Organizational_Responsibility_and_Current_Health_Care_Issues

Organizational Responsibility and Current Health Care Issues HCS/545 Health Law and Ethics May 30, 2011 Dr. Ruth Bundy Organizational Responsibility and Current Health Care Issues Health care organizations are facing many issues today. These issues have a negative impact on the countries health care system. One example of the major issues they are facing is medical errors. Medical Error can be defined as a “preventable adverse effect of care, whether or not it is evident or harmful to the patient. This might include an inaccurate or incomplete diagnosis or treatment of disease, injury, syndrome, behavior, infection or other ailment” (The Free Dictionary by Farlex, 2011). Medical Errors are rising as one of the leading causes of death in the United States. Patient safety is a concern of growing importance that affects both patients and health care providers. This is also financially draining. The Institute of Medicine estimates that medical errors cost the Nation nearly $37.6 billion each year and that $17 billion of those costs are due to preventable errors (Harrington, 2005). This can be caused by both human and system errors. This is a major issue because patients are apprehensive about their lives and safety in the hands of health care providers. Medical Errors became prominent in 1999, when the Institute of Medicine published a report based on studies conducted in 1984 and 1992 that concluded 44,000 to 98,000 patients die every year in hospitals due to medical error (Harrington, 2005). After the report was published the Institute of Medicine mandated that all medical errors be reported. In addition, the Institute of Medicine formed a set of recommendations to reduce errors. They emphasized that the key to reducing medical errors is to focus on improving the systems of delivering care and not to blame individuals (Harrington, 2005). It is the responsibility of the hospital to report any errors and have doctors, nurses and other medical support staff, establish an error-reporting system that will reduce medical errors. An example of this is the incident that happened at Rhode Island Hospital in November, 2007. The patient had surgery on the wrong side of the head. The CT scan showed bleeding on the left side and the neurosurgeon began drilling on the right side (abcNEWS Health, 2011). Once the surgeon realized his mistake, he quickly closed up the hole and began performing surgery on the correct side. The patient was ok and the hospital was fined $50,000 for its transgression. Two other patients at the same hospital had surgery on their heads and one died three weeks later. The hospital has enforced new measures to prevent errors and promote patient safety; however they still do not know what went wrong and how this error was made. Another example is the much publicized overdose of Dennis Quaid’s twins. They were over dosed with heparin a blood thinning drug used to prevent blood clots. This accident happened at Cedars-Sinai Medical Center in Los Angeles. The hospital released a statement claiming this was a preventable error and they did not follow the proper procedure and protocol (abcNEWS Health, 2011). Luckily, the children survived especially since this drug is potent and could do serious harm to the children. There are also a lot of medical errors in intensive care units as well. In the intensive care unit, tension is high and everyone is busy trying to treat a patient as quickly as possible and to the best of their ability. In the intensive care units nurses developed strategies that identifies, interrupt and correct medical errors and to minimize preventable adverse outcomes (Henneman, Gawlinski, Blank, Henneman, Jordan, & McKenzie, 2010). In these intensive care units, nurses are emotional, and over worked, which also plays a major role in medical errors. If the system isn’t working, everything else will fail. These medical errors will have patients nervous about going to the hospital for treatment and care. It violates their right to safety, and autonomy by respecting their rights as patients, because they may not be informed that they were harmed in a medical error. It violates the ethics of nonmaleficence in that they are being harmed, as well as the ethics beneficence because the patient is not being protected. This can lead to patient’s view of the competency of doctors, nurses and staff. Overall, the general population has faith in their doctors and nurses. The population is trusting, with their lives and that of their loved ones. They are relying on doctors and nurses to perform correct surgeries, give them the proper care and treatment and to give them the right medication dosage for their needs. Lack of communication with the doctors and patients can also contribute to medical errors by administering and writing wrong medication. There are times that doctors write orders that the nurses and pharmacy technicians are unable to read, resulting in wrong medication doses or wrong medication on a whole. This is a communication error and one that is preventable. At my institution they have a hospital wide program called risk management. The program monitors missed routine doses, over dose of medication and administering of wrong medication. The year is divided up into four quarters; in addition, my hospital has incorporated hospital wide of physician’s, nurse practitioners and physician’s assistant’s entering doctor’s order’s as oppose to writing them on the carbon copy order sheets. They believe that computers assist with precise and safe administration of medicines. At the end of each quarter, an email is sent out to all nursing, medical support and administrative staff at the hospital comparing reports from previous quarters. This is a good method on following up and making sure that everyone is reporting their errors, whether they intervened in a potential error or unfortunately made an error. There is always room for improvement and the institution that I work for strives to improve the system on a whole, rather an individual. Everything is checked twice sometimes three times. The nurses and physician’s assistant are trained that if they do not understand a doctor’s order or dosage amount seems too high, to call the doctor no matter what. Anyone can make an error and if everyone works together for the safety of the patient, lives will be saved, and patients will feel safe in their care. As a manager I will implement workshops in an effort to reduce medical errors. In the workshops, the errors will have to be identified. In my attempt, I will try to develop a system or disclosure policy where doctors and nurses are reporting all errors. This will promote a value based ethical environment where an employee will want to do the right thing in reporting medical errors. This can include support groups where advice and support is given to a colleague and can lead to employees being honest with one another about medical errors as well as being honest to the patient and apologizing to the patient. Apologizing, demonstrates that people may make mistakes and that it wasn’t intentional, it also demonstrates integrity. In my attempt, I will not threaten immediate firing, should someone admit it right away that they made an error. This may be the only way to reduce it and keep it from happening in the future, because it will give us the necessary data for us to see how we are reducing medical errors. This would be hard to accomplish, because nurses and doctors will be in fear of losing their jobs, or embarrassed that they are not competent in their field, as well as all the legal issues such as lawsuits, they may face in dealing with a medical error. Reducing medical error is a goal that cannot be attained because of the inaccuracy of measuring errors (Harrington, 2005). It is hard to account for all errors that are being made because it is doctor’s, nurses or medical staff that will identify the errors and assess whether or not it is detrimental to the patient’s safety or illness, not computers. No one will ever know if all hospitals, clinics and medical facilities are reporting medical errors to even demonstrate if there is improvement on reducing medical errors. Quality and safety care are very complex in health care and shouldn’t be judged by statistics alone. There will always be under reporting of medical errors for various reasons, and we shouldn’t expect to have a problem free health care system. References Harrington, M. M. (2005). Revisiting Medical Error: Five Years After the IOM Report, Have Reporting Systems Made a Measureable Difference' Health Matrix: Journal of Law Medicine, 15(329), 329-382. Henneman, E., Gawlinski, A., Blank, F., Henneman, P., Jordan, D., & McKenzie, J. (2010, November). Critical Care Nurse to Identify, Interrupt, and Correct Medical Errors. American Journal of Critical Care, 19(6), 500-509. The Free Dictionary by Farlex. (2011). Medical Errors. Retrieved from http://encyclopedia.thefreedictionary.com/medical+errors abcNEWS Health. (2011). Medical Errors, Past and Present. Retrieved from http://abcnews.go.com/Health/story'id3789868