Critical Decision Making for Providers

Question

View the scenario called “Critical Decision Making for Providers” found in the Allied Health Community media (http://lc.gcumedia.com/hlt307v/allied-health-community/allied-health-community-v1.1.html)
In a 750-1,200 word paper, describe the scenario involving Mike, the lab technician, and answer the following questions:
What were the consequences of a failure to report?
What impact did his decision have on patient safety, on the risk for litigation, on the organization’s quality metrics, and on the workload of other hospital departments?
As Mike’s manager, what will you do to address the issue with him and ensure other staff members do not repeat the same mistakes?
A minimum of three academic references from credible sources are required for this assignment.
Recommended references:
1. “Simulating Changes to Emergency Care Resources to Compare System Effectiveness,” by Baeyens et al., from Drugs & Aging (2012).
2. For additional information, the following is recommended: “Evidence-Based Strategies for the Optimization of Pharmacotherapy in Older People,” by Topinkova et al., from Drugs & Aging (2012).
3. “Reducing Long-Term Cost by Transforming Primary Care: Evidence From Geisinger’s Medical Home Model,” by Maeng et al., from American Journal of Managed Care (2012).
4. “Shattuck Lecture: A Successful and Sustainable Health System—How to Get There From Here,” by Fineberg, from New England Journal of Medicine (2012).

Answer

Decision making refers to the process of choosing the most plausible course of action from a list of available alternatives. It involves assessing the merits and demerits of various options as well as predicting the possible outcomes of each choice (Makoul & Clayman, 2006). Effective decision making is crucial for providers of healthcare services. From patient and administrative decisions to hospitals and other medical environments, timely and effective decisions promote the smooth running of operations and ensure quality of services rendered (Edwards & Elwyn, 2009). For example, in hospital settings, employees should know how to respond appropriately to various ethical dilemmas in order by choosing the most advantageous course of action in order to avert negative outcomes in the workplace thereby ensuring patient safety and quality of care. This can be demonstrated using a case scenario of Mike, a lab technician at a hospital, who had to make a decision between address a floor spill and reporting to his supervisor to avoid losing his job for lateness.

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            The scenario described in the section “Critical Decision Making for Providers” involves a lab technician named Mike, a young married man with a small child, working at a hospital to provide for his family as the sole breadwinner. Lately, he has been running late to work despite the fact that the job means so much to him. On this particular day, he had promised his supervisor that he would report early, yet he ended up being late. His decision to leave his house twenty minutes earlier did not pay off as he was delayed at an accident scene along the way. Upon arrival, Mike saw a spill on the floor in another work area and was at odds as to whether he should stop and call for help to clean it up or rush on up and sign in with the supervisor in time to prevent termination. Choosing to report the problem meant that Mike would stop at the front desk and page for housekeeping to come and clear the spill. While waiting for a few minutes for their arrival, he would dial up to his office to inform his supervisor that he has already arrived in the building but is sorting something out briefly downstairs. His manager would agree and request him to make up for the lost time at the end of his shift.

Failure to report the spillage on the floor resulted in a woman at the hospital lobby slipping and breaking her hip bone and causing excruciating pain for her. Mike’s decision to ignore the spill and clock in on time resulted in more consequences than he would have imagined. His choice to rush and finish his assigned tasks from the previous day as well as the current day’s assignments blinded him to the obvious danger the spill posed to people. This failure to report the spillage as well as failure to admit responsibility for neglecting the spill made Mike feel very guilty as he felt like he had an opportunity to prevent the accident, but did nothing to that effect. The immediate impact of not reporting the spill was the endangerment of patient and staff safety through tripping, falls and possible fractures or dislocations. This is evident in the case of the woman Mike was called to attend to who indicated that she had fallen in the lobby due to a pill on the floor. Evidently, compromising patient safety exposed the hospital to the risk of litigation. Patients who would be hurt from the spill, or impacted by it in one way or another could move to the court and build up a case of negligence against the hospital (Branas, Wolff, Williams, Margolis & Carr 2013). Patients would argue that hospitals are supposed to be a place of refuge and a safe haven for the sick and those recovering as opposed to a hotbed of potential safety risks.

By choosing to ignore the spill in the lobby and consequently paving the way for the injury of a woman, Mike compromised the quality metrics of the organization. A hospital which has an ongoing court case on negligence or one which is thought to not care about its patients’ and staff’s safety tends to lose credibility in the face of the public (Maeng, Graham, Graf,  Liberman, Dermes, Tomcavage… & Steele Jr, 2012). This results in a decline in patient numbers and, by extension, a loss of business to the hospital. The hospital’s quality standards are also likely to be compromised as patients would begin to doubt if the hospital can truly provide the best healthcare when something as small as a spill on the ground is being ignored. This would be viewed as an indicator of a toxic culture in which patient needs are ignored and the hospital environment neglected (Topinková, Baeyens, Michel & Lang, 2012).

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On the same breathe, failure to report would increase the workload of other departments such as the housekeeping department, which would be forced to clean up a larger area as individuals continue to unknowingly trod on the spill and spread it around. A more concerning problem would be the emergence of a situation where medical staff would have to contend with rising patient numbers arising from a growing list of fall incidents at the hospital. The legal department might have to send lawyers to court to block the establishment of a case while the public relations department might have to work hard to reassure the public and restore the hospital’s image.

As Mike’s immediate supervisor, I will call him to a meeting in my office to discuss the incident. After allowing him to present his case and listening to his side of the story, I will proceed to remind him of the importance of maintaining safety standards at the hospital. Moreover, I will highlight the importance of having a teamwork mentality and collective responsibility (Fineberg, 2012). Then I will issue him with a written warning to this effect and write out a memo to all hospital staff briefly describing the occurrence and urging them to uphold safety in their work stations. As a manager, I will also advise the housekeeping department to be more vigilant and look around for any spills or hazardous trash items left lying around such as gloves, empty medical bottles, bandages and syringes. To ensure that the mistake is not repeated, I will also write to the senior management of the hospital and recommend a workshop on safety techniques and standards as well as emphasize the need for critical decision making skills especially in high-pressure and high-risk situations.

Undoubtedly, critical decision making skills are mandatory in the world of healthcare provision since doctors, nurses and other staff members are called upon to make quick calls which, in one way or another, have an effect on the patients’ lives (Edwards & Elwyn, 2009). This is demonstrated in Mike’s scenario. The lab technician’s decision not to report a spill resulted in the slipping and subsequent injury of a woman who had just visited the hospital as a patient. Mike’s actions had a negative effect on patient safety, exposed the hospital to the risk of litigation, lowered the hospital’s quality assurance metrics, and added to the workload of other departments. All the above were consequences that could have very easily been avoided had Mike chosen to put safety ahead of his concerns about lateness. The ideal situation would have unfolded had Mike set up a coordinated strategy of ensuring that the spill problem is addressed while simultaneously alerting the supervisor about the reasons for his lateness.

References

Branas, C. C., Wolff, C. S., Williams, J., Margolis, G. & Carr, B. G. (2013). Simulating changes to emergency care resources to compare system effectiveness. Journal of Clinical Epidemiology66(8), S57-S64.

Edwards, A., & Elwyn, G. (2009). Shared decision-making in health care: Achieving evidence-based patient choice. Oxford: Oxford University Press.

Fineberg, H. V. (2012). A successful and sustainable health system—how to get there from here. New England Journal of Medicine366(11), 1020-1027.

Maeng, D. D., Graham, J., Graf, T. R., Liberman, J. N., Dermes, N. B., Tomcavage, J., … & Steele Jr, G. D. (2012). Reducing long-term cost by transforming primary care: Evidence from Geisinger’s medical home model. The American Journal of Managed Care18(3), 149-155.

Makoul, G. & Clayman, M. L. (2006). An integrative model of shared decision making in medical encounters. Patient Education and Counseling, 60(3), 301-312.

Topinková, E., Baeyens, J. P., Michel, J. P., & Lang, P. O. (2012). Evidence-based strategies for the optimization of pharmacotherapy in older people. Drugs & Aging29(6), 477-494.

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