The six areas of improvement identified in the report are the following: safety, effective care, patient-centered care, timely health care, efficient care, and equitable care (IOM, 2001). I have noticed improvements in the safety of care and its effectiveness, as well as inequitable care. However, more attention should be paid to patient-centered care as both physicians and nurses in this organization tend to choose a paternalistic approach rather than a holistic one.
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As a nurse leader, I can speak to my colleagues about the importance of the family’s involvement in patient care, pointing out how preferences of patients or spiritual guidance, as well as respect for their cultural background, can increase compliance with the prescribed treatment.
The identified safety issue is diagnostic errors. According to Conlan (n.d.), diagnostic errors cause from 40,000 to 80,000 deaths a year. They can vary in their severity, but their impact on healthcare is substantial: these errors can lead to delayed or incorrect admissions and readmissions, a lengthy patient stays additional losses for hospitals, and even penalties and lawsuits. Furthermore, physicians or nurses who have made the error can lose their licenses or be sued as well.
To address this issue, the organization chose the Institute for Healthcare Improvement (IHI) Model for Improvement. First, three questions are asked: “what are we trying to accomplish?”, “How will we know that a change is an improvement?”, and “what change can we make that will result in improvement?” (IHI, n.d.). After that, changes are tested using the PDSA cycle (plan-do-study-act). This method implies that the identified change (or changes) are first planned, then tried or implemented in the workplace, then studied, and then the organization uses the obtained results to learn from them.
The organization was able to decrease the number of diagnostic errors by restructuring the work of physicians who had more time per patient than earlier, while nurses were assisting them in entering all data into electronic health records.
This strategy addresses safe care by identifying the cause of diagnostic errors. It also enhances the effectiveness and efficiency of care by showing what processes affect physicians. It could also be said that the strategy addresses the aim of patient-centered care because physicians have more time per patient to understand their needs and preferences and diagnose them correctly. The inter-professional work, in this case, consisted of the collaboration between nurses, physicians, and IT specialists.
IT specialists in the department helped nurses customize EHR in such a way that they could use it without a physician’s assistance, while physicians were able to spend more time on patients’ examinations. According to Supper et al. (2015), facilitators in inter-professional work can be acknowledged by leadership and trustworthiness, as well as the clear assignment of roles to professionals working in the team. Thus, nurses had the opportunity to work with EHR and also assist physicians in various cases and provide patient-centered care along with them, which increased patient satisfaction and reduced the number of diagnostic mistakes during the implementation period of the proposed change.
There was a lack of inter-professional work in determining what exact factors caused diagnostic errors as physicians named burnout as the main cause, while nurses argued that the shortage of staff and the limited time spent on each patient contributed to the problem. The professionals had difficulties working on the root cause analysis because their opinions on causes differed. However, overall, their work was effective.
Conlan, C. (n.d.). The 10 patient safety concerns every health care worker needs to know about. Web.
IHI. (n.d.). Science of improvement: How to improve. Web.
IOM. (2001). Crossing the quality chasm: A new health system for the 21st century. Washington, D.C.: National Academies Press.
Supper, I., Catala, O., Lustman, M., Chemla, C., Bourgueil, Y., & Letrilliart, L. (2015). Interprofessional collaboration in primary health care: A review of facilitators and barriers perceived by involved actors. Journal of Public Health, 37(4), 716-727.