A Quality or Risk Scenario Case Study
February 17, 2013
Table of Contents
I. Thesis and Introduction:
2. Patient care and safety scenario
B.HIM role in helping reduce risk and cost
3. Scenario related to a physical plant
A. Power failure risk in health care institutions
B. How HIM can help prevent and prepare for a power failure
4. Scenario related to staffing
A. Using operational checklists to reduce staffing liability
B. HIM responsibilities in creating and developing an evolving program
The HIM professional can have a direct impact on the quality or compliance of specific operations or employees within a healthcare institution. Healthcare institutions, such as hospitals, can be huge institutions made up of hundreds or even thousands of treatment or operation specific areas operation. This can include anything from the surgeon who performs coronary artery bypass to the neonatal intensive care nurse who directly cares for struggling newborns to the physical plant worker who makes sure all the lights in the building stay on and the operating room is maintained at a certain temperature. As an overall institution the thought of identifying risk and liability within the organization can be quite overwhelming and daunting. The best way to approach this is to break things down into specific issues or areas and focus on one thing at a time, with the overall goal to be improving quality and reducing risk to the institution. This paper will focus on three specific scenarios that represent an area of risk and liability for the institution. These three scenarios will include the safety of blood transfusions within a hospital, dealing with power failure risks within a hospital and using operational checklists to improve employee efficiency, consistency and reducing the human factor of making mistakes.
Scenario one is to be specific to a scenario involving patient care and safety. The specific discussion here will be the use of blood transfusions within the hospital setting. This is a procedure that has been done for dozens of years even as medical science has made tremendous progress. The reality is that science just hasn’t found a synthetic way to carry oxygen through the blood stream and blood infusions still remain today the best way to do just that. While the best procedure out there for this, blood infusions don’t come without their risks and financial impacts.
A study by the University Healthcare Consortium analyzed over 29,000 blood transfusions over a 7 year period from 2003-2009 (Williams, 2011). These transfusions ranged anywhere from scheduled routine outpatient surgeries to unexpected traumatic injuries brought in through the emergency room. The analysis identified many risks associated with blood transfusions, including poorly trained staff, lack of trained staff, minor hemolytic allergic reactions all the way up to severe anaphylactic reactions. The study was even able to identify that the time of day that the transfusion was performed could positively or negatively affect the patient outcome. So, while this can be a lifesaving procedure a blood transfusion should not be taken lightly.
Another study published in the April, 2012 issue of the professional journal Anesthesiology was conducted by Johns Hopkins Hospital analyzing the outcomes of over 3000 patients who received blood transfusions. This study reveals that measuring the hemoglobin level in patients can be an accurate indicator of when a patient should receive a blood transfusion. This is a significant study because it could have a positive effect on both patient outcome and the financial costs involved in giving a blood transfusion.
The Johns Hopkins study revealed that patients were being given blood transfusions when they really didn’t need it. A normal hemoglobin level ranges...
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Planning for Power Outages: A Guide for Hospitals and Healthcare Facilities. (n.d.). Retrieved February 17, 2013, from www.hhs.org
Tammy Williams, Stephen Thomas, Kathy Vermoch. (2011). An Analysis of Blood Transfusion -Related Events in the UHC Patient Safety Net. OakBrook: UHC.
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