Health_Care_Management_Issues

Health Care Management Issues | March 29 2013 | Medical errors and the quality problems to which they lead harm millions of Americans each year. If the errors reduce and improve quality substantially professionals must create systems and care processes that anticipate inevitable human errors and either prevent them or compensate for them before they cause harm. National surveys of registered nurses, physicians, and hospital executives document considerable concern about the U.S. nurse shortage. There were also many areas of divergent opinion within and among these groups, including the impact of the shortage on safety and early detection of patient complications. Healthcare providers need quick access to patient medical information whenever and wherever patients present for care. A system to standardize electronic medical records, such as the National health Information Infrastructure, would provide quick access to patient information. | HEALTH CARE | Health Care Management Issues There is now a robust evidence base in the quality improvement literature on process and outcomes, but structure has received considerably less attention. The health care field would benefit from expanding the current interpretation of structure to include broader perspectives on organizational attributes as primary determinates of process change and quality improvement. Solutions to the health care management issues dealing with the quality of care should be discuss with the following key elements of organizational attributes from a management perspective, executive management, including senior leadership and board responsibilities, culture, organizational design, incentive structures and information management and technology. Medical errors that injure or cause death in patients have become a significant and costly problem prompting government and regulatory agencies, health care organizations, and private industry to seek solutions to release errors and minimize their effect on individuals while limits their cost. The most recognized are hospital errors: approximately one in ten patients in hospitals experience errors that cause harm. However, while they are less well recognized or documental, errors that harm patients also occur in other environments of care. Nurses play a pivotal role in the identification, prevention, and reduction of medical errors and promotion of patient safety. The Joint Commission on Accreditation of healthcare organizations developed patient safety standards that went into effect in 2001. The standards address: the implementation of patient safety programs, the responsibility of organizational leadership to create a culture of safety, the hospital responsibility to tell a patient if he or she has been harmed by the care provided, the prevention of medical errors through the prospective analysis and redesign of vulnerable patient systems, and the Joint Commission publishers revised National Patient Safety Goals each year. These goals assist organizations in working towards standardizing documentation, improving communication, and ensuring compliance with care protocols and standards that improve patient safety. The human cost of medical errors is high. Based on the findings of one major study, medical errors kill some 44,000 people in U.S. hospitals each year. Another study puts the number much higher at 98,000. Even using the lower estimate, more people die from medical mistakes each year then from highway accidents, breast cancer, or AIDS. The committee sets a minimum goal a 50 percent reduction in errors over the next five years. They believe that with adequate leadership, attention, and resources, improvements can be made. Ways Nurses can solve patient care problems. Identity crisis is one of the patient’s care problem; many people take responsibility for different aspects of a patient’s care. In the course of one shift, a patient may see several members of the nursing staff, a dietitian, the cleaning staff, a doctor, or two, a physic therapist, a phlebotomist, and so on. Some hospitals have a protocol that calls for every group within the hospital to wear identifying scrubs or uniforms by color, while others require only nametags, making it even more difficult to identify who is who. The solution to this problem you should introduce yourself to your patient at the start of every shift; explain to your patient who you are and what your role is. If possible, explain who else is coming in to see her, so she’s prepared. Even if your patient’s don’t remember names or roles, the act of making that connection helps a patient feel more secure in a strange environment. Explain everything is another patient care problem which nurses can solve. Going to the hospital whether it’s because of an emergency or it’s planned, frightening is even more so when you don’t know what’s going on and everything is out of your control. Patients, who are kept out of the loop about procedures, processes, and general knowledge concerning their health, are understandably lost and confused at the hospital. Solution to this problem is; before entering a patient’s room, gather as much information as you can about the patient status and what is happening. If a nurse is getting ready to prep a patient for a test, nurse’s need to make sure she can explain the procedure to patient. If giving medication, nurse’s need to know what it is and why they’re giving it. Patients feel much better when the staff give their full attention. If staffs don’t know the answer to a question that the patient asks say so and tell the patient you’ll try to find out. Never let a patient wondering if you’re going to keep your word. Language Barrier can be another problem for patient care. Hospital’s has a language and a system of its own. When nurses and other health care personnel talk to each other; it’s often in hospital speak, a language that non-medical professionals don’t understand. Solution to this; professionals need to remember to use terms and expressions that everyone is likely to know. Constant interruptions is another issue for patient care, patient’s often said that if you want to get some rest, don’t go to a hospital. Sometimes patients who didn’t sleep well at night due to pain or discomfort. When the patient trying to rest after breakfast, nurse go into start an IV. After nurse hooked it up and leaves, a CNA goes into change bed. Not long after nurse aid done, another nurse comes in to give patient his medications and take vital signs. Just as the patient thinks it’s safe to close his eyes, the housekeeper comes in and empties the trash, followed by dietary aide who brings him his early lunch. Solution may sound too ideal to be done, perhaps with a bit of organization; some of the disruptions could be minimized or eliminated. Professionals should speak with other members of the nursing team to see what needs to be done for your patient’s during report or right after. If possible; suggest how you can work together, working as a team, or take over a few of the tasks and do them all at the same time. Patient concerns can be an issue as well; with all the news and TV programs about medical errors, professionals are going to come across a patient who is afraid he is going to get the wrong medication, have the wrong limb amputated, or be put through unnecessary tests. Solution for patient concerns; if a patient is concerned about medication errors, nurse should explain to him how her distribution system works from the time the doctor writes the order, to the time it is administered. Nurses make sure you show your patient the medication before he takes them so he knows what color each pill is, and why he takes them. Often, once a patient understands that it’s okay to look and question, they relax. The same advice goes for the other mistrust issues. Professionals need to know the best way to get a patient on her side is with good patient teaching and by letting him know that you are listening to his concerns, no matter how they appear to you. Patient cares also have problems with volume control. While many times people co-exist peacefully in semi-private rooms, there are times when the match just doesn’t work. Inconsiderate patients may talk on the phone loudly or late at night. They may have rowdy visitors, turn up the volume on the television, or eat smelly, nauseating foods that make neighbor ill. Or, the disturbance may be unintentional: a patient moan because of discomfort, pain, or dementia, a noisy suction machine, or even snoring. These are all things that keep a roommate from getting the rest he needs. Solutions for volume control; the first step to resolve this type of conflict is to speak to the offending patient. Sometimes a quiet word with the noise maker has the desired effect. While he may not stop all the disturbing behavior, if there is a compromise, the complaining patient may be able to cope. If nurse have a disruptive patient gets you nowhere, consider moving one of them to another room. Sometimes the situation can’t be resolved so simply. In that case professionals need to just listening to the patient’s complaint and acknowledge the uncomfortable situation makes a tremendous difference. Your health records use to be considered a private matter between your doctor and you. With the continued growth of the third person health maintenance organizations, doctors are required to share their records with each other and the health maintenance organizations. A health maintenance organization provides a form of health coverage very different from the traditional insurance plans in the past. Each participant in an (HMO) agrees to use a specified network of medical providers (doctors and hospitals). In return the HMO will usually offer broader coverage with a lower out of pocket expense to the user. Now without your knowledge, your health records are sometimes being perused by employers, insurance companies, and drug manufacturing companies. Because medical records contain some sensitive information, such as past drug use or genetic predisposition to various diseases, it’s important to keep this information truly private. In a typical teaching hospital, many people can have access to your medical reports. Anyone from the nursing staff to the x-ray technician can have a look at your records. As hospitals begin to computerize their medical records, there is a legitimate fear that more people will have even more access to your medical records. Hospitals are not the only ones archiving medical records on patients. Data banks of such organizations as HMO’s and drug companies are also gathering information and storing them in a computer format. By the linking of these computers together, some companies are beginning to sell and trade this valuable information across this vast network of computers. Your medical records may also be used in a medical court case, if you are involved in a case in which your medical condition is an issue. The relevant parts of your record may be copied and introduced into a court case. How this information is is being used' Over the years, more than a quarter of the people who responded said that information about them had been improperly disclosed. This is a list of some agencies that already have access to your medical information; health and life insurance companies require you to release your records before they will issue a policy to you, Government agencies such as Medicare or Social Security Administration, the medical information bureau has approximately 15 million files in a central database. Every time you file an insurance claim, a copy of this information goes to MIB. Some institutions gather medical information on individuals and sell this information to drug companies. Some advantages of medical database; some health care providers and insurance companies are forming regional information networks to share electronic medical records. Their reasoning for setting up these data banks is to help with the reduction of paperwork, help with billing, identify the most cost effective treatment, and to fight against false claims; a person’s medical information would be immediately available for the attending doctor. Therefore if an individual was injured in another part of the country, the attending physicians would have the patient’s entire medical history at their fingertips. Included in this information could be lifesaving information that would be invaluable to the attending doctor, the creation of a large database would also allowed researches to track certain diseases as well as to patient’s responses to certain drugs. This information could be valuable to drug companies for research purposes only; the certain of these databases would allow for better organization and more legibility of medical files, and since elaborate security systems can be develop to monitor these medical data base, electronic records may actually be more secure than paper records. Anyone can steal and fax a copy of a paper record without leaving a trace. Some disadvantages of a medical database; with the creation of medical database many individuals have expressed some apprehensions as these and other information begin to become computerized. One compliant is the fear that employers might have access to this information about their employees to this information about their employees and then based on this information denied employment or job advancement. Based on past medical information people are fearful that they might be denied insurance because they are considered to be high risk. There is a fear that digitizing records will allow many more people legitimate access to medical records. This information can easily be misused if it is accessed by so many individuals. Conclusion: from a research tradition in which nurse staffing factors were primarily background variables, the study of nurse staffing and patient outcomes has emerged as a legitimate and strategically crucial field of inquiry. However, despite significant growth in the number and sophistication of studies responding to public policy and provider demand for these findings, results have been inconsistent. In the face of myriad pressures to adapt a position for or against mandated nurse to patient ratios, it is essential to advancing the field that future studies replicate, extend and refine the current body of knowledge, making explicit how characteristics of the workforce. In addition to the dose of the nurse, are linked to processes of care that ultimately result in clinical outcomes both desirable and adverse. Until then, selected better practices have been noted, with the potential to contribute to pragmatic efforts to improve patient care quality and safety in hospitals.