According to an article published by the Becker’s Hospital Review (Vaidva, Zimmerman, & Bean, 2018), the top 10 patient safety concerns for 2018 are:
1. Disparate EHRs (electronic health records)
2. Hand hygiene
3. Nurse-patient ratios
4. Drug and medical supply shortages
5. Quality reporting
6. Resurgent diseases.
7. Mergers and acquisitions
8. Physician burnout
9. Antibiotic resistance
10. Opioid epidemic
Each of these concerns has led to poor patient outcomes, including deaths (Vaidva et al., XXXXXXXXXXThe good news is that number of hospital-acquired health conditions (e.g., infections, falls, pressure ulcers, adverse drug events, etc.) has decreased by 21%, between 2010 and 2015 (Agency for Healthcare Research and Quality, XXXXXXXXXXSimilarly, there has been a decrease in medical, medication, or lab e
ors or delays, which may indicate that policy efforts to keep patients safe have been successful (Davis, Kristof, Squires, & Schoen, 2014).
In this Discussion, you will consider the impact of policy on patient safety and recommend policies that could address different topic areas.
References
Agency for Healthcare Research and Quality XXXXXXXXXXNational scorecard on rates of hospital-acquired conditions 2010 to 2015: Interim data from national efforts to make health care safer. Retrieved from https:
www.ahrq.gov/professionals/quality-patient-safety/pfp/2015-interim.html
Davis, K., Kristof, S., Squires, D., & Schoen, C. (2014). Mi
or, mi
or on the wall: How the performance of the U.S. health care system compares internationally. Retrieved from https:
www.commonwealthfund.org/sites/default/files/documents/___media_
files_publications_fund_report_2014_jun_1755_davis_mi
or_mi
or_2014.pdf
Vaidya, A., Zimmerman, B., & Bean XXXXXXXXXXTop 10 patient safety issues for 2018. Retrieved from https:
www.beckershospitalreview.com/10-top-patient-safety-issues-for-2018.html
To prepare for this Discussion:
· Review this week's Learning Resources. Pay particular attention to the Learning Resources focused on policy in the healthcare setting to improve patient safety.
· Review Vaidya, Zimmerman, and Bean’s op 10 patient safety issues for 2018.”
· Find a peer-reviewed journal article (no more than 5 years old) in the Walden Li
ary that focuses on policy in the healthcare setting and its impact on patient safety. NOTE: Do not just focus on medical e
ors. Instead, find an article that addresses the circumstances that led to an unsafe action (i.e., that compromised patient safety), which in turn led to the implementation of a policy in the healthcare workplace.
By Day 4
Post a comprehensive response to the following:
· In your own words,
iefly summarize the article. Include 1) the purpose/aim(s) of the study/article, 2) a description of the healthcare setting (e.g., hospital, clinic, urgent care, etc.), 3) the circumstances that created a patient safety issue (e.g., lack of training, working too many hours, understaffed, etc.), and 4) the policy or need for a policy.
· Describe a change in policy or procedure that could help address this patient safety issue.
· Explain what other factors besides policy may have contributed to the safety issue and how these can be addressed.
· Support your post with in-text citations and references from specific Learning Resources and at least one outside scholarly source. Note: Your outside source can be the article you selected for the Discussion.
Note: Initial postings must be 250–350 words (not including references).
https:
eds-a-ebscohost-com.ezp.waldenuli
ary.org/eds/pdfviewe
pdfviewer?vid=23&sid=7cc9da6a XXXXXXXXXXb674-e536593b3f8e%40sessionmgr4007
Title:
Incident reports involving hospital administrative staff: analysis of data from the Japan Council for Quality Health care nationwide database. By: Akiyama, Naomi, Akiyama, Tomoya, Hayashida, Kenshi, Shiroiwa, Takeru, Koeda, Keisuke, BMC Health Services Research, XXXXXXXXXX, 11/20/2020, Vol. 20, Issue 1
Database:
Academic Search Complete
Incident reports involving hospital administrative staff: analysis of data from the Japan Council for Quality Health care nationwide database
Background: Task shifting and task sharing in health care are rapidly becoming more common as the shortage of physicians increases. However, research has not yet examined the changing roles of hospital administrative staff. This study clarified: ( 1) the adverse incidents caused by hospital administrative staff, and the direct and indirect impact of these incidents on patient care; and ( 2) the incidents that directly involved hospital administrative staff. Methods: This study used case report data from the Japan Council for Quality Health care collected from April 1, 2010 to March 31, 2019, including a total of 30,823 reports. In April 2020, only the 88 self-reported incidents by hospital administrative staff were downloaded, excluding incidents reported by those in medical and co-medical occupations. Data from three reports implicating pharmacists were rejected and the quantitative and textual data from the remaining 85 case reports were analyzed in terms of whether they impacted patient care directly or indirectly. Results: Thirty-nine reports (45.9%) involved direct impact on patient care, while XXXXXXXXXX%) involved indirect impact on patient care. Most incidents that directly impacted patient care involved administrative staff writing prescriptions on behalf of a doctor (n = 24, 61.5%); followed by e
ors related to system administration, information, and documentation (n = 7, 17.9%). Most reported e
ors that indirectly affected patient care were related to system administration, information, and documentation used by administrative staff (n = 22, 47.8%), or to reception (n = 9, 19.6%). Almost all e
ors occu
ed during weekdays. Most frequent incidents involved outpatients (n = 23, 27.1%), or occu
ed next to examination/operation rooms (n = 12, 14.1%). Further, a total of 14 cases (16.5%) involved patient misidentification. Conclusions: Incidents involving hospital administrative staff, the most common of which are medication e
ors from inco
ect prescriptions, can lead to severe consequences for patients. Given that administrative staff now form a part of medical treatment teams, improvements in patient care may require further submission and review of incident reports involving administrative staff.
Keywords: Hospital administrative staff; Incidents; Medication e
or; Task shifting; Task sharing; Patient safety; Quality improvement; Risk management
Background
The rate of population aging and the number of older adults, defined as people aged 65 years and above, are increasing in some countries [[ 1]]. Japan faces serious policy problems regarding its aging society, including a shortage of physicians. In an effort to address these problems, the number of physicians per capita continues to rise with the goal of reaching the level recommended by the Organisation for Economic Co-operation and Development. The numbers of physician assistants and advanced practice registered nurses also continue to increase. However, the estimated supply of physicians will not fulfill the demand for health care in an aging society; to meet the projected needs, the number of new physicians must increase by 53% over the cu
ent pace [[ 2]]. Thus, the Japanese government has strategized a new solution to the problem of physician shortage as part of a series of actions for promoting work-style reform [[ 3]]. Comprehensively, the reforms aim to create greater stability in the national workforce by formalizing improvements to various aspects of employment in Japan, such as improved work-life balance and ensuring equal access to health care. To meet these goals, the reforms will allow for "a wide variety of work patterns" and "expand the duties of industrial physicians and strengthen the function of occupational health services." [[ 3]]
Task shifting from physicians to nurses has created interest among policymakers as a strategy for responding to staffing shortages and increasing access to primary care; task shifting in this sense has been reported as efficient and cost-effective [[ 4]]. This strategy of work reform in Japan is part of a global trend [[ 3]]. However, the long working hours of physicians continue to be a serious problem in Japan, prompting the government to provide incentives to hospitals that have adopted systems that shift some tasks to nurses and pharmacists. For example, the Ministry of Health, Labor and Welfare offered incentives for physicians' offices adding work support systems. In the Ministry's 2008 medical fee revision, a new qualification of medical assistant was introduced. For registration as a medical assistant, 32 accredited education hours related to medical care, followed by a qualifying examination are necessary [[ 6]]. Medical assistants are authorized to enter prescription information and predetermined examination orders onto patients' charts on behalf of doctors. They are hired as hospital administrative staff and usually work in outpatient departments or hospital wards.
After registered nurses, who, at 38.5% of the total staff, comprise the largest number of employees per hospital, administrative staff and physicians are the second- and third-largest groups, accounting for 10.5 and 10.3% of all hospital staff, respectively, as of 2017 [[ 7]]. Yet previous studies have indicated that administrative staff in Japan report fewer incidents than nurses. However, few nationwide studies have described the roles of administrative staff in Japan, and many of them were case studies involving one hospital, such as Ishibashi et al. [[ 8]] and Osawa [[ 9]].
Previous studies of incident reports focused on reports involving clinical staff such as physicians, nurses, and pharmacists whose major roles directly impact patient care. However, the roles of hospital administrative staff encompass an indirect impact on patient care, which may be the reason why recent studies of incident reports have not focused on reports involving administrative staff, choosing instead to focus on roles with a direct impact on patient care. Therefore, the objective of this study was to examine incident reports involving hospital administrative staff to clarify: ( 1) the types of incidents reported, and ( 2) how situations involving incidents were reported, focusing on their direct and indirect impacts on patient care.
Methods
Operational definitions
Administrative staff in health care include clerks, medical secretaries, medical assistants, receptionists, and accountants. Direct care is care that directly impacts a patient, through the provision of services to a patient that require some degree of interaction between the patient and the health care provider. Examples include assessments, performing procedures, advising, and implementation of a care plan [[10]]. Indirect care is care that does not directly impact a patient; services that are related to patient care but do not require interaction between the health care provider and the patient. Examples include charting and scheduling [[10]]. It is common to divide care into direct and indirect care in the nursing field [[11]].
Study design
This study used secondary data from the Japan Council for Quality Health care (JCQHC). JCQHC collects all reports of adverse events and incidents (including e
ors and near-misses) nationwide from hospitals in Japan. The total number of reports was 1018 in 2015, with 275 mandatory reports and 743 voluntary reports from institutions. These institutions voluntarily collected the reports from their staff, and selected a portion of the reports to send to the JCQHC. In FY2004, the Division of Adverse Event Prevention began implementing the Project to Collect Medical Near-miss/Adverse Event Information, which gathers information about medical adverse events and medical near-miss events, with the objective of promoting safety in medical care. The JCQHC compiles the information gathered concerning medical adverse events and anonymizes it before releasing it to the public [[13]]. The JCQHC website contains open data, which have been used to study medical incidents in previous studies. For example, Akiyama et al. [[14]] used JCQHC data to compare differences in nurse-related incidents in terms of various factors, such as clinical experience level, drug administration, and medical