...Running head: QUALITY AND SAFETY IN HEALTH CARE MANAGEMENT 1 Quality and Safety in Health Care Management Murimi Stephen muriets@gmail.com JKUAT December 2014 QUALITY AND SAFETY IN HEALTH CARE MANAGEMENT 1. Introduction 2 Although health care facilities are designed to ensure people are safe, they remain a dangerous place to be (Mitchell, Gardner, & McGregor, 2012). The sources of risks in the hospital include medical errors, falls, and health care associated infections (HAIs). The World Health Assembly (WHA) held on 18th May 2012 passed a resolution that addressed the issue of patient safety and quality in health care (Briš & Keclíková, 2012). WHA called for continued improvements in health care quality and patient safety (Briš & Keclíková, 2012). Therefore, there is a need to evaluate the existent health care systems in order to identify the causes of risks and come up with a plan that can improve health care standards. The plan should also aim at improving the safety techniques applied in other high risk industries, such as the mass transportation, chemical engineering, and nuclear power generation sectors (Shillito, Arfanis, & Smith, 2010). According to the accident causation model developed by Reason in 1990, accidents are caused by many factors that work in concert (Shillito, Arfanis, & Smith, 2010). Such accidents must be prevented by instituting the necessary checks and controls within the system (Shillito, Arfanis, & Smith, 2010). According to Shillito...
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...Organizational Organizational Culture Analysis There is no single definition of organizational culture. One of many definitions states that organizational culture is a set of values and behaviors that contribute to a unique social and psychological environment of an organization (Schein, 2010). In the past 30 years, the interest in connection between organizational culture and organizational success has increased. The link between organizational culture and its success is far from certain. Each organization has a unique social structure that drives much of the individual behavior of its members. Organizational culture is difficult to observe, measure, or sketch. It can support and/or reinforce organizational structure, it could conflict with it, and it could be of an alternative to it. This paper will analyze organizational culture of Hospital. The author will attempt to identify and provide examples of the artifacts, values, and underlying assumptions of the Hospital culture. The data for this analysis was collected through direct observation, review of internal materials published by the Human Resources (HR) Department, and reports provided by external consultants and the State of Maryland. The observations are based on direct interactions with current employees of the Hospital. Employees observed represent executives, senior level management, clinical staff, and the bottom line. HR materials used for this analysis are published on the Hospital internal website that...
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...Running head: QUALITY AND SAFETY IN HEALTH CARE MANAGEMENT 1 Quality and Safety in Health Care Management Murimi Stephen muriets@gmail.com JKUAT December 2014 QUALITY AND SAFETY IN HEALTH CARE MANAGEMENT 1. Introduction 2 Although health care facilities are designed to ensure people are safe, they remain a dangerous place to be (Mitchell, Gardner, & McGregor, 2012). The sources of risks in the hospital include medical errors, falls, and health care associated infections (HAIs). The World Health Assembly (WHA) held on 18th May 2012 passed a resolution that addressed the issue of patient safety and quality in health care (Briš & Keclíková, 2012). WHA called for continued improvements in health care quality and patient safety (Briš & Keclíková, 2012). Therefore, there is a need to evaluate the existent health care systems in order to identify the causes of risks and come up with a plan that can improve health care standards. The plan should also aim at improving the safety techniques applied in other high risk industries, such as the mass transportation, chemical engineering, and nuclear power generation sectors (Shillito, Arfanis, & Smith, 2010). According to the accident causation model developed by Reason in 1990, accidents are caused by many factors that work in concert (Shillito, Arfanis, & Smith, 2010). Such accidents must be prevented by instituting the necessary checks and controls within the system (Shillito, Arfanis, & Smith, 2010). According to Shillito...
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...A culture of safety includes the organization’s activities, standards, approaches, communication methods, and leadership attitudes to prevent or minimize adverse events, and to support safety behaviors at all levels. “Improving the culture of safety within health care is an essential component of preventing or reducing errors and improving overall health care quality” (“Safety Culture,” 2016). A culture of safety would benefit Drew’s case and the patient’s at his hospital, because a culture of safety promotes the staff’s commitment, confidence, increase the staff’s morale, and consistently safe behaviors among leaders and healthcare providers. In addition, a culture of safety would improve the communication and collaboration between co-workers,...
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...Of Medicine report (IOM, 1999 ), as high as 98,000 patients die in hospitals each year as a result of preventable medical errors [2] which makes medical errors the second leading cause of death in US. . The report further estimates that, medical errors cost the nation approximately $37.6 Billion each year; about $17 billion of those costs are associated with preventable errors. Medication incidents are commonplace in healthcare [1, 2, 3, 4, 5]. In Australian study, out of over 14,000 admission records reviewed, 16.6% of admissions were associated with an "adverse event",[6]. A study by Ahmed E Aboshaiqah...
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...Analysis of Organizational Culture HAD 5731 Fitzpatrick, Harris, Kerr, Malhotra, Perkins, Salisbury, Topping Introduction Organizational culture encompasses the fundamental values, assumptions and beliefs that are held in common by members of an organization (Helfrich et al, 2007). Culture can be characterized as a basic implicit theory of mutual assumptions, invented, discovered, or developed by a group that determine how they think, feel and behave as they assimilate internally and adapt to the external environments of an organization (Schein, 1996). Culture is an important variable that defines an organization and has significant implications on its ability to be effective and efficient. Culture can be a critical barrier to leveraging new knowledge and implementing technical innovation (Helfrich et al, 2007). This paper will first provide an overview and analysis of the cultures and subcultures of two Ontario healthcare organizations - Trillium Health Centre (THC) and Credit Valley Hospital (CVH) in the context of a recent voluntary merger of the two organizations. The paper will then examine the impact of the dominant and sub- organizational cultures on the capability of the two organizations to be more effective, efficient and patient focused, as will the ways in which these cultures create barriers to current change efforts. Finally, the paper will identify recommendations for the merged leadership of the organizations to consider in order mitigate the identified...
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...Please write an Op-Ed to your newspaper of choice in which you argue for national attention to quality and patient safety improvement OR to expanding access and equity in the U.S. health care system. For those that write about quality, you may wish to include discussion of some of the following: provide evidence on the current state of quality and patient safety in the U.S. health system: National attention is currently focused on the debacle of The Affordable Care Act’s (ACA) roll out. The Federal Health Exchange website, cancelling of thousands of insurance plans and the dismal enrollment numbers are some of the items inundating our headlines. One of the main goals of the ACA is to improve access to health care. It seems as though, with all the partisan squabbling, we do not see much in the media about how the ACA plans to address safety and quality issues. Medical errors and unsafe care are responsible for the death of an estimated 90,000 patients each year, costing more than $4.5 billion in hospital health care costs. According to the Agency for Healthcare Research and Quality (AHRQ), healthcare associated infections are one of the top 10 leading causes of death in the United States with approximately $33 billion in excess health care costs per year. For solutions to the healthcare cost conundrum, this is arguably the prime target for reduction. However, addressing the quality issue does come with its own challenges. For the most part, quality is seen as a quantity...
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...Chelsea Millard Performance Measures An intensive care unit (ICU), also referred to as a critical care unit, is a healthcare operating unit that treats persons who have been inflicted with life-threatening injuries and illnesses. Patients in an intensive care unit are observed closely by specially trained health care providers. Problems that are treated range from accidents to severe breathing problems. Patients are normally exposed to monitors, intravenous (IV) tubs, feeding tubes, catheters, and breathing machines. These particular items are used to extend a patient’s life, but infection risk can become common also. In an intensive care unit, many patients recover and are moved to a regular hospital room to receive care. Death is a common outcome for patients in an intensive care unit. If a patient’s family and health care providers have to make end-of-life decisions, advance directives will help the individuals come to a final decision (“Critical Care“). In the article “The Competitiveness and Balanced Scorecard of Health Care Companies,” the balanced scorecard has become an idea that has become influential to the business aspect. A balanced scorecard measures employee knowledge, relationship with customers, cultures of innovation, and change generated success. Many businesses has improved their performance by improving processes and becoming more competitive in the market (Mavlutova, Babauska, 2013). In the article “Pabon Lasso and Data Envelopment Analysis: A Complementary...
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...instance of leading” (2012). Nurses, in their role as manager of patient care, have many possibilities for exerting leadership on an interdisciplinary team. One way that a nurse can exert leadership is to motivate her peers to take action when presented with a problem. Too often, people are prone to complaining or complacency when confronted with a problem. People believe that the problem is something that is out of their control, or may simply not have the empathy to clearly understand that the problem at hand is important (Kruger, 2010). For example, there has been a recent increase in Emergency Department activity in the past few months. Due to the hustle and bustle on the unit, rooms are not getting cleaned by Environmental Services as quickly as they should, but the rooms are being cleared on the tracking board (a computer program that shows the status of all of the ED rooms). This is causing a problem with the triage nurses, as they are bringing patients back to dirty rooms and must return patients to triage while the triage nurse cleans the room. This backs up triage even more, and causes a cascade of events that breaks down the flow of patient traffic into rooms. Rather than complaining, two of the nurses on the unit decide to take action. They ask the Unit Secretary to not take patients off of the tracker board until the room is cleaned. This will prevent the triage nurse from bringing the patient back to a dirty room. The nurses also ask their charge nurse if Environmental...
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...at the patient bedside, the nurse has a unique position to see many problems first hand and can become an advocate for the patient. Acting as this patient advocate, the nurse can be a leader by identifying the problems and coordinating efforts with the entire team for a solution. The nurse must communicate effectively to make sure information is relayed correctly and in ways each team member can identify with. Again because the nurse is at the patient bedside, the nurse is in a critical leadership role to provide follow up reports and update the team regarding improvements. Another way the nurse provides leadership on an interdisciplinary team is by reviewing current problems with the team and explaining current work flow from the nurse perspective. This allows all team members to understand the situation first hand rather than just as a problem on a report. By showing respect as other team members share their perspective, the nurse is also showing leadership skills and can become a role model for other co-workers. Additional leadership skills shown are “cooperation, commitment, and a willingness to accomplish shared goals.” (Cherry, 2011). C. Active Involvement It is important for a nurse to be actively involved in the interdisciplinary team since teamwork and communication are essential in patient care. Communicating effectively is one way a nurse remains involved in the interdisciplinary team. As stated above, the nurse has a firsthand view of patient care and...
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...Nursing Contributions in the Promotion of Safety Western Governor’s University Interdisciplinary teams are formed in most hospital settings. The individuals involved in the total care of a patient come together to discuss, plan, and implement patient care or care based improvements in protocol. Discussions on proposed topics reviewed by the team present an opportunity to weigh out all options and develop the best way to resolve issues with which they are faced. These teams give nurses the opportunity to be actively involved in determining the path of care of their patients. When a nurse serves on the team, they can exhibit leadership qualities without serving in the capacity of an official role. Often the role of the nurse is overlooked by other members of the team. The role of the nurse is to serve as an advocate for their patient and to work in their best interest toward their full recovery and well-being. This can be fulfilled by displaying certain characteristics. Examples include embracing effective teamwork skills and communication and also promoting safety during planning. Effective teamwork and communication helps a nurse to display a sense of leadership and confidence in her own abilities and judgments. According to the Institute for Healthcare Improvement, possessing these qualities will “help groups navigate competing priorities” (PS-103). Utilizing these qualities will allow groups to work in an environment of togetherness and success...
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...2012 Risk Management Plan for Little Falls Hospital Patient Safety and Risk Management Program 1. Purpose: The Risk Management Plan is designed to support the mission and vision of Little Falls Hospital as it pertains to clinical risk and patient safety as well as visitor, third party, volunteer, and employee safety and potential business, operational, and property risks 2. Culture Principles: The Patient Safety and Risk Management Program supports the Little Falls Hospital philosophy that patient safety and risk management is everyone’s responsibility. Teamwork and participation among management, providers, volunteers, and staff are essential for an efficient and effective patient safety and risk management program. The program will be implemented through the coordination of multiple organizational functions and the activities of multiple departments. Little Falls Hospital supports the introduction of a just culture that emphasizes implementing evidence-based best practices, learning from error analysis, and providing constructive feedback, rather than blame and punishment. In a just culture, unsafe conditions and hazards are readily and proactively identified and admitted, medical or patient care errors are reported and analyzed, mistakes are openly discussed, and suggestions for systemic improvements are welcomed. Individuals are still held accountable for compliance with patient safety and risk management practices. As such, if evaluation and...
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...Abstract Healthcare unlike many high-risk industries has made slow progress in improving patient’s safety. The role of nursing in improving medication safety has been largely underestimated. Much of the research undertaken to date in relation to adverse medication events has neglected the impact that nurses have or could have in improving patient safety. In examining literature regarding adverse medication events one can see the urgent need for significant improvement in medication practices and processes. In addition that this health care issue will only improve with the participation of all disciplines working towards a common goal of improving the safety of those in our care. Introduction Medications play a key role in healthcare but can also be a significant key cause of medical error and of adverse patient outcomes. Nurses by the nature of their roles in medication administration can be the last line of defense in eliminating or reducing adverse medication events. The administration of medication is a common and almost routine activity in a nurse’s daily work, yet it is fraught with complexity and risk for both the patient and nurse. As a student nurse working in partnership with a registered nurse I have observed a variety of practices in medication administration that have varied from what I have been taught in class. On reflecting on these practices and questioning nurses why such practice has been adopted has illustrated to me both the flawed processes and environment...
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...management in organizations. The objective of the study was to assess the culture of the health care organization and how it influences organizational behavior, as well as productivity. The study also seeks to identify the comparisons of one organizations culture to the culture of the other. This paper will also examine the easiness to change an unhealthy or unproductive organization to a healthy one with time. Health Care Management Culture of a Health Care Organization Culture is ‘how and why you do things the way you do'. It is comprised of the strategies within a health care organization. It is made up of unwritten rules governing behavior in the organization. These rules are the norms, values, believes and assumptions that lead to excellence in duties performed within the organization. In a health care organization, different units have different cultures leading to their set goals. Climate of a Health Care Organization Organizational climate refers the employees' perception of the organizational culture and is easily measured through patient turn over and employee outcomes. Members' perceptions of organizational features involve; decision-making, leadership, and norms about work. Culture and climate are linked to behavior, attitudes, and motivations among clinicians. These orientations and behaviors can affect the quality of processes and outcomes. Recent studies show that employees in climates and cultures that have supportive and empowering leadership and organizational arrangements...
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...hospital, patients, visitors, volunteers, and employee safety, and any possible operational, business, and property risks. Culture Principles The Patient Safety and Risk Management program will support Little Falls Hospitals philosophy; everyone is responsible for patient safety and risk management. It is essential to have participation and teamwork among providers, management, staff and volunteers. The Patient Safety and Risk Management program will be implemented with the coordination of multiple organizational and department functions and activities. Little Falls Hospital will support the introduction of a just culture with emphasis on evidence based best practices, learning from errors, and providing feedback instead of punishment and blame. In a just culture any unsafe conditions or hazards will be identified quickly, medical or patient care errors will be reported and analysed, open discussions of mistakes and suggestions for improvements are welcome with patient safety and risk management practices. Individuals will still be held accountable for compliance. When evaluation and investigation into errors reveals there has been reckless behaviour or there has been wilful violation of policies then disciplinary action may be taken. Development, review, and revision of the practices and protocols of the organization are stimulated by the hospital risk management plan in view of identified risks and the chosen loss prevention and reduction strategies Good patient-physician...
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