Application of Quality and Safety Concepts Case Study

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Introduction

In the US, healthcare safety isn’t up to the mark, as it ought to be. Figures from a couple of important research works reveal that between 44,000 and 98,000 individuals lose their lives per annum within healthcare settings owing to preventable clinical errors. Even if one uses the lower figure, preventable clinical mistakes within healthcare facilities surpass mortality attributed to feared risks like motor accidents, AIDS and breast cancer. The term ‘clinical error’ may be described as non-completion of an action according to plan or employing the wrong plan for accomplishing an objective. The issues which mostly crop up whilst delivering healthcare services to patients include wrong transfusions, adverse medication related events, operation-related injury, wrong-site operations, mistaking patient identity, suicide, pressure ulcers, restraint-linked loss of life or injury, falls, and burns. Error cases that have the gravest consequences will most probably transpire in ICUs (intensive care units), emergency rooms, and operation theatres (IOM, 1999).

Ordinary people hold the view that technological advancement means improved efficacy, safety, expenses and quality of health care services delivered. But there are some who feel that these very same advancements can give rise to adverse events and clinical errors. Considering the fact that several million healthcare practitioners worldwide utilize almost 5,000 kinds of clinical tools and equipment, such device-linked issues are unavoidable. Even with the above challenges, mistakes and inefficiencies persist within the healthcare domain owing to the low-key technology utilized by the sector for management. Most healthcare systems across the globe continue to stick to a pen-and-paper system, including those in developed nations such as America. This is an obstacle on the medical science path as well as gives rise to regression due to the waste caused by it. Besides patients paying the price through adverse health events and inconvenience, there is also an increase in litigation and administrative costs on account of such mistakes and inefficiencies (Amit, 2019). Of particular concern is: patient information exchange when patients are shifted between departments or hospitals. Conventionally-performed record sharing of patients is ineffective and time-consuming, as well as puts patient data in jeopardy (i.e., risk of data leaks and loss of confidentiality/ privacy). Inefficient or partial information interchange may be highly dangerous if the patient requires complex or emergency treatment.

Hence, this paper holds that the sole means of addressing the above-mentioned medical problems is through the utilization of more, advanced technology for delivering an all-inclusive healthcare experience to allow diverse entities participating in the healthcare process (namely physicians, patients, and healthcare insurance and scheme providers) to exchange patient data in a secure and timely manner.

Brief literature review

Federico and Alotaibi (2017) state that ever since the IOM (Institute of Medicine) report was published, health IT (HIT) is being created and implemented at a quicker pace, with varying levels of evidence regarding health IT’s effect on the safety of patients. The report analyzed existing scientific proofs regarding the influence of diverse HITs on patient safety result improvements. It was concluded that HIT gives rise to patient safety improvements through decreasing clinical errors and adverse reactions to medication, in addition to improving adherence to clinical practice guidelines. Furthermore, it was concluded that HIT constitutes a key instrument when it comes to improving the safety and quality of healthcare. Hospitals and other healthcare facilities must selectively choose technologies for investment, since research works reveal that certain technologies have only limited evidence when it comes to improving the safety outcomes of patients.

Sittig and Singh’s (2016) study indicates that HIT is capable of bringing about patient safety improvements, though its adoption has resulted in unintentional outcomes and fresh safety-related concerns. One of the major challenges to improvement of HIT-enabled hospital system safety is: development of effective, reasonable approaches for the measurement of safety concerns where HIT intersects with patient safety. As a solution to the basic methodological and theoretical gaps that are associated with the definition and measurement of HIT-linked patient safety, the authors put forward a novel framework labeled HITS (HIT Safety) measurement, for offering a theoretical basis for HIT- linked patient safety improvement, measurement, and monitoring. This framework abides by sociotechnical as well as CQI (Continuous Quality Improvement) strategies and demands novel measurement tasks and measures for dealing with safety concerns.

Feldman, Hayes, and Buchalter’s (2018) article titled “Health Information Technology in Healthcare Quality and Patient Safety: Literature Review” assumed the form of a review of literature for identifying peer-reviewed texts dealing with actual HIT employment in the areas of patient safety and healthcare quality. The authors classified 41 research works through the use of inductive thematic studies with open coding. They utilized 3 pre-established groups, namely, prevention, action, and identification.

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Coding helped create 3 more groups, namely, challenges, location, and outcomes. This research aimed at providing a basis to comprehend where to concentrate HIT linked human and financial resources, in addition to expectations for HIT implementation for patient safety and healthcare quality, since the above two areas are beginning to adopt HIT for preventing preventable events, taking action in case of inevitable problems, and identifying preventable events prior to their development into actual problems. Hospitals considering HIT utilization in this domain are usually uncertain of where to concentrate human and financial resources.

Description of the situation from a theoretical perspective

HIT has been conceptualized to cover information technology articles and associated nomological networks that encompass systems promoting the healthcare goal, including CDSS (clinical decision support systems), EHR/ EMR (electronic health/ medical records), CPOE (computerized physician order entry), PCHR (personally-controlled health record which can be accessed by patients as well as their doctors in different ways), (Halamka, Mandl, & Tang, 2008) admin support functional systems, and other information management IT systems. HIT may be distinguished from general IT on account of its particular focus and possibly more inflexible and limiting standards and framework. AST (Adaptive Structuration Theory) improves IT analysis, especially in case of new adoption. Based on the 1984 Structuration Theory of Gidden, Poole and…

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…assess community-based telemonitoring or remote monitoring of patients have revealed that it enhances patient results for distinct chronic ailments such as stroke, heart failure, stroke, asthma, elevated blood pressure, and chronic obstructive pulmonary disease. PDMS (patient data management systems) automatically retrieve information from bedside clinical devices such as patient monitors, ventilators, and intravenous pumps). The information is then synopsized and restructured for facilitating its interpretation by healthcare practitioners.

Evaluation using an appropriate research instrument

Further, assessment can be carried out based on systematic monitoring of the main indicators of patient care service quality, which includes those that are affected by digitalization. Monitoring can help identify the undesired changes which stakeholders such as governmental entities are capable of influencing via policies. Digital healthcare services are highly diverse in their types. The term ‘monitoring’ may be described as “the continuous process of collecting and analyzing data to compare how well an intervention is being implemented against expected results”. Therefore, this involves “the routine collection, review and analysis of data, either generated by digital systems or purposively collected, which measure implementation fidelity and progress towards achieving intervention objectives”. The content of, and part played by, assessment as well as monitoring alters when an intervention develops further. The process of monitoring may be perceived to be a process of checking whether or not the evaluation-established ‘right thing’ is being properly done. While some interventions may continue to be ‘right’, they may fail at effecting the desired or anticipated outcomes and advantages if they aren’t appropriately applied or adopted. Thus, the process of monitoring can lead to the healthcare sector and its employees doing things in a better way, thereby resulting in better performance whilst the 2016 WHO report does recognize the linkage between monitoring and assessment, it frames the former slightly more “internally”, with the latter being considered more “externally”.

Summary of the case

There is a need for healthcare institutions to cultivate a “culture of safety” in order for their processes and employees to concentrate on bringing about improvements in patient care safety and reliability. Safety ought to be explicitly recognized as an institutional objective, demonstrated through robust leadership by clinicians, governing entities, and management. This implies incorporation of various adequately-understood safety rules like working condition and job planning keeping safety in mind; ensuring healthcare providers refrain from relying on memory; and standardization and simplification of processes, instruments, and supplies. Additionally, systems to constantly monitor patient safety need to be developed and financed appropriately.

The process of medication offers an example of improved system implementation giving rise to improved human performance. Drug errors are currently occurring often in healthcare facilities; in spite of this, a number of facilities haven’t been availing themselves of established safety improvement systems like computerized drug order entry, and aren’t actively considering novel safety systems. Further, patients themselves can be the source of major safety checks within a majority of healthcare organizations. They ought to be familiar with the drugs prescribed/administered to them, what they….....

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