SNPG902 Effective Management In Health: Case Study Assessment Answer

Answer :

CASE STUDY: EFFECTIVE MANAGEMENT IN HEALTH

Executive Summary

Medication error is a critical issue regarding the all kind of medical error. The issue is faced by all the healthcare organisations throughout the world. A numbers of factors are incorporated with the medication error regarding, Lack of therapeutic and management   training, lack of drug and management knowledge, lack of experiences, inappropriate risk management planning as well as the, poor communication between the service users and providers. On the other hand, excessive workload and time pressures, insufficient resources, distractions, lack of standardized protocols and procedures and interruptions also causes the issue in the healthcare industries. Therefore, effective approach over these issues by the healthcare service providers and healthcare organisations may be useful in this regard. Moreover, application of benchmarking process, open reporting can help the issues to be identified. On the other hand, team management, scientific management and quality management is effective for minimising the issues. Considering this background the current report presents a literature review on medication error revealing that it is necessary to understand individual differences and needs to ensure proper medical care and avoid any medication error. 

Introduction

Medical errors are responsible for millions of severe injuries, excessive financial loss, and deaths. It can be considered as the biggest challenge for providing hassle-free medical care and presents humankind with the most unwanted outcomes. Different organisations in many countries are struggling to manage medical errors due to various internal and external factors. Medical error relates to preventive measures of disease and deals with peripheral outcomes. The study has been formed to find out several issues related to the source of the challenge and analysis through a literature review done by various researchers. Managerial aspects of practising benchmark tests and applying management tools such as quality and team management module can reshape inconvenience coming from medical errors.

Method

The search strategy applied is to identify relevant literature from 2015 to 2018. The library resources of University of Wollongong were used to identify relevant journal articles and peer-reviewed articles. The keywords used for search were medical error, medication error, medication administration and careful medication. Any irrelevant studies not related to medication administration error were rejected and the most relevant talking of such errors, methods to avoid errors and reasons of such issues were selected to conduct a literature review.

Literature review of the topic 

Introduction

In this research, the researcher has chosen the topic the effect of medication error throughout the issues regarding the medical error in the healthcare services (Hayes et al. 2015). Within the aspects of medical error, the medication error is one of the most important factors that have become a critical issue for the health care service within the patient rather than the surgical errors or laboratory errors and so on. 

Background

A number of issues may lead to an inappropriate medication approach and causes harm of the service users. As suggested by Cloete (2015), the issue is reflected from widely varying medication errors rate that is reported in the different parts of the world. In the UK the rate of medication errors that causes harm for the patient are almost 12% in the total users of the healthcare services throughout the nation. However, Sweden the reported rate of medication error within the medical error is about 42% of the total populations (Schiff, 2015). 

Causes of Medication errors

Factors incorporated with the service providers

These include the lack of different therapeutic training for the service providers. Therefore, numbers of mistakes have occurred within the mediation services provided by the healthcare industries. The management system of the healthcare systems is also incorporated in the issue. Inappropriate knowledge over the drug the important issues for the service providers regarding medication error. Therefore, this leads to an increased risk over the issue. On the other hand, the overworked health care service providers also cause such issues due to excessive workload and lack of time in the service profession. As suggested by Stavropoulou, Doherty & Tosey (2015), poor communication channel within the service providers and service users cause such issues regarding the increased medication error. Therefore, an improved communication service is required to avoid such issues.

Figure 1: Factors associated with health care professionals

(Source: Stavropoulou,  Doherty  & Tosey, 2015)

Factors associated with the work environment

These include the excessive workload as well as the time pressure that are faced by the healthcare service providers during servicing the patient. Therefore, the work environment is disturbed and mistakes occur regarding the medication error by them. A distraction, as well as the interruptions in service providers and service users, also disturbs the total work environment that in most cases leads to medication error. As suggested by Norman et al. (20170, the lack in the standardisation of the services and in the different healthcare protocols causes issue regarding the poor approach of medication and the medication error throughout the staffs. Moreover, the issues of insufficient human resources such as experienced doctors, staffs, and nurses also cause the medical error in terms of medication error due to insufficient experienced human resources.

Figure 2: Factors associated work environment

(Source: Stavropoulou, Doherty & Tosey, 2015)

Factors associated with tasks

In this regard, the repetitive systems for the healthcare staffs for authorisation, ordering and processing sometimes causes a lack of timing and thus causes the medication error in the provided services. As opined by Nanji et al (2016), in case of inappropriate monitoring of the patient, also leads to the medication error by the healthcare service providers.

Factors associated with computerized information systems

The effective factors that are associated with the computerised information systems include lack of accuracy for recording the patient pieces of information. On the other hand, the difficult process of the healthcare industries for developing the prescription also causes such issues in the healthcare industries. 

Rationale of the problem with Recommendation

Identifying the source of challenges can help an organisation to create a management plan for avoiding serious issue regarding the medical error. Medical care is considered, as the most important value creating process, which if conducted carefully is most useful otherwise; it can create an overall grievance containing potential risk. According to Garrouste et al. (2016), medication error can constitute to medical error, which can decimate organisational reputation and destroy organisational orientation. Medical error can only be treated with an effective management plan with capable leadership and construction plan. Effect of the failure can cause lethal damage to humankind, thus improvement and governance of the plan need to be done with utmost importance.

Recommendation for gaining improvised healthcare management needs competencies from management leaders, medical professional and executives along with understanding the need for enacting prescribed changes. Different medical management tools such as benchmarking, application of systems theory, scientific management can be used as rectification mean of the medical errors. Occurrence of a medical error and rectifying for further development is secondary option from management end because certain management changes can help avoid occurring of medical errors and generate a healthy, sustainable medical care service. Management tools such as team management, quality management and communication plan by higher management can help reduce the errors by minimising risks averting from the medical process (Makary & Daniel, 2016). Management of healthcare issues needs integrative healthcare management from both company management and medical professional for establishing an interactive pathway for communication. Medical error can be of different types such as medication error. Most important aspect of medication error is emerging most crucial among these and this study will focus on various managerial tools to avoid medication error.

Benchmarking

 Medication error needs resolution due to the ill effects, which can result in death thus it is important to eradicate this problem and most relevant way of managing medication error can be considered as benchmarking. It can be meant as the comparison of medical error reports and producing a standard for rectification of medication error. A healthcare organisation uses a benchmarking process for managing medication error, by comparing error rates and constructs a safe medication safety policy for the future. Various organisation use different means through benchmarking, which includes proper information regarding patient information, knowledge of the staffs regarding proper drug information. Management need to focus on communication strategy for drug orders and labelling. Medication errors need rectification by drug standardisation, storage information, and distribution of drugs. As stated by Bari, Khan, & Rathore (2016), medical error reports help to identify the source of medication error can be traced from the lack of knowledge in medication delivery and monitoring with effective usage instruction. Benchmarking can be considered as the preliminary process of team management, where team management prospect will be built upon the error reports. Staff competency and education are found to be a crucial factor for occurrence of an error in medication. Recommendation for developing an enhanced benchmarking process needs to implement for adopting managerial practices and develop a sustainable framework.

Systems theory

Managerial prospects involved in the process can be considered as an effective recommendation for avoiding medication error. Leaders and medical professionals need to be a system thinker and part of a whole system approach to developing an environment for communication through leadership aspect. Systems theory can be enacted for resolving medication error as it can be useful in avoiding silos between different mentality and variety of execution. Neuspiel & Schuman (2018) argued alternative system thinking approach can be considered for health professionals to development of a healthy relationship to interact with each other and create a solution framework with equal responsibility to avoid an error. System thinking can be useful for cooperation in finding medical errors and rectifying before implication. Healthcare organisation can be considered as a complex adaptive system as it comprises of different job responsibility, different management role. Ability to adapt the changes made for avoiding medication error needs reliability with this approach so that the overall behaviour of the components in organisations and different aspects of learning can be adapted accordingly. Role of leadership is most crucial for this complex system and governance of staff activity and motivation of contributing to an error-free environment needs to be produced for future success.

Scientific management

Scientific management is the method of applying scientific method in healthcare management program and obtaining result through investigation and further development of care giving policy. Human effort related to the management of medication error needs arrangement in a scientific process with a capable team with different role and prospect. Scientific management in order to avoid medication errors can be considered as risk management plan, which starts with identification of such medication error. Prompt reporting of an error to manager, obtaining medicinal knowledge from prescriber before providing to a patient for further construction of report form and presented to the line manager for investigation and report back to supplier if needed resupply and further allocation. 

Team management

Management quality of a healthcare organisation needs to be formulated by capable leadership thus it needs accuracy and effectiveness along with easy guidelines, which can be understood and followed by different components in the organisation. Team management is necessary for achieving the desired outcome in any field of management. Team management includes prominence in leadership, development of communication skill, understanding necessary for performance-enhancing training and monitoring team activity and rectification accordingly. As noted by Koller et al. (2016), transparency in task execution needs ethical practice by health professionals due and needs to be unaffected under any circumstances as healthcare can cost loss of life. Team management to avoid medication error is divided into various sectors such as prescribing error, which occurs from the medical professional’s end, so it needs revision before handing off to patient or pharmaceutical teams. Dispensing error is another important aspect resulting into medication error and harm to the patient by supplying wrong medicines after receiving proper prescription. 

Management of dispensary professionals and proper training with the recruitment of a dispensary manager can help avoid potential risks such as wrong medication, date expired medicine, incorrect labelling and so on. Administrative error in medical errors is mostly overlooked as this segment is considered as the terminal monitors of the process. Administrative associates are responsible for wrong administration of medicine allocation, mistake in determining infusion rate, incorrect preparation of prescribed medicine. Deviation from informal medication policy and LCHS management module can lead to medication error thus need governance and regular monitoring. Team role and responsibility of individuals are subjected to individual capability and can be enhanced by scheduling required training. Occurrence of a medication error needs to be analysed and discussed in the meeting held in a monthly or weekly basis for performance evaluation.

Quality management

Quality management of prescribed drugs need proper governance from various levels starting from medical consultant to caregiver. Construction of a quality management team is important for managing risk averting from wrong medication. Components quality management team needs to create based on performance-based criteria. Regular quality check, storage check, proper labelling, disposing of expired products is related to the day-to-day task in avoiding medication error. Tawfik et al. (2018), quality management guideline provided by various countries are maintained while preparing a particular drug; still, it needs quality check before frequent use especially in cases of critical diseases. Apart from enhancing product quality, management needs to focus on quality of services, which start from primary care for providing stability through treatment and applying for proper medicine. 

Conclusion

Management of errors in the medical field can help avoid serious harm to brand reputation and fatal outcomes. Most important medical error coming from errors in medication can be identified through benchmarking or open reporting system. Factors leading to medication error can be solved through system approach, team, and quality management and adapting changes in management practices. Apart from that, the ethical concern of the medical professional can contribute to the urge of the establishment of a proper medication cycle and hassle-less treatment procedure with the least chances of potential risk. Avoiding medication errors are very crucial for the establishment of a systematic healthcare management plan. Professional can do it though understanding the needs for implicating management and use of management tools in medical errors is inevitable. Healthcare professional needs to understand managerial changes and improve communication skill along with coordination and proper training for creating a healthy environment, with the reliability of getting proper medical assistance.