Blog #3: Patient’s Perspective on Adverse Events.

Question: In your own words, explain why or why not the perspective of the patient is the most important determinant as to whether an adverse event has occurred.

No, the patient should not be viewed as the most important determinant as to whether an adverse event has occurred. The patient observations, although extremely valuable and important, are not always available or reliable. If a system is established to utilize the patient as the most important determinant to monitor adverse events, then what happens when the patient is incoherent or does not have any family members to observe treatment? The system of checks and balances would fall apart.

Understandably, the common patient will tend to have a natural deficit in the language of adverse events. Patients might not have a complete understanding of the adverse events, but they do have the first hand perspective of understanding the effects being applied in their treatment. Patient’s lack of understanding for the system checks in place to interrupt adverse events does not mean they do not play a vital role in notifying their care workers of an event. Essentially, an observant patient or family member is a key player in the balance for the system of checks and balances, but only a component of the entire system. If a patient is coherent and mentally keeping track of what is going on, then in the event there is a repeated process then the patient can notify the care worker of the event. This helps to strengthen the overall system.

The patient, when in a state to participate, can offer much value to a system that utilizes patient input. This could be in the form of a digital survey interlaced with the patients viewing device for example. The patient could answer a couple of quick multiple-choice questions that would be calculated and uploaded to the EMR. Then, based off those answers the system could flag the EMR if an adverse event has occurred or is about to occur.

Patients need to focus on recovery, not system process to ensure adverse events are not occurring. This speaks volumes about the state of our current healthcare system. Errors occur at such an alarming rate that the environment of healing is now approaching a quasi healing/monitoring system where the patient is being asked to make sure things are being done correctly. This is not a standard of care we should be embracing. The organizational structures and communications must improve for the benefit of the patient. It is good to have patients who take a vested interest in their own health, but patients should not have to worry about maintaining a “defensive observation” while entrusting their care to a healthcare organization.

Blog #2. Nursing Education: A Collaborative Effort at Quality Improvement.

Recently, I was allowed to attend a unique meeting of local healthcare organizations, and local colleges in a round-table like discussion on the educational standards of local nursing programs. By the end of this meeting I personally had a new appreciation for all the hard work, and collaborative effort between competitors to improve the nursing education. It was encouraging to witness the inner workings of a mix of competitors coming together in a collaborative, and unbiased effort to improve quality.

The meeting began with the host college touching on nursing program enrollment, graduation rates, and practicum examples for the previous semester. The other colleges in attendance then followed one another with statements of their own institutional figures pertaining to each of their respective nursing programs. After this, the dynamic of the discussion shifted to problems with the curriculum, examination, and real-world training through practicum experiences. Some problems the colleges noted had to deal with practicum training not matching classroom teaching. One college official was very concerned that students are being taught one way, only to be told to practice a different way when integrated with a local organization.

After the college officials had an opportunity to present their observations from the last semester, the local healthcare providers then presented their observations of the nursing students. The most common theme from this side of the table had to deal with students overall lack of professional skill sets. Statements highlighted student’s general lack of understanding how to communicate, failure to act professionally, critical thinking qualities, and lack of basic interpersonal relationship skills. There was little mention of any clinical observations; overall the healthcare providers seemed pleased in that area.

The discussion then shifted to an open discussion for ideas how to improve on the concerns raised by all stakeholders. All the stakeholders agreed on some new approaches that would be tested over the next semester in an effort to improve the aforementioned conditions, and a few others not mentioned.

This meeting was a wonderful opportunity to witness educational, and institutional competitors come together to ensure that the quality of nurses being turned out by the local educational institutions are performing at the highest standards. All the stakeholders understand how critical it is that an open communication exists between all parties because they all expect the best quality of care for their patients. It is my belief that this kind of transparency, and collaboration between competitors will lead to higher quality in the Orlando area.