HCA375– Continuous Quality Monitoring and Accreditation
HCA375 – WEEK 4 ASSIGNMENT
PART 1 – DETAIL OF THE ADVERSE EVENT CHOSEN
| CONTENT | DESCRIPTION |
| ADVERSE EVENT | The adverse event to chosen for this assignment is about medical errors. More specifically, I will narrow down to medical errors in Kuwait’s healthcare systems. Medical errors are of vital importance since they affect the economic boundaries of patients and hospitals as well as adverse events for patients.
In Kuwait, there is a scarcity of literature detailing the causes, risks, and forms of medical errors in their hospitals despite having a big impact on the patients. A report done on the issue of medical errors that occur in the state-owned hospitals indicated that common medical errors resulted from incomplete dosage, incomplete instructions, and incomplete route of administration. Labeling errors, and diagnosis errors. The according to the report, the perceived causes of these errors include lack of support systems, high workload, inadequate training, medical negligence, stress, poor collaboration, miscommunication, and not adhering to the safety guidelines required in performing specific tasks in the healthcare profession (Ahmed et al., 2019). Medical errors in the Kuwait Hospital were found to occur in nearly all the departments within the hospital. The outcomes of the questionnaire aimed to identify the areas where medical errors commonly occur indicated that in the emergency room (57%), medical wards (43.3%), Theater rooms (33.1%), ICUs (17.8%), while other areas contributed (17.8%) of the errors (Ahmed et al., 2019). According to the report, the main reason for medical errors is due to the negligence of the nurses and clinicians supposed to take care of the patients. Another section of personnel involved is the dieticians who fail to follow the required guidelines in their task (Ahmed et al., 2019). Medical errors are also prevalent in the healthcare system due to errors during diagnosis that results in wrong treatment. |
| HISTORICAL BACKGROUND | Medical errors are one of the common causes of adverse events in the healthcare industry. Medical errors can be defined as failures to achieve planned actions or using mistaken plans to accomplish an objective (Makary & Daniel, 2016). In some instances, a medical error may occur due to an unintentional act (either of omission or commission) or an act that fails to achieve the correct output.
The safety of patients is a basic right to the patients which should be ensured during patients’ visits to the hospitals and admissions. It is the duty of healthcare providers including the state and the medical practitioners to promote patient safety and reduce the chances of adverse events occurrence. There is a paucity of information regarding the incidences of medical errors in Kuwait. Few academic studies have been done to address this issue in Kuwait. However, a recent study conducted in Kuwait stated that the participants who included administrative staff, physicians and rated patients’ safety to be high where the score of 74% and within that year there was no reported incidence of adverse events occurring. Only 13.0% of the participants reported occurrences of adverse events within the same period. |
| LEGAL & ACCREDITING AGENCY REQUIREMENTS | The legal and accreditation agencies require that caregivers adhere to the set guidelines and procedures so that to reduce the adverse events from occurring. Healthcare providers should prioritize the processes that reduce medical errors. The body ensures that the involved caregiver is punished when medical error severely occurs in his/ her watch. |
| CQI TEAM COMMUNICATION | Continuous Quality Improvement (CQI) is a task force team to address the current events that occur in the healthcare system, especially in Kuwait. The election of the CQI team members will be based on the position held within the hospital and the roles taken by every participant. The CQI team aims to identify the root course of the adverse events and propose a solution that will help reduce the menace.
The members of the CQI team will include nurses, clinicians, pharmacists, laboratory experts, surgeons, and the hospital’s record keeper. The CQI team will also feature members of the administration so that they can contribute to the decision-making process. The nurses will help provide useful information on the procedures undergone within the hospital to cate to the patients’ safety. Nurses are the people concerned with the daily welfare of the patients hence will be useful in the process of quality improvement. Clinicians and pharmacists will be useful in the team as they will give quality information on the methods and procedures followed while prescribing the drugs to patients. The laboratory experts are also fruitful in this study since they are mostly concerned with the testing of illness. This is a vital role since most of the medical errors occur as a result of wrong lab tests. Medical errors occurring due to the wrong record of the patients will be addressed by the record keeper thus becoming a crucial member of the team. The major issues that would arise in the quality improvement process are poor communication among the team members. Each of the members of the CQI team will be accorded a specific task in which they will be required to report to the team upon completion. This process requires communication within the team which is most likely to challenge the team members due to overburden of the daily hospital activities. To ensure effective communication in the team, we will utilize digital reporting where the participants will have to post their reporting on the digital portal. The platform will reduce the complexities in communication since the participants will only be required to post their reports without necessary traveling. The main barrier of communication that is likely to occur in the CQI team is the use of different reporting formats. In some cases, the reports will involve accounting figures which is not well understood by all the team members. |
| OPERATIONAL OR SAFETY PROCESSES | According to the medical errors recorded in the hospital, the main causes are contributed by the healthcare providers. The hospital is therefore required to address the matter by instilling training to the medical practitioners and nurses. The hospital should also train the lab experts for proper tests and diagnosis. Additionally, the hospital should invest in quality MRI images for proper image quality used in diagnosis. These processes will help improve the quality of care by reducing medical errors in the hospital.
By training the medical practitioners and nurses, medication will be done in the required procedure thus reducing medical errors at the long last. The training of extra staff will also reduce the workload on a few workers hence incidences of nurses getting exhausted will be a thing of the past. The MRI image quality dictates how accurate the diagnosis for treatment will be done. Poor imaging results in poor diagnosis and hence poor treatment. |
| IMPACT OF THIS EVENT | Medical errors contribute to the financial crisis in the hospital since the hospital must compensate the affected patients. The administrators are forced to adjust the budget to cater for emergencies that may occur due to medical errors.
The patients are the most affected by medical errors in hospitals. Medical errors can lead to the death of patients, disability, stress, and prolonged stay in the hospital. |
WEEK 4 ASSIGNMENT
PART 2 – GRAPH THE DATA
You are tasked with graphing the data in Excel for your chosen event. The data is located in the classroom under the Week 4 Assignment Directions. Make sure to use only the data for your chosen event. The directions identify which columns of information to use depending on the chosen adverse event. Once you complete the graph in Excel, copy/paste your graph below.
Include an analysis of the data in paragraph format.
| Discuss the frequency of the adverse event as compared to the increase or decrease of patient discharges. | |
| What is the data telling you? | |
| What possible factors in your opinion could be attributed to the change? |
WEEK 4 ASSIGNMENT
PART 3 – CQI TOOL
Flowchart
WEEK 4 ASSIGNMENT
PART 4 – FUTURE PREVENTION
APPLYING PDSA – Worksheet
| PHASE | PHASE ACTIVITIES | EXPLANATION |
| PLAN | Problem
Objective Team members Communication Data collected Pilot phase |
The medical errors experienced in this report were due to problems in the diagnosis phase of patient treatment. The major department involved in the occurrence of these adverse events is the nurses and laboratory experts who are required to provide an accurate diagnosis for the medical practitioners to conduct the treatment procedures. The use of worn-out equipment to assist in the diagnosis also contributed to the adverse event.
The objective of this task is to quality improvement in the hospital. The CQI aim at providing a solution to the current problem by evaluating the root causes and make solutions on how to avoid such incidences. The major stakeholders in this project include hospital administrators, pharmacists, nurses, and laboratory attendants. Their role in this task is to provide the team with information regarding the departments they work in. Data will be reported every week using an online portal provided to the CQI team members. The data collected in the process will be useful in providing the solution since every information regarding medical errors will be considered for every department. The solution for this adverse event will be implemented in a pilot phase where a parallel process with the current one will be done. By doing so, the CQI team will identify the strengths of the proposed solution and provide necessary adjustments where errors may occur. |
| DO | Three possible solutions
One solution to implement Result of the pilot (create own scenario) Methods of communication |
The proposed solutions to the occurrence of medical errors in the hospital include; improvement of equipment used for diagnosis, implementation of a hospital management system to assist in patient management, and training of hospital staff including the nurses.
Implementation of a hospital management system will ensure the proper flow of information in the hospital that will be vital in the decision-making process. The system will ensure that patients’ records are safely stored within the system and records of a specific patient can be retrieved any time it is needed. The CQI team will communicate with the administrators concerning the implementation of the system whenever a single phase is completed. |
| STUDY | Summarize data
Observations and problems Comparison of the pilot plan to pilot results Revisions needed to meet the objective |
According to the data collected in this study, there is an indication that most of the errors occur due to poor reporting and poor ways of recording patients’ data. As such, the medical attendant will use the wrong information to treat the patient results in medical errors.
While conducting the pilot test for the solution, we observed that there is quick processing of information for the decision-making process. The major problem in implementing the pilot solution is that we utilized only one hospital department to represent the whole hospital. This was a problem since every department has its own set of procedures. The objective of the planning phase was met in the pilot phase as the system implementation reduced the time for reporting. The area of improvement in the plan is to eliminate unnecessary steps to reduce the amount of waiting time for the patients. |
| ACT | Revised improvement plan
How to Implement the planned hospital-wide Plan for monitoring the improvement plan Checks and balance |
The revised improvement plan involves the implementation of a system to manage patients’ data. The system will replace the current traditional methods which are slow and error-prone.
The proposed solution will be implemented in phases to ensure that the processes in the hospital are not interfered with. The CQI team members will be continuously monitoring the system to ensure that every module works according to the requirements. While implementing the proposed solution, it is important to note the importance of data collection since every patient data is useful. As much as the solution is intended to reduce the amount of time wasted and reduce medical errors, the record keeper must collect all the necessary information regarding patients. The aim is to induce an equilibrium for better treatment and save costs for the hospital. |
References
Makary, M. A., & Daniel, M. (2016). Medical error—the third leading cause of death in the US. Bmj, 353, i2139
Ahmed, Z., Saada, M., Jones, A. M., & Al-Hamid, A. M. (2019). Medical errors: Healthcare professionals’ perspective at a tertiary hospital in Kuwait. PloS one, 14(5), e0217023.
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