Mproving quality health care in the hospitals net
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Mproving quality health care in the hospitals net

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Mproving quality health care in the hospitals net Mproving quality health care in the hospitals net Document Transcript

  • MPROVING QUALITY HEALTH CARE IN THE HOSPITALS Dr.T.V.Rao MD Today Indiaisa fast healthcare givingnation,inthe World,hundredsof Medical andNursing Institutions,apartfrommanyPrivate andcorporate hospitalsattractingmanypatients.Itiscertain soonthe patientswill realise whatisgoodforthemwhomto consultfortheircare and thisprocess manyhightech and well-builtinstitutesmaynotdoa goodbusinessasheathcare costs are increasingandthe paramedical andMedical professionalsmigrate tothe neweropportunitiesand evenforfewmore benefits,Inlookingatthe factsmanylow profile hospitalssurvivedwiththe few dedicatedmedical andparamedical staff,the expectationsof the poorora richpatientislittle humancare. Whensomeone reallybecome sickthe machineswill notmatter,andfind the human touch andconcern isthe most important,bringthe greaterrapportwithpatients,andreduce litigation'saftermore than4 decadesinthe medical professionif Ibecome patientIwishtobe treatedbygood humanbeingandnot a great Doctors,and withlittle of myresourcesIwishnotbe experimentedwithcostlydiagnosticexperimentswhichmanyDoctorsdofor the benefitof builtin advantagesinthe systemwe live.InaverydevelopedNationlike USA the patientswantattentionin spite of high technological interface aswithhealthcare professionalswhoare mostfrequentlyat patients’bedsides,nursesplayacentral role inensuringthe qualityof hospital care thatpatients receive,andtheirvigilance isanimportantdefence againstmedical errors.Butwhentheyare overburdenedwithnonclinical demandsandsysteminefficienciesandfailures,patientcare suffers and disillusionednursesoftenleavetheirjobs.We shouldnotforgetif the fasterthe peopleare leavingthe Institutewithoutvalidreasonswe shouldtake feedbackwhatmakesthemtoleave,they leave certainlywhenthe youngpeoplehave noopportunitiestolearnfromseniorsandsystemisnot considerate,itmeanswe will have fasterturnoutof employees.A significantchallenge all overthe worldisto provide high-quality,patient-centredcare isthe highturnoverof nursingstaff.The national average fornursingturnoverinU.S.hospitalsrangesfromabout8 percentto 14 percent peryear, andthe rate for nursesonmedical/surgical unitsmaybe evenhigher.Itmeansitismuch unavoidable factoreveninIndiaandevenmaybe muchmore inKeralaas manylookingfor opportunitiesinhightechhospitalsandmore lucrative jobsabroad.Researchhasshownthat70 to 90 percentof errors inhospitalsresultfrombadlydesignedsystemsof care.Close to40 percentof all unanticipatedhospital deathsoccuronmedical/surgical units.Iwisheveryhospitalshouldhave an auditof mortalityandprolongedmorbidityafterthe care by a particularunit,andI thinkit is essential unlesswe have self-assessmentof mattersof care in our hospital anditmay notsustain withtime as everyuntimelydeathanddissatisfiedrelativesof the patientwillbringdownfall and reputationof the highlyqualifiedprofessionalsLearnwhatqualityimprovementactivitiesare underwayinourarea, learnfromotherhospitalshow theyare managingthe mattersandask how youcan contribute andtoimprove ourselves.Ithinkthe firstface of the hospital isourcausality departmentseveryone andthe relativeswhoaccompanypatientstake the mattersintoserious considerationwhenthe mattersgowrong.Many upcominghospitalsare empoweringthe human resource departmentswithgoodcommunicationintimesof crisisinhospitalsacrossthe nation, teamsof doctors,nurses,otherfront-line staff,andadministratorsare workingwithpatientsand otherstakeholderstoimprove the qualityof hospitalcare.Toa trulyProfessional Nurse oradoctors the life isverystressful the impactonhealthcare staff isreal.Staff healthispoorerinhealthcare than inothersectors,as we see inmany nursingmothersandpregnantstaff andstressand sickness ratestoo are higher.Unlessthese stressesare recognizedanddealt with,healthcare staff are at risk of burnoutandcan become disengagedfromtheirpatients.Thisdoesnotexcusethe failingsbystaff workinginhospitals,butthisburnoutanddisengagementisundoubtedlyafactorwe needto
  • considerwhere the quality andcompassionthatpatientsneedislacking.Manyhealthcare staff believetheyare surviving,notthriving.Staff stressshouldbe addressedacrossthe systemrather than as an individual problemorweaknessforthe benefitof patients,staff andthe systemasa whole.We cannotblame the materson few ina DevelopingcountrieslikeIndiaandmajorerrors happeninthe developedcountrytoo.UnitesStatesStatisticsshow Asmanyasone-fourthof hospital deathsmightbe preventable;nearly180,000 people die eachyearpartlyas a resultof iatrogenicconditions.Moreover,asmuchasone-thirdof some hospital proceduresexpose patients to riskswithoutimprovingtheirhealth;one-thirdof drugsprescribedare notindicated;andone- thirdof laboratorytestsshowingabnormal resultsdonotgetfollowedupbyclinicians(Duboisand Brook 1988; Brooket al.1990; Leape 1994; Institute of Medicine 2000).We needtoaddressthe matterson a priorityfinally,extensiveinvolvementof hospitalstaff acrossmultiple unitsmayalso strengthenthe effectivenessof Qualityimprovementeffortsbypromotinga“quality”culture.That is,pervasive participationinQIpromotessharedvaluesaboutthe importance of continuous improvement,usingdataandscientificmethods toidentifyproblems,communicatingopenly,and collaboratingtoimplementsolutions.Qualitycare isthe needof the Hour neglectingwill perishnot onlyInstitutes,Medical colleges,andeventhe populardoctorsinthe highregard,the choice isyours to realize where we standandthinkandunderstandthe problemswithpositiveattitude.Itis essential forthe UpcomingInstitutesandMedical Collegesshouldhave workauditof Departments, SeniorconsultantsandProfessorsshouldinteractwithadministratorsandmanagements,every6 monthsto bringbefore the administratorsandmanagementsproblemsinworkplace inimproving the servicestoimprove the qualityperformance,andtofindbettersolutiontoimprove the quality assurance whichisan neverendingtopicif we wishtosurvive inthe competitive world. Dr.T.V.RaoMD Professorof Microbiology,Travancore Medical College,KollamKerala