Medical Errors and Adverse Events
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Apr 3, 2024
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Medical Errors and Adverse Events
Critique of Approaches to Addressing Medical Errors in the Health Care System Approach 1: Evaluation of Healthcare professional’s competence and Accountability
This approach, as mentioned in the reading, places a significant emphasis on evaluating the competencies and continuous competencies of healthcare practitioners or professionals (Melnyk & Tan, 2021), (Adverse events, near misses, and errors, 2022). The primary mechanism
for this evaluation is through health regulatory schools / universities, which play a vital role in ensuring that health care providers meet required established standards and are held accountable for any errors caused by them (Melnyk & Tan, 2021). Although, holding individuals accountable is important to ensure the safety of the patients, this approach, however, may contribute to a culture of blame and fear, which may result
hesitation in healthcare professionals in reporting errors due to fear of punitive measures, impacting the transparency needed for effective learning from mistakes (Melnyk & Tan, 2021) and (Baker, Norton, & Flintoft, 2004), (Higgins, & Herpy, 2021). Approach 2: Focusing on Systems and Design to Encourage Reporting Errors in healthcare
The ERR is human reading emphasizing the importance of addressing the impact of systems and its design to avoid and mitigate the errors in the healthcare system (Kohn, Corrigan, & Donaldson, n.d.), (Higgins, & Herpy, 2021). This approach downplays individual responsibility to create an environment where health professionals feel encouraged to report errors, promoting a culture of safety and continuous improvements (Kohn, Corrigan, & Donaldson, n.d.), (Higgins, & Herpy, 2021).
While the system-focused approach is important for fostering a culture of safety, there is a risk of downplaying individual responsibility to the extent that it might be perceived as neglecting accountability. The challenge lies in finding the right balance between acknowledging
systemic issues and ensuring that individuals take responsibility for their actions (Kohn, Corrigan, & Donaldson, n.d.). Possibility of Pursing Both Approaches The two approaches; evaluating individual competence and emphasizing system-based improvements is not contradictory but complementary (Garrouste-Orgeas, 2012).
While continuous evaluation of the healthcare professionals’ competencies is important for ensuring that they posses the necessary skills and knowledge to deliver safe care, concurrently, the recognizing the impact of the systemic factors are also important for ensuring to address the organizational flaws and create a safe culture for healthcare individuals and safe care mechanisms for patients (Garrouste-Orgeas, 2012), (Kohn, Corrigan, & Donaldson, n.d.). As mentioned, a comprehensive strategy to pursue both approaches, would highly effective as one approach would involve evaluating individual competence and accountability and the other approach would be addressing systemic factors contributing to errors (Kohn, Corrigan, & Donaldson, n.d.). In summary, an integrated strategy that combines evaluating individual competence with a system-based approach is not contradictory, rather, it is essential for comprehensive and effective healthcare quality improvement (Garrouste-Orgeas, 2012). Therefore, a combined strategy will help the healthcare industry, to significantly mitigate the errors in the treatment of patients by holding professional accountable and by addressing systemic issues to create a culture of safety and continuous improvements synergically (Kohn, Corrigan, & Donaldson, n.d.), (Higgins, & Herpy, 2021), (Garrouste-Orgeas, 2012).
References Melnyk, B., & Tan, A. (2021). Patient Safety Issue. AJCC AMERICAN JOURNAL OF CRITICAL CARE
, 30
(3). https://avenue.cllmcmaster.ca/d2l/le/content/605530/viewContent/4563004/View
Kohn, L. T., Corrigan, J. M., & Donaldson, M. S. (n.d.). To Err Is Human: Building a Safer Health System
. National Academies Press. https://avenue.cllmcmaster.ca/d2l/le/content/605530/viewContent/4563003/View
Baker, G. R., Norton, P. G., & Flintoft, V. (2004, May 25). The Canadian Adverse Events Study:
the incidents of adverse events among hospital patients in Canada
. Recherche. https://avenue.cllmcmaster.ca/d2l/le/content/605530/viewContent/4563002/View
Garrouste-Orgeas, M., Philippart, F., Bruel, C., Max, A., Lau, N., & Misset, B. (2012). Overview
of medical errors and adverse events. Annals of Intensive Care
, 2
(1). https://doi.org/10.1186/2110-5820-2-2
Adverse events, near misses, and errors. (2022, March 30). PSNet. https://psnet.ahrq.gov/primer/adverse-events-near-misses-and-errors
Higgins, M. C., & Herpy, J. P. (2021). Medical error, adverse events, and complications in interventional radiology: liability or opportunity? Radiology
, 298
(2), 275–283. https://doi.org/10.1148/radiol.2020202341
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250 words Reply Hi Anurag,
Your article provides a compelling exploration of the intricate dynamics between healthcare practitioners, evaluation methodologies, and systemic responses to adverse events. I appreciate the nuanced perspective presented, particularly the recognition of potential limitations in an evaluation-centric approach as highlighted by Dr. Michael Evans and the insights from the 2004 CMA study. The understanding that errors may stem not only from a lack of knowledge but also from the inherent complexity of healthcare situations is a crucial insight that warrants attention.
The focus on the mental health of CCNs and its association with errors adds a valuable dimension to the discussion. The proposition to shift towards systemic solutions, exemplified by the success of Alberta's Hip & Joint replacement service system, is well-founded.
While there's agreement on the importance of not solely relying on evaluations, your suggestion to integrate continuous learning and development into the evaluation process resonates well. The proposal to evaluate practitioners every 5-8 years, with a focus on recent developments, aligns with the evolving landscape of technology and medical practices.
Your acknowledgement of the potential critique regarding over-reliance on technology is noteworthy. Striking a balance between technological advancements and preserving the human aspect of healthcare is indeed a critical consideration.
In conclusion, your article prompts valuable reflections on the need for a comprehensive approach that integrates evaluations, continuous learning, and systemic improvements to enhance
both practitioner well-being and patient care. It raises essential questions about how the healthcare system can evolve to adapt to challenges while maintaining a human-centered focus.