it has been observed that, perfection and improvement of the operating systems in the health care facilities have been given a relatively little effort (Brennan et al., 2004). This neglect has resulted in the adverse effects in medical care safety problems which is well documented in health care facilities data. This medical errors can cause a range of clinical consequences which includes, severe damages such as chronic pain, loss of sight, undiagnosed tumours, and even direct fatalities or may only result to indirect and mild clinicals effects (Ranger and Bothwell, 2004). The recent research studies has focused on ways of minimising the medical injury and malpractice litigation, and how this adverse effectscan be reduced by the medical hospital management in order to improve the quality of health care services in hospitals by clinicians. Lack of effecient patient identification systems It is now clear that for clinical services to achieve a quality delivery, a high degree of transformation in information technology is required, to assist in patient safety assurence especially in terms of effecient individual care services in the hospitals (Wolff and Bourke, 2002). This is because patients require a high diversity of customised health care services and wothout a proper identification, there might be instances of wrong medication or care services and patient. This has called for an efficient computerised system, to support highly individualised health care services as indicated for instance by dose adjustments for multiple levels of renal dysfunction (Bates and Gawaande, 2003). Human prescription of doses for multiple levels disease conditions can be highly improved by accurate computer-based decisions, and this results in the enhancement of physician performance and outcomes. Information and technology can improve health care service provision through strategies of prevention of errors and adverse events. This includes improved communication,ready accessability of medical knowledge, calculation and real time checkings, as well as provision of supprt decision on health care service delivery. Failure of communication among the healthcare professionals may lead to errors and adverse effects, and this can lead to poor service delivery in hospitals (Bates and Gawande, 2003). But this can be reduced by introduction of a new generation of technology which include a signing out computerized coverage systems, hand-held digital personal assistants, and electronic access of medical records (DHS, 2005). Technology can facillitate an improved exchange of information among clinicians, especially when a common clinical database is set to harmonise various applications, and thus preventing the errors resulting from inadequate access to clinical data. Effecient data systems can automatically and readily identify and rapidly portray possible difficulties experienced by healthcare professionals, and this will be communicated to authorities responsible for taking of an immediate action. Preventing errors in patient treatment—right patients right care Another area which can improve patient safety, is the reduction of adverse effects caused by a mismatch of clinical service to patients within an health care facility. The health care management needs to work with an objective of reducing and possibly eliminating the errors of matching of patients with their care, which accounts for a great number of medical care adverse effects (Ranger and Bothwell, 2004). Wrong presentation of medical prescriptions to patients may result to a wide adverse events to these patients, and this usually occurs due to lack of proper communication between the healthcare professionals working in an hospital and proper patient identification. These medical injuries can be prevented and for instance the National Patient Safety Agency which was established in July 2001 as a special health authority in England and Wales, has worked to improve patients safety on this grounds by development of a national reporting system. The mismatch of patient and clinical care can be reduced or even eliminated, if there will be a development of safe patient identification and check-up through applied modern technologies. This can be achieved by the use of barcodes, radio frequency identification with identical patient tags and use of biometrics which automatically identifies a patient based on the physiological and behavioural characteristics. Patients are required to wear an identification labelled-tag, with details of full name, admission number, date of birth, and ward (Runciman et al.,, 2003). Depending on the identification method, the patient may also be required to be barcoded with a machine readable information or a radio tag at the wristband. An alternative biometric identification such as an iris scan will be necessary to code for a unique number worn in a barcoded wristband (Department of health, 2000). This systematic identification will ultimately ensure an effecient identification of patients and thus matching them with their correct medications within the complex hospital environments. This identification is only limited to conscious and adult patients, and mentally unhealthy, psychiatric, distressed, and young patients can not be able to hold the identification tags for a long period of time (Cleopas et al., 2004). This can complicate the hospital system of information recording and data storage including patient identification. Lack of proper reporting system for adverse events Usually the seniour medical staff have been seen reluctant in reporting of clinical incidences and this is usually done by the juniour nursing staff. Thus medical schemes pay undue attention to the medical procedures excution by juniour nursing staff instead of focusing on the planning, coordination and administration of medical treatments carried by senior personnel. This may result in a biased participation in adverse events reporting, as the exposure time of nursing staff is also greater than their seniour medical staff counterparts (Johnson, 2003). Problems of elicitation of incidence reports and form completion, as usually in a busy hospital facility healthcare professionals rarely finds enough time to fill and channel this information to the correct authorities. For instance unlike computer data softwares, manual form completion is very difficult as multiple adverse events such as wrong medical admission may be difficult to record. There can be difficulties in data analysis of adverse events as these may reflect further differences between the aviation and healthcare units. The cost of setting a national data analysis and recording system may be high, since all medical events have to be covered by a group of dedicated employees for data coding. Due to this analytical tools, safety managers have stipulated and the schemes classified, to give an appropriate identification of causes of adverse event as shown by incident information (Reason, 2000). However these techniques show many limitations for example, more exhaustive taxonomies have a high probability of finding an incident and classification match or an extended classification can reduce the consistency of any similar adverse event analysis carried by different investigators. Complex and sophisticated computer programs despite being seen as more effecient than manual recording of adverse drug incidences they have been proved to be far much effective compared to chart reviews. This is because of the fact that they particularly identfies fewer cases of adverse drug events in hospitals, and different detection methods records different events (Kuperman et al., 1998). Recruitment of specialist expertise in the recording, storage, retrieval and subsequent interpretation of large data records may be necessary especially in incidences of adverse drug events and relying on conventional databases may be a risk to patient safety (Nickols et al., 2008). It is advantageous to include allternative techniques, such as free text retrieval to offer a greater human flexibility and support on the use of computer-based monitoring system for measuring adverse drug events occurences and thus formulate effective prevention programs. Some of the health care institutions may lack interest in getting data records of adverse drug events and their rates of occurences. This may render the process of implementing and maintaining adverse drug event surveillance systems irrelevant, as the management may find it a deficient in laying down a definitive strategy for their reduction (WHO, 2007). This can be achieved through research studies on the nature and frequency of adverse events in hospital settings and how formulation, implementation and evaluation of effective improvement strategies can be done (Kilbridge and Classen, 2006). Otherwise, hospitals should be able to set aside resources targeted for this oejective, as this can result in reduction of cases of adverse drug events and thus improve on patient safety in busy hospital environment. References Bates, D.W. and Gawande, A.A. (2003). Improving Safety with Information Technology. The New England Journal of Medicine 348(25): 2526‐2534. 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Available: www.health.vic.gov.au/sssl/ Wolff, A.M. and Bourke, J. (2002). Detecting and Reducing Adverse Events in an Australian Rural Base Hospital Emergency Department Using Medical Record Screening and Review. Emergency Medicine Journal 19:35‐40. World Health Organization (2007). Patient safety solutions. Patient identification. Geneva, Switzerland: World Health Organization, Volume 1, Solution 2. Read More