Patient Safety and Risk Management - Coursework Example

?Patient Safety & Risk Management The issue of accountability, responsibility, and professional ethics has been a looming problem in the health sectors for a long time. The patient safety document that was released as a result of this concern recognizes the fact errors in the medical profession are caused by hardworking, committed, and good people who try to do the right things in serving patients (Wachter & Pronovost 2009, 1401). The document suggests shifting attention from finding out who is responsible for these errors, to new ways of arresting these errors before they reach patients and cause harm. This was a positive move that led to a drastically shift from perfecting the doctor’s prescriptions and handwritings, to involving computerized systems, which can to stop errors before they reach the patient. The increasing use of evidenced based prevention strategies were also embraced to ensure these errors were prevented. However, concerns were later raised concerning this ‘no blame’ approach to new ways of indentifying and dealing with poorly performing health practitioners; stressing on responsibility and accountability. The idea of shifting from a blameworthy to blameless culture was also floated. Rather than viewing problems as systems problems, the culture of viewing them as accountability problems was able to reduce some of the problems such as low hand hygiene significantly, making surgeries safer (Wachter & Pronovost 2009, 1402). The article therefore elaborates how to strike an acceptable balance between errors caused by lack of accountability, and those that result from the system where such practitioners cannot be blamed for their occurrence. Wachter & Pronovost (2009, 1402) elaborates that the cost of failure to adhere to professionalism and enforcement of safety standards in United States accounts to about 4000 wrong-side surgeries. This is despite the fact that these errors may be preventable through strict adherence to Universal Protocol, which clearly outlines the correct surgery sites to be followed by all surgeons. Campbell, Chin & Voo (2007, 431) argues that over the past few decades, medical profession has evolved to come of age, in enhancing more ethical practice. The above patient safety document is an example of actions being taken to ensure this objective is met. However, the above large number of poor surgical cases portrays a weakness on effectiveness of these approaches. This implies doctors are employed in the medical fraternity due to their skills and academic qualifications, devoid of imparting and stressing adherence to standards as a norm or culture in the medical field. Though the article provides concerned efforts towards solving this problem such as enhancing hygiene and computerization of systems, the large numbers of unethical practices portray ignorance is live in the medical field. Marx argues the importance of stressing on a just culture which is blameless rather than trying to solve the problems of blameworthy acts (Wachter & Pronovost 2009, 1401). This can only be possible through strict ethical practices that are well integrated within the medical profession from early training stages. Rather than finding ways to improve the hand hygiene problem, this weakness can be narrowed down to lack of ethics and professionalism in the medical fraternity. The issue of systems is a pertinent issue in the medical fraternity. For example, Wachter & Pronovost (2009, 1402) argue that in order to create safer activities, the medical fraternity is looking towards other industries to learn how these safety mechanisms, are implemented. To support this, the idea that a pilot who ignores the slightest use of checklist in the aviation industry cannot be allowed to fly, is floated as the best example. This is a good proposal as it deals with strict code of conduct in a profession, which forms a culture in such operations.. Patient welfare is central in the medical field. Brockopp & Eich (2007, 163) argue that in the current highly technologically advanced settings in the medical care, important key principles in social welfare have to stand out. Campbell, Chin & Voo (2007, 432) notes that an ethical doctor has to have the welfare of his patients at heart, has to have the ability to deal with uncertainties and complexities, and has to have all the qualities that a patient would be looking for in a physician. Quality and advanced systems in the medical practice have to be used in operation cases as outlined. However, systems are not enough to deal with patient’s welfare and mechanization of the process. Through these highly placed qualities in the medical fraternity, the idea having elaborate mechanisms to watch and follow up on doctor’s to indentify the less accountable ones would not exist. In addition, most hospitals are at fault of hiding and failing to take necessary steps to negligent doctors in fear of losing business (Wachter & Pronovost (2009, 1403). Systems are therefore not to blame; the lack of ethics and morals in patient’s welfare is to blame for the largest number of slips in medical activities. In addition, systems are operated by people and do not function independently. Most of system faults can be traced down to lack of accountability in the relevant persons. Elsayed et al (2009, 286) notes that medical ethics have to be understood as applied professional concept, apart from the concept of avoiding doing harm to patients. This would require acknowledging that medical professionals are confident regarding medical ethics, as an essential branch of general ethics, and as the most valuable framework that would guide in defining the norms of medical care. The above suggestion would be an ideal answer to the above pertinent questions raised by Wachter and Pronovost. The issue of preferring to work on easy and less contentious safety activities, which include computerization and use of checklists (Wachter & Pronovost (2009, 1403) though essential in the medical practice would amount to burying the real problem at the bottom of the deck. Hope (2004, 58) explains the importance of taking medical practice as a questioning and critically reflective discipline. The role of philosophy in this case as Hope elaborates would be to offer a critical view through critical reasoning, and subjecting this reasoning to critical analysis. Some of the best questions that may be used to enhance the issue of accountability raised by Wachter and Pronovost, as Hope elaborates should include: what is the evidence that this is the best treatment? How good is this evidence? What are the evidences that would support an alternative treatment? These questions in addition to philosophy, which demands reason for moral choices (Hope 2004, 58), would be the key to enhanced accountability in the medical profession. The patient safety movement was launched to increase safety during surgery, heavily borrowing form practices in other industries. The plan was to balance accountability and the use of systems to shift some of the blame from the practitioner in cases of any mishap during patient- practitioner encounter. Though computerized systems have been embraced as the best approach to arrest any harm before it reaches the patient, the effectiveness of these systems in removing the blame from practitioners is still delicate; accountability still remains as the largest cause of mishaps in patient safety. Though the article has strengths in proposes ways in which accountability and safety may be enhanced, these approaches are not enough to solve the issue of patient safety during surgery. Medical ethics and professionalism is the most important norm that can be enhanced to reduce these mishaps. The weakness of this article is trying to shift the responsibilities from the medics themselves, but not solving the actual cause of these mishaps. Negligence, lack of ethics and norms, and lack or moral responsibilities are the key towards ensuring patient safety in surgery. A good doctor has to have the welfare of the patient at heart, and has to maneuver complex and uncertain paths to ensure the patient is treated as required. This would eradicate the enhanced use of standards as proposed; these would be elaborate in the very cultural norms of the medical practitioner, if the patient’s welfare is held at heart. Though many mishaps occur as doctors try to do what they know is right, ignorance in some cases accounts to these mishaps, as doctors believe they are too competent and knowledgeable enough to jump some required protocols. This can only be solved though cultivating ethics and norms in the early training of these medical practitioners. References List Brockopp J.E., & Eich T., 2008. Muslim Medical Ethics: From Theory to Practice. Columbia: South Carolina Press. Campbell A.V., Chin J., & Voo C.T., 2007. How can we know that Ethics Education Produces Ethical Doctors? The Medical Teacher, 29; pp 431-436. Elsayed D.E. & Ahmed, R.E.2009. Medical Ethics: What is it? Why is it important? Sudanese Journal of Public Health, 4(2); pp 284-287. Hope R.A., 2004. Medical Ethics: A Very Short Introduction. Oxford: Oxford University Press. Wachter R.M., & Pronovost, P.J., 2009. Balancing “No Blame” with Accountability in Patient Safety. New England Journal of Medicine, 361; 14. Read More