Patient Complaints In Healthcare Systems: Critical Analysis

Quality and Safety Issues in Patient Care

Discuss about the Patient Complaints in Healthcare Systems.

The patient safety and quality are at the heart of the most of the hospitals, clinics, and nursing care centers in the Australian Healthcare Systems because of increasing competitive of the healthcare service providers and higher health safety and quality expectations from the patients. This report presents the critical analysis of the safety and quality issues in the case of Dad cared by his carer, Mum who supplies the lists of the medicines to the doctor of the emergency department. The report will critically analyze the safety and quality issues in the patient’s care and summary of the issues raisedalong with causes, incidence, factors, and actions. It will also analyze the safety issues in the workplace culture of the hospital, actions to address the issues, and PDCA cycle use to implement a suitable solution for managing the issue effectively and efficiently(Department of Health, 2013). This overall analysis is based on the given case scenario.

The quality and safety issues are related to the improvement of the patients’ security and quality care practices by the service staffs after following the safety and health guidelines. The quality and safety issues were raised because of the human errors by the service staffs working in the hospital, like not attending the emergent patient (dad) for treating effectively as per the National Hospital standards. Dad’s experiences (patient) regarding the hospital service quality could not said be ‘satisfied’ because of the problems in the hospital staffs service delivery, hospital culture, communicational problems, the lacks of the sufficient staffs, and missing the emergent medicine by Mum. The quality and safety issues were raised due to the unrealistic service expectations by the service staffs (Department of Health, 2013).

The main issues were related to the poor management of the service staffs to patient problems and complaints. Some of the service staffs of the hospital not acted up to follow up the patient’s complaints that were due to the senior hospital staffs delegated the complaints to others for resolution with no ending outcomes. Some hospital staffs were aware and concerned about the patient’s health problems, but they didn’t follow up the Dad’s family complaints because of other casual and irresponsible service staffs. Some hospital staffs didn’t understand the responsibility toward the patient by not following the standards of safety and quality of care. These service staffs not acted on the patient’s actual complaints by stating that the Dad relates to Frequent Flyer family with unrealistic service standard and unexpected outcomes (Parker, 2009). The staff kept its favor by stating that the patient’s service expectations are never-ending or unsatisfactory because the dad always comes regularly to the hospital with his wife to diagnose and treat the health problems and raises questions on the service quality of the hospital.

Poor Management of Service Staffs to Patient Complaints

The senior management favored the staffs by reporting to CEO, Karol that the problems were actually caused due to expectations of the high standards of care by Dad and his family members. Along with this, Dad has the chronic illness and complex health problem that require time to cure. Additionally, the problems with dad were occurred due to the staff lacking and busy ward staff in Emergency department that were attending other patients. The staff said that it is not possible for them to attend Dad all the time by not following other patients. The lack of staffing and high workload also enforced the staff for not attending Dad properly. Dad’s family is not agreed to understand the current staffing problems and extra work pressure on the employed staffs(Ashcroft, Morecroft, Parker, &Noyce, 2005).The regular ward staff and emergency staffs were not fully aware of the health problemsof Dad despite knowing his health complexities as his wife was keenly involved in her husband’s care. The changing medication pattern prescribed by the doctor and not proper medications by Mum every time is also another reason for the complex health problems to Dad’s health. Along with his, Carol found herself frustrated and irritable because of disinterested responses from the hospital staffs.

The safety culture and leadership development issue is related to providing the safety and standardized health care to the patients through the supportive workforce culture. The current organizational culture or workplace conditions in the hospital are not good because of the not sufficient service staffs, low staffs’ commitment and low morale, less productive staffs, and the lack of teamwork and shared care service practices for providing better treatment to the patient(Waterson, Griffiths, Stride, Murphy, &Hignett, 2010). The lack of adequate training, the lack of coordination, trust, and teamwork, the low staff’s commitment, poor or ineffective management support, and the lack of the disciplined activities contribute to occurrence for the workplace culture problems in the Hospital. To deal with this problem, the senior management should reinforce a supportive and learning culture that encourages the doctors, supervisors, and nursing staffs to work interactively by informing each other about the patients’ health complexities, medications, and treatment required.

The Medication chart prescribed by the doctors could be followed by the service staffs, like Mum to ensure the ethical working practices in order to give the right kind of medicinesby looking the Wristband for the scheduled treatment and care practices to the patient (Singla, Kitch, Weissman, & Campbell, 2006). The hospital is required to ensure an improved information infrastructure by using the information and communication technologies for ensuring the high communication level, scheduled training and learning programs for educating the staffs, and effective workforce planning to measure the proper staffing requirements to employ in the hospital for meeting all patients’ needs.

Safety Culture and Leadership Development Issue

The rigid complaint settlement procedure is another issue that is caused from the casual staffs not following the complaints of Dad’s family members because the working staffs not accepting their own fault, the working staff find Dad and his family member blame for this and stand responsible for their critical health problems. This was contributed by the busier and low morale staffs who were troubled with the staffing problems. It was not possible for the staffs to meet the care standards of Dad and his family because of higher expectations from them that couldn’t be met with the current staffing and service facilities. The busier staff in Emergency department didn’t understand their primary responsibility toward Dad’s critical illness and serious health concerns and spent time in attending other patients. Some service staffs of them stated the medication change is responsible for his daily health problems because his carer, Mum always likely to change the medicines (Reader, Gillespie, & Roberts, 2013). Mum was also found faulty for missing some medicines, prescribed by the doctor because she didn’t look at the medication chart. Sometimes, Mum was found faulty for writing down the medicines at the end of list that could not be read or seen by medicines department or chemists. Due to missing of medicines and improper schedules for medicines, caused only because of the human errors by the service staffs, as a result Dad had to suffer from the health complexities and had to come to the hospital on daily basis.

To avoid this issue or finding solution to this issue, there should be a controlled disciplined procedure to take action against such irresponsible or casual staffs, like Mum who didn’t understand her responsibility toward the safety treatment and emergency careof Dad. The senior management can suspend such type of staff or terminate for the temporary unemployment. This disciplined action could change in the behaviors, practices, and service quality of the staffs (Schnitzer, Kuhlmey, & Adolph, 2012). Along with this, a medication chart is needed to provide and instruct the nursing staffs to follow the medicine chart while giving medicines to the patients as per their scheduled prescriptions in the chart. There should be an effective reporting system for following the customers’ complaints and investigate into the matter for finding the root cause and immediately take an appropriate action so that the number of complaints could be minimized.

The assessment of the safety culture is an increasing interest among the healthcare organizations for managing the risks effectively. Manchester Patient Safety Framework (MaPSaF) is associated with the safety culture for allowing the safe and healthy workplace practices in the hospital to treat the patients efficiently by ensuring their quality care and safety. The organizational working culture in the hospital could not be said safe and standardized because of the lack of proper staffs for attending the patients effectively. Different staffs have different views, opinions, and thinking about the patient’s safety. Some staffs among them feel high workloads due to attending of a large number of patients. Along with this, in the hospital, the working staffs are busier because of lacking proper staffs in handling the patient(Lawton, R., McEachan, R.R., & Giles S.J, 2012). MaPSaf is related to access and strengthen the safety culture through the standardized care practices in the hospital.

Medication Chart Management

The different dimensions of this framework could be applied to the case scenario for ensuring the safety and quality working practices in the organization. The nine dimensions include Overall commitment to safety through the continuous improvement, Priority to the patient safety, System errors and Individual responsibility, Recording and evaluating the Patients’ safety incidents and the best practices, learning and effective change to the organization, Communication about the safety management, Proper management and safety issues, Staff education and training, and Team working. The lack of the staff management, ineffective leadership, and low morale and low staff engagement in the patient safety are main causes for the patient safety problems in the hospital. According to MaPSaF, there are five levels of cultures in the healthcare organizations including pathological, reactive, bureaucratic, proactive, and generative. The hospital should have a reactive culture that will include always taking the patients’ safety seriously with the appropriate response and do something or taking suitable action when we have an incident(Pham, Aswani, & Rosen, 2012). According to this, the patient’s safety should be given high priority by taking an immediate action rather than waiting for other staffs or delaying the services. The senior management should respond to the patients’ complaints or queries with the immediate action for providing the effective treatment till the patient’s safe zone.

The appropriate actions could be taken to deal with the issues that were identified from the case scenario. The quality and safety management is a preventive action to address the growing health problems. There should be proper arrangement with sufficient staffing, advanced medical facilities, healthcare service standards, safety arrangements, and quality care standards to reduce the health-related complexities of the service staffs.

The performance evaluation and feedback reporting is an action that could be adopted by the management to get the consistency reports on the service quality levels and safety performance of the service staffs in the hospital. On the basis of the performance evaluation of the staffs, like Mum (carer of the patient Dad), the feedbacks should be constructed. Positive feedbacks in the form of efficient service quality and better care of the patients through the loyal staffs should be awarded in the form of thee financial incentives or promotion. While in opposite the negative performance should be avoided or punished to reduce the occurrences of the negative health outcomes critical to the patient’s health(Hornby, Ray, Shipp, & Hall, 2014).The action, like disciplined health procedure and compliance of the health regulations and laws could be effective to determine the safety standards and deliver the quality care to the patient (like Dad) by following the national health standards and legislation.

Rigid Complaint Settlement Procedure

There should be an effective complaint settlement procedure to hear the patients’ complaints by following them and listening their concerns or issues attentively. After this, the senior healthcare manager is required to investigate into the matter by employing a supervisory panel to investigate the matter and after this, an appropriate decision will be taken based on prioritizing the patient’s health and safety. The blamed service staffs will be terminated or deducted some payment in his/her monthly salary account. A safety culture will be developed that will foster the teamwork, group performance, shared tasks, informed decisions, and added responsibilities that will be effective to attend the serious patients by another staff in the absence of the relevant staff members in this employment team.This culture will promote the health and safety practices greatly by determining the safety measurements and treatment standards for the patients in the hospital(Kirk, Parker, Claridge, Esmail, & Marshall, 2007). Additionally, new service staffs with skills and adequate competences will be hired through the effective recruitment and selection procedures to recruit the talent, experienced, and high performing doctors and nursing staffs who understand the patients’ critical healthcare issues and accordingly to provide the emergency treatment as per the current patients’ conditions and service needs.

The standard clinical practices by using the professional ethical code of conduct and CSR reporting could be considered for maintaining the accountability, transparency, and materiality of the hospital care services through the right kind of information and regular reporting from the nursing staffs to the senior management and from where it should be reefed to the CEO for the final review. The CSR and ethical practices will assist in the better treatment and individualized care of the patients. The care staffs found in any corrupted activities will be withdrawn from the immediate effect through the suspension order from the CEO without giving notice to such employees(Law, Zimmerman, Baker, & Smith, 2010). The Medication management is an action to ensure the right kind of medicines prescribed by the doctors by following the Medication Chart to attend the patient, like Dad and give the right kind of medicines for the scheduled treatment and quality care of the patient.

Medication management is an important part of the healthcare service policy that includes use of the right kind of medicines as per medication chart and schedules in the most of the hospitals in the Australian healthcare industry. The case scenario involved different medication management issues including the improper medication schedule, missing medicines in the list for the medicine department, not added other or new medicine as per the schedule change for treating other problem, and writing down the medicines at bottom in the list by Mum that is not seen by the medicine department or drug store. The missing of the medicines is a medication management issue that is identified as an important intervention, caused from higher incident of human errors (mistakes of staff, Mum) and creates the health problems for Dad. PDCA cycle is used to deal with this intervention or issue that involves four steps- planning, doing, acting, and checking for developing an effective plan to investigate the root cause of the medication issue and potential solutions to deal with the issue (New South Wales Government, 2015).

The planning for this will include the preparation of the medical chart for specifying the particular medicines to a particular patient. It will also include the workforce planning, like employing a Medical safety and Quality Unit (MSQU),pharmacy barcode scanning, user-applied labeling, and the National Impatient Medication Chart. The doing phase will include working on the medication chart, specifying and providing the specific medicine matching the wristband of the patient, scanning of the bar code on the medicines before giving the patients, hiring of the high-risk machines and employment of the competent staff who understand the patients’ medicines properly(Reader, Gillespie, &Mannell, 2014).The checking phase will include revising the medicines of the suffered patient with the hospital medication chart and matching the medicine schedules of the patient (Dad) with the chart. It will also include checking of the barcode on the medicines, linking the requirements for the user-applied labeling, and checking of the high-risks or emergent medicines by MSQU department.

The final step, acting phase will include providing drugs to the patient by checking his wrist band, looking attentively at the medication chart and giving each dose of medicine as per schedule prescribed by the doctor. It will also include the medication safety self-assessmentthat is related to the development of processes and tools designed to facilitate the effective monitoring and evaluation of the medication management that will highlight the opportunities to bring further improvement in the missing of the medicines.The VTE prevention programs will assist the clinical teams and healthcare service facilities to implement the robust programs and processes for the prevention of the wrong medicines or missing medicines(Runciman, Hibbert, & Thomson, 2009). The application of PDCA Cycle will bring major improvement in practicing safer medication management for giving right drugs including the emergent and high-risk medicines to the patient, Dad for the quick treatment of the current or emergent health problem.

Conclusion

The PDCA cycle is used to deliver an effective solution to the medication intervention in the form of missing medication issue through different stages (plan, do, check, and act). This process provided a platform to bring improvement in the medication management for supplying the right medicines to the patient. The safety and quality issues, like staffing management problems, ineffective complaint redressal procedure, rigid information flow and inefficient reporting system, and errors in the medication by the service staffs were also discussed along with the contributory factors, effects, causes, action plans, and incidents for the issues. The cultural safety issues were caused due to the leadership development issues, the lack of the learning culture, ineffective information system management infrastructure, communicational problems, staffing management issues, and the lack of scheduled reporting and performance evaluation system. Finally, the action plans for addressing the workplace culture concerns were suggested in order to provide the right kind of treatment with the quality care by ensuring the safety of the patient from the high-risk zone.

References

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