Unit 5 Quality Care and Safety
HA255: Human Resources for Health Care Organizations
Prof: Patricia Giddens
What would you do when implementing a CQI process to reduce medical errors? A successful CQI program will guide the way for improvement of organizational processes; create a structured problem-solving process, incorporate the use of interdisciplinary team’s methodology, create employee empowerment and most importantly focus all efforts and outcomes on the patient or customer (Hernandez, S. R., & Connor, S. J., 2010). The CQI (continuous quality improvement) system implemented by the senior management and total quality management experts had none of these essential pieces. Due to the punitive nature of the system it did help change the problem of poor quality of care. The staff became afraid to report medical errors because the system could determine their salary increases, hinder their promotion opportunities and ultimately lead to termination. I also believe they relied on the CQI system as there soul source of information. Seeing no errors reported through the system, they assumed the problem was fixed. This leads me to believe there was also a lack of chart auditing to assure there was strong clinical outcomes in the facility. The ultimate aim of collecting and analyzing medical error data is to implement change that results in safer care (Henriksen, Battle, Marks, & Lewin, 2005). In 1999 President Clinton asked the Quality Interagency Coordination Task Force to analyze the problem of medical errors and patient safety, and make recommendations for improvement (Doing What Counts for Patient Safety, 2014). One of the primary findings in their report was the majority of the errors are the result of systemic problems rather than poor performance by individual providers, and outlined a four-pronged approach to prevent medical mistakes and improve patient safety (Doing What Counts for Patient Safety, 2014). With that being said the first item on the agenda should be to create a culture where the staff no longer feels reporting errors will be treated with punitive actions. Next through observation, questioning, and development the current the processes need to be evaluated for effectiveness. I would then recreate the CQI program with a new vision geared to improving practice culture by foster teamwork and shared responsibility (Henriksen, Battle, Marks, & Lewin, 2005). The shared responsibility is a huge leap for any organization. It is a step in the right direction that will bond the entire organization. In addition interventions should be established to reduce hazards and preventing errors before they occur involving the active participation of all the subject matter experts, meaning an interdisciplinary approach (Henriksen, Battle, Marks, & Lewin, 2005). My changes closely compare to the plan created by the Institute of Medicine and latter the applied strategies for improving patient safety project in 2000. How would you change the incident reporting and performance appraisal systems? The changing of a failed performance system should be priority number one for any organization. In fact Edward Deming creator of Deming’s 14 Points on Quality Management, is quoted as saying “ Appraisal practices of American industry to be the root cause of its quality problems” (Ghorpade, Chen, & Caggiano, 1995).You must get a handle on the nature of the challenges present (Ghorpade, Chen, & Caggiano, 1995). The most crucial challenges in this situation that must be addressed are the fact that the current performance and appraisal system is of a punitive model. Time and efforts must be extended to assure the staff that reporting of incidents is not only made easier for them but that they can report incidents without disciplinary actions taken. The performance appraisals will then need to be restructured to remove the ability of incidents reporting having a negative scoring process. At...
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