Clinical Scenario of Mrs Gambal - Case Study Example

Running Head: CLINICAL SCENARIO OF MRS. GAMBAL Clinical Scenario Of Mrs. Gambal [Writer’s Name] [Name of Institute] Clinical Scenario Of Mrs. Gambal Berwicks Theory Of Continuous Improvement And Its Application To Mrs. Gambal Scenario Self-evaluation programs balance Berwick's Theory of Continuous Improvement for health professionals. Berwick disagrees that actual development in quality depends on comprehending and revising procedures on the basis of statistics about the procedures themselves. He describes that knowledge be offered to health care professionals, for instance pharmacists, based upon statistics that they can utilise and take action (Wiederholt, Schommer, Mount, McGregor and Braatz 2002). The primary advancement in presenting such knowledge should be one of education and communication somewhat than an implementing approach. An implementing approach describes evaluation and publication of insufficient performance (e.g., publication of reprimands, fines, and forfeitures levied on pharmacists) somehow will persuade otherwise apathetic caregivers to better their level of care and competence. Berwick proposed that dificulty in quality like non observance with pharmacy regulations are not due from shortage of motivation or hard work, but rather due to poor employment design, malfunction of leadership, or unobvious reason. If the danger of punishment is effectual at all, it applies only to a little of actual "bad pharmacy practitioners." For the greater part, using retribution as a motivator induces horor, which has been recogninized as a larger contraint to creating a surrounding that fosters quality betterment. While it is important to distinguish truly bad care and bad practitioners, it is significant not to poison the complete quality improvement procedure with a compulsive preoccupation with the most negative sections of the delivery system (AHA’s Quality and Patient Safety Agenda, Online). Deming Obstacles are as follows: expectation for instantaneous pudding (there are no straightforward solutions) The conviction that solving problems & using tools will source the required transformation  looking for examples (no theory) - replication will not work Obsolescence in higher-ranking staff improvement Poor or unsuitable use of data Use of predefined principles for approval Deming’s obstacle that examples should be searched and copying will not work agrees to Berwicks Theory Of Continuous Improvement. Since starting of Mrs. Gambal’s case, there was no improvement in handling of her case. The case was neglected from starting till the end. Previous reports were not considered where data could be achieved and no one listened to the patient queries (Jackson & Sevil, 1997, Pg 39-40). Organizational Culture In Clinical Scenario Of Mrs. Gambal In healthcare expertise, when raising a hospital with fresh technology there are three aspects that come into action: organizational culture, tactical planning and clinical/financial worth. If these three do not assemble with a selected technology, that technology will never work for the hospital. Policy-makers have forever found it challenging to put together fair and steady counting rules for public hospital outpatient actions. In the circumstance of output-based funding, such rules have results which can influence patient care. The culture found in Mrs. Gambal’s hospital case is very non professional. There are no senior staffs or concerned doctors available on time to attend the patients on time. There is o responsibility to keep patients records in safe. There is no one to ask the staff about their mistakes and they are accountable to no one (Plsek, 1999, Pg 206-208). Culture is the major concern for fitting technology at a hospital, making certain that the physicians and patients can change with little problems. The information technology staff has to find technology that the employees can exercise with little endeavor, which at the same time does not get in the system of how the hospital looks out for its patients (Chappell, 2005, Online). Unintended Outcomes From Clinical Scenario Of Mrs. Gambal And Its Impact On Her Satisfaction/Perception Of The Services Delivered With the purpose of succeeding in present market, providers require to focus their hard work on their most grave service lines with an eye in the direction of increasing their service volumes and revenues while noticeably improving effects and customer fulfillment. Through clinical services arrangement, providers of health care can get better the performance of their organization on a product-line level. Health care is an information-intensive industry, and information expertise holds momentous prospective to progress both the deliverance of health care and the consequential outcomes. Yet the industry all together remains years at the rear to other industries, for instance banking and finance, in the acceptance of information technology and the accomplishment of technology-enabled procedures (Chick, Sánchez, Ferrin, and Morrice, 2003). In this particular hospital where Mrs. Gambal was admitted, many accidental outcomes occurred during her stay in the hospital. Her CT scan results were lost due to which another similar procedure had to take place. She was forcefully given constipation tablets and unfortunately she fell on floor breaking her hip bone and was admitted to another hospital without her problem being properly solved. Key Principles Of Quality Used To Prevent Satisfaction/Perception Outcomes Millions of people obtain high-quality health care services. Though, too often, patients get extra services that demoralize the excellence of care and unnecessarily increase costs. At other times, they do not obtain services that have proven to be effectual at improving health consequences and even reducing costs (Research on Health Care Costs, Quality and Outcomes (HCQO), Online). In Mrs. Gambal’s case firstly she was very much delayed though admitted in emergency to look for. She and her family were never answered properly about any question regarding her health or operation to take place. The hospital staff should take particular care for elderly patients which were never taken in her case. She slipped due to mismanagement and bad surrounding which was never noticed or registered. Three Processes In Clinical Scenario Of Mrs. Gambal That Were A Patient Safety Issue Safety is the elementary foundation stone of the health care system. If care is not given in a safe mode in a safe surroundings, the chances of a good effect occurring is lessened considerably. Patients should not be debilitated by the care that is planned to help them, nor should harm to those who work in health care. Three procedures in this case of Mrs. Gambal which were patient safety issue are: Timeliness: Long stays in the emergency room or holdup in the beginning of operative or diagnostic procedures are a commonly accepted standard within health care at present. Because these kinds of delays can be an obstruction in patients getting timely care or providing treatments in an appropriate manner, we require getting everyone more concerned in making patient care procedures flow effortlessly. Efficiency: Efficiency does not mean maintenance of health care services. Relatively, effectiveness means eradicating medical errors and overdoes of services whose risks prevail over the advantage to the patient. Efficiency additionally means falling administrative costs by, for instance, eliminating duplicative paperwork, superfluous testing and frequent re-entries of various kinds of practitioner orders. Patient-Centeredness: The actual business of health care is about averting ill health, healing those who are not well, meeting the requirements of people who must live their lives with disabilities or chronic illness, and helping people in our communities attain improved health. Patient-centered care comprises esteem for patients’ values, preferences, and expressed wishes; the harmonization and incorporation of care; information, communication, and education; physical console; emotional hold up; and the participation of family and friends (AHA’s Quality and Patient Safety Agenda, Online). A process Improvement Model/Method That Could Be Used to Improve One of the above Processes and How It Can Be Used Every hospital is responsible for providing the maximum quality of patient care to every patient, every day. It is this responsibility that serves as the basis for the culture of each hospital, and it should be one of the foundational motivations for every medical professional. Quality plans help to ensure that hospitals will have a systematic method of providing the highest quality of care. Many new hospitals are experiencing an increase in quality of care with the development and implementation of a Continuous Quality Improvement Model, or CQIM, used with the coding procedure in government-sponsored teaching hospitals in the major cities. Thus far, the success of this model has been measured by noting improvements in the decreased errors, and increased quantity of coding outputs once the CQIM was implemented. CQIM is just one of the ways in which health information managers can improve the coding procedure and make the acquisition and utilization of data more conducive to high quality medical care (Quality and Patient Safety Background, Online). CQIM has been modified for health care in more than a few ways. One acronym for this is FOCUS-PDCA work: Initially, FOCUS on a particular concern. Find a procedure to develop Organize to get better a procedure Clear what is known Understand disparity Select a procedure improvement Then, move through a procedure improvement plan, PDCA Plan: produce a timeline of resources, activities, teaching and objective dates. Build up a data collection sketch, the tools for measuring results, and threshold for shaping when targets have been met. Do: put into practice intercessions and collect data. Check: examine results of data and assess reasons for distinction. Act: act on what is learned and establish next steps. If the intervention is doing well, work to make it part of standard operating process. If it is not doing well, examine sources of malfunction, design fresh solutions and recur the PDCA cycle. (Healthcare Services, Online) Role Of Clinical Governance In The Prevention Of The Problems That Occurred In Clinical Scenario Of Mrs. Gambal The NSW’s Clinical Excellence Commission is guided by seven principles: openness about failures, emphasis on learning, obligation to act, accountability, just culture, appropriate prioritization of action, and teamwork and information sharing. The idea of a just culture would seem to mandate keeping a closer eye on Mrs. Gandal’s catheter, so she would not reach the level of discomfort that she experiences before her operation. While the nurse is open about the failure involved in misplacing Mrs. Gandal’s chart, a better system of teamwork and information sharing might have kept the chart in someone’s conscious possession, and it might have led the custodial staff to notice and mark the puddle water on the ground where Mrs. Gandal slipped, and it might have led the ordering department to keep a supply of fluid orders around. Information About Tools, Resources And Other Quality Improvement (QI) Strategies That Could Be Used To Improve Service Monitoring And Evaluation In This Organization The Incident Information Management System (IIMS) has been utilized in NSW Area Health Services since May 2005. Its goal is to identify, track and manage clinical, workforce and corporate incident information throughout the entire NSW health system. It could potentially link 100,000 users, which includes all NSW health system employees and contractors. (Quality and Safety, Online.) Over time, tracking cases like Mrs. Bandal’s could help hospital administrators to determine the causes of such lapses in quality of care. Bibliography AHA’s Quality and Patient Safety Agenda, Helping you do what is best for your patients, Online: http://www.aha.org/aha/key_issues/patient_safety/contents/QualityInsertJuly2004.pdf Bale, J. and Krohn, R.; Performing Physician Organizations, accessed July 22, 2003, Available online via http://www.healthsystems direct.com/article8.html Fact Sheet; Improving Health Care Quality, Online: http://www.ahrq.gov/news/qualfact.htm Healthcare Services, online: http://www.mitretek.org/HealthcareServices.htm Jackson T, Sevil P.; Problems in counting and paying for multidisciplinary outpatient clinics, Monash University Health Economics Unit, Aust Health Rev. 1997;20(3):38-54. Joseph B. Wiederholt, Jon C. Schommer, Jeanine K. Mount, Thomas D. McGregor, Patrick D. Braatz; American Journal of Pharmaceutical Education, (US ISSN: 002-9459), Contents: Volume 66, Number 1, (Spring 2002). Les Chappell; Health Technology; Digitizing hospitals with the right tools, Published 06/14/05, Online: http://wistechnology.com/article.php?id=1905 Paul E. Plsek; Evidence-Based Quality Improvement, Principles, And Perspectives: Quality Improvement Methods in Clinical Medicine, Roswell, Georgia, Pediatrics Vol. 103 No. 1 Supplement (January 1999), pp. 203-214. Prevention Better Than Cure - Ensuring Safer Patients And Better Doctors, Roles And Responsibilities, Online: http://www.scotland.gov.uk/library3/health/pbtc-07.asp Principles, Online: http://www.cec.health.nsw.gov.au/principles.html#obligation Quality and Patient Safety Background, Online: http://www.hospitalconnect.com/aha/key_issues/patient_safety/background/background.html Quality and Safety, Online: http://www.health.nsw.gov.au/quality/iims/index.html Research on Health Care Costs, Quality and Outcomes (HCQO), online: http://www.ahrq.gov/about/cj2002/hcqo02a.htm S. Chick, P. J. Sánchez, D. Ferrin, and D. J. Morrice, eds.; Simulating Six Sigma Improvement Ideas For A Hospital Emergency Department, Proceedings of the 2003 Winter Simulation Conference. Read More