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Accountability important in healthcare
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Critical Analysis
Paradigm Shift
According to the Institute of Medicine (IOM) which has been on the forefront in undertaking research studies, pertaining to the prevalence of medical errors; systemic flaws are largely to be blamed for the high number of medical errors (BMJ Publishing Group Ltd 2011). The Hastings centre also shares the same sentiments when they state that “Many errors can be traced to flaws in complex systems of healthcare delivery, not flaws in individual performance” (The Hastings centre 2011, 5). These revelations come amid increased blame on healthcare workers for their apparent neglect of safe healthcare practices. IOM gives an example of poor communication between healthcare providers as one of the main problems associated with systemic flaws which consequently lead to medical errors. Because of this reason, the institute claims that focusing less on individuals and more on systems is likely to reduce the prevalence of medical errors.
This is one method through which people can bestow their trust again on the healthcare system and it is also a platform through which subsequent reforms can be done. One of such reforms is the importance of accountability when handling medical errors. The element of accountability deals in the restructuring of responsibility for medical mistakes and shifts the blame from individuals to rules, procedures and policies (The Hastings centre 2011). This therefore means that justice will be achieved for the injured people and statistics obtained from the process can also be utilized to further improve the system (in prevention of future errors). The entire essence of changing or reinforcing accountability standards is aimed at replacing existing health rules, procedures and poli...
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...to eliminate healthcare system--based errors through centralized records and other streamlining methods to improve processes. In doing so, it seems likely that our patients will gain confidence in us and our ability to help them navigate a complex and confusing system" (Science Daily 2007, 17)
Conclusion
Designing an efficient safety healthcare system will change the paradigm through which medical error occurrence is perceived from. It is also ethically correct to adopt this system because it is the fair way through which medical errors should be tackled. In other words, this study establishes that system flaws are the biggest cause of medical errors and therefore, it is unfair to place all the blame on healthcare personnel. These factors abound, this study proposes a shift in the contextual analysis of medical errors from the individual to the systems involved.
The Institute of Medicine (IOM) reported in 1999 that between 44,000 and 98,000 people die each year in the United States due to a preventable medical error. A report written by the National Quality Forum (NQF) found that over a decade after the IOM report the prevalence of medical errors remains very high (2010). In fact a study done by the Hearst Corporation found that the number of deaths due to medical error and post surgical infections has increased since the IOM first highlighted the problem and recommended actions to reduce the number of events (Dyess, 2009).
The world of healthcare changes every day. Technology, as we know it evolves and changes the actual care that patients receive and even post care as well. It has been determined that most faults are caused by system failures. When a break in the system has occurred it must then be decided where the,” inefficiencies, ineffective care and preventable errors” to then influence changes within the broken system (Hughes, 2008). Improvements sometimes can begin with measurements and benchmarks which in turn will allow organizations to assess the trouble spots and broken areas within the system. Many times those broken areas within the system will be owned by the humans who operate within these systems. According to the Institute of Medicine (IOM)
Kohn, L., Corrigan, J., & Donaldson, M. (1999). To err is human: building a safer health system. Committee on Quality of Health Care in America Institute of Medicine National Academy Press Washington, D.C.
The serrated edge of a blade cuts deeply into the unsuspecting victim. She lay unconsciousness while blood flowed into her abdomen. This was not part of the plan however. Unable to feel anything she gained consciousness and began to feel a strong pain in her stomach. She was unaware of the lethal puncture that was killing her with every breath she took. While she lay there, her stomach began to expand and her blood pressure plummeted. Just fourteen hours after the artery in Andrea’s spine was pierced, she died from internal bleeding.(hall) Got confused here While imagining Andrea Green’s situation did you envision a hospital? Oddly enough this was in a hospital, and the lethal laceration was a mistake made by English surgeon
Medical professionals have a better idea of what the system should have or be able to accomplish to allow the end-user to achieve a seamless workflow along with efficient and effective patient care.
Also, these studies question those who are effected; in this case, those who are most effected, is everyone. Doctors and nurses spend the most time working within these systems, but the information that is put into these systems effects every individual in America, because it is their information. Because nurses are often considered “both coordinators and providers of patient care” and they “attend to the whole patient,” their opinion is highly regarded (Otieno, Toyama, Asonuma, Kanai-Pak, & Naitoh, 2007, p. 210). It is clear that the use of these new systems is much debated, and many people have their own, individualized opinion. This information suggests that when there is a problem in the medical field, those who address it attempt to gather opinions from everyone who is involved before proceeding. It has been proven by multiple studies that this system of record keeping does in fact have potential to significantly improve patient health through efficiency, and it is because of this that the majority of hospitals have already completed, or begun the transfer from paperless to electronic (Otieno, Toyama, Asonuma, Kanai-Pak, & Naitoh,
It is shocking to know that every year 98000 patients die from medical errors that can be prevented(Kohn, L. T., Corrigan, J. M., & Donaldson, M. S. (Eds.), 2000). Medical errors are not a new issue in our healthcare system; these have been around for a long time. Hospitals have been trying to improve quality care and patients safety by implementing different strategies to prevent and reduce medical errors for past thirty years. Medical errors are the third leading cause of death after heart disease and cancer in America (Allen, 2013). In addition medical errors are costing our healthcare system an estimated $735 billion to $980 billion (Andel, Davidow, Hollander, & Moreno, 2012).
For most people, medical facilities are considered to be safe and healing centers, where people visit to improve their wellbeing. But it is very unfortunate that lot deaths are caused by errors committed by medical teams in this facilities. Every year, almost 144000 people die as a result of medical errors (The Leapfrog Group2015), which also took the life of an eighteen months old Josie in 2001 at John Hopkins Hospital. Josie’s death is very painful and sad as it is a result of avoidable medical errors. Josie’s death would have been prevented if she was provided with adequate care and close attention while she was exhibiting some changes in her behavior. Also, listening to the concerned mother who knows her daughter better could have also help prevent Josie’s death. and likewise, effective communication among the care providers would have made a great difference in the outcome of Josie’s care.
This process allows information to be readily available and transmitted to the right people which, in turn, increases process flow, leading to overall better quality of care for the patient. (Godby, Gomes, Valle, & Coustasse, 2016).
As Nissenbaum (1996) explains, there is a lack of accountability in healthcare information technology (HIT) systems for a number of reasons, including contract verbiage that prevents organizations from reporting issues or holding HIT vendors liable for system errors. Singh and Sittig (2002), indicate that determining the cause of patient safety events can be difficult because of the technical and non-technical factors that are involved in providing patient care now that HIT is so integrated into the healthcare system. This is similar to Nissenbaum’s barrier of too many hands as there are many individuals who play a role in the design, development, and utilization of HIT systems, so it can often be difficult to pinpoint where the error occurred, whether it could be identified, and who is accountable. Sometimes the issue is caused by an accumulation of several factors that when they occur in the same scenario cause the system failure. I’ve experienced the issue of the “bugs are common” with vendors in the past.
207-208, 2014). Besides the positive outcomes that an integrated information system brings to healthcare organizations, “many physicians are reluctant to implement EHRs due to financial constraints, usability concerns, and apprehension about unintended consequences, including the introduction of medical errors to EHR use”(Love et al., 2012). Nevertheless, “EHR systems offer opportunities to transform healthcare, but only if the systems are properly designed and used and the data in the systems are accurate (Bowman, 2013). Human errors can cause detriment to patients’ information and consequently to their health.
Keeping patients safe is essential in today’s health care system, but patient safety events that violate that safety are increasing each year. It was only recently, that the focus on patient safety was reinforced by a report prepared by Institute of medicine (IOM) entitled ” To err is human, building a safer health system”(Wakefield & Iliffe,2002).This report found that approx-imately 44,000 to 98,000 deaths occur each year due to medical errors and that the majority was preventable. Deaths due to medical errors exceed deaths due to many other causes such as like HIV infections, breast cancer and even traffic accidents (Wakefield & Iliffe, 2002). After this IOM reports, President Clinton established quality interagency coordination task force with the help of government agencies. These government agencies are responsible for making health pol-icies regarding patient safety to which every HCO must follow (Schulman & Kim, 2000).
Atul Gawande suggests that people should not be frowned upon for making mistakes, including doctors. Mistakes are inevitable in any field of study. Doctors have an extremely difficult job; therefore, when they make mistakes, it does not mean they are incompetent or lazy, it simply means they’re human. Doctors should not be castigated for their mistakes, rather they should be welcomed to share them. The mistakes that doctors make cannot be deterred; however, the machines that they use and the policies that are enforced in medical settings can be revised in order to reduce the amount of mistakes
When utilized and maintained properly, behavioral and mental health electronic medical records (EMR) strengthen patient-doctor relationships and support clinical and care-related activities. Centralizing all relevant data in a secure, paper-less environment enables quality of care management, outcomes reporting and decision support.
The health care is extremely important to society because without health care it would not be possible for individuals to remain healthy. The health care administers care, treats, and diagnoses millions of individual’s everyday from newborn to fatal illness patients. The health care consists of hospitals, outpatient care, doctors, employees, and nurses. Within the health care there are always changes occurring because of advance technology and without advance technology the health care would not be as successful as it is today. Technology has played a big role in the health care and will continue in the coming years with new methods and procedures of diagnosis and treatment to help safe lives of the American people. However, with plenty of advance technology the health care still manages to make an excessive amount of medical errors. Health care organizations face many issues and these issues have a negative impact on the health care system. There are different ways medical errors can occur within the health care. Medical errors are mistakes that are made by health care providers with no intention of harming patients. These errors rang from communication error, surgical error, manufacture error, diagnostic error, and wrong medication error. There are hundreds of thousands of patients that die every year due to medical error. With medical errors on the rise it has caused the United States to be the third leading cause of death. (Allen.M, 2013) Throughout the United States there are many issues the he...