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Medical Accidents Leading To Death And Disability Essay
Building upon the outline for an educational session you created in the Educational Program on Risk Management Part One: Outline of Topic 2 assignment, develop a 12-15 slide PowerPoint presentation that expands in greater detail on how and why your organization should implement your proposed risk management strategy. Incorporate any instructor feedback from the Topic 2 assignment into this presentation and include talking points in the speaker notes section of each slide.Medical Accidents Leading To Death And Disability Essay
Keep in mind that the PowerPoint is meant to serve as a visual aide to bolster your presentation and is intended to highlight main ideas and key points. Do not use dense blocks of text or more than 7 bullet points of text per slide. However, you may include supplementary images, graphs, and data where relevant.
To successfully complete this assignment, include the following sections as per your outline from Topic 2, though you may include any additional sections as needed:Medical Accidents Leading To Death And Disability Essay
You are required to support your statements with a minimum of six citations from appropriate credible sources.
Refer to the resource, “Creating Effective PowerPoint Presentations,” located in the Student Success Center, for additional guidance on completing this assignment in the appropriate style.
While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.Medical Accidents Leading To Death And Disability Essay
This assignment uses a rub
Risk management program outline
Risk management topic: Medical accidents.
• Medical accidents are the leading causes of death and disability (Atsuji, 2019).
• This topic is important because the key to delivering quality healthcare services is ensuring patient safety.
• Healthcare services ought to be safe, patient-centered, and effective (Carlesi et al, 2017).
• In this organization, 4 in every 10 patients have reported being harmed during treatment.
• This mainly occurs through wrong medication which can be caused by improper storage of medicines and lack of verification before administering the medicine among other factors (Atsuji, 2019).Medical Accidents Leading To Death And Disability Essay
• The current risk management plan does not include a risk management strategy to minimize the chances of medical accidents occurring.
• Local, state, and federal healthcare compliance standards dictate that patientcare should be equitable, timely, safe, efficient, and integrated (Carlesi et al, 2017).
• Implementation of this risk management strategy will ensure that the chances of medical accidents occurring are reduced and therefore patient care will be safer and more efficient.
• Research shows that 1 in every 10 patients in the world is harmed during their treatment at the hospital and this causes them adverse effects.
• Most of the medical accidents occur during primary care and in outpatient healthcare services (Atsuji, 2019).
• Hospitals spend 15% of their revenue taking care of the adverse effects that have been caused by medical accidents (Ghaffari et al, 2020).Medical Accidents Leading To Death And Disability Essay
• 50% of the medical accidents that occur are preventable and 80% of the harm that results from these medical accidents is preventable (Atsuji, 2019).
• Most of these medical accidents occur in hospitals in low-income countries causing more than 2 million deaths annually (Carlesi et al, 2017).
• Implementing a risk management strategy to reduce medical accidents can reduce patient harm by 15% and can help hospitals to save a lot financially (Ghaffari et al, 2020).
• The risk management strategy will be communicated to the staff and the employees of the organization so that they can be ready for change.
• The organization will then formulate policies and programs that will support the implementation of this strategy.
• The organization will budget for and allocate the necessary resources required to implement this strategy such as finances.
• Functions and activities will then be discharged in the implementation of this strategy (Candido & Santos, 2015).
• This will be an expensive course because the hospital will have to create more space to store medicines so that mix-up does not occur.
• The hospital will be required to change its culture to involve patients in their care as one way of preventing medical accidents. Changing organizational culture is not an easy course (Verweire, 2018).
• The evaluation of the strategy will be done by assessing how much the cases of medical accidents in the hospital have reduced (Punt et al, 2016).
• This will meet the organization’s short-term goal which is to reduce the cases of medical accidents by at least 20 in the first 2 months after strategy implementation.
• It will also meet the organization’s long-term goal which is to ensure that no medical accidents causing patients harm will be occurring in the hospital.
• The organization needs to consider improving communication with different medical providers to reduce the risks of medical accidents.Medical Accidents Leading To Death And Disability Essay
• The organization should come up with a standard procedure to store medicines that look alike to avoid mix up.
oad traffic accidents are a major growing but neglected global health problem causing more than 1.2 million deaths per year. Every minute, more than two people die as a result of these accidents (Unece.org, 2018). The mortality rate represents only the tip of the iceberg of the total burden, with the number of injured people reaching as high as 50 million, which equates to the population of 5 of the world’s largest cities combined (WHO, 2004). With the economic growth, motorisation and without any changes to present prevention policies, the road fatalities are forecast to rise by 65% in 2020 compared to 2000. A lot more dramatic increase is estimated in low- and middle-income countries, where the rate can increase by in excess of 100% (Ameratunga, Hijar, Norton, 2006). Road traffic accidents are the leading cause of death in the young population aged 5-14 and 15-29, along with being number 3 in the 30-49 group (Figure 1). In addition, approximately 50% of all collisions occur in the most productive age group (15-44) leading to major economic losses. WHO (2004) predicts road collisions to rise to the 6th place for mortality rate worldwide with the rise to the 3rd place for the cause of DALYs lost by 2020.Medical Accidents Leading To Death And Disability Essay
Ischaemic heart disease
Ischaemic heart disease
Lower respiratory infections
Lower respiratory infections
Alzheimer disease and other dementias Medical Accidents Leading To Death And Disability Essay
Trachea, bronchus, lung cancer
Lower respiratory infections
Ischaemic heart disease
Lower respiratory infections
Figure 1: Leading causes of death by age group in 2016 (adapted from WHO, 2018)Medical Accidents Leading To Death And Disability Essay
Paradoxically, low- and middle-income countries account for approximately 90% of the total traffic fatalities despite the fact that this region has only around 54% of the world’s vehicles (Figure 2). This can be partly explained by the fact that a large number of deaths occur among the vulnerable road users such as pedestrians, cyclists and motorcyclists. The global rate of road fatalities is 17.4 per 100 000, however, there are significant disparities among countries depending on the economic status. While the high-income countries have a rate of 9.2 per 100 000, both low- and middle-income countries have rates twice as high (18.4 and 24.1 per 100 000 respectively) (Figure 2, WHO, 2015). The highest mortality rates are found in the African region. In addition, people from low socioeconomic backgrounds even in high-income countries have also higher rates demonstrating the link between accidents and poverty (WHO, 2018).
Figure 2: Population, road traffic deaths, and motorised vehicles by proportion and road traffic deaths per 100 000 populations, by country income states 2015 (adapted from WHO, 2015)Medical Accidents Leading To Death And Disability Essay
Why is it a public health concern?
Infectious diseases and more recently non-communicable diseases have dominated the public health effort with road traffic accidents never appearing as a global health concern until the second half of the twentieth century (Borowy, 2013). Funding for research and development for traffic collisions is at the bottom of a league table with a value of less than $1 per disability-adjusted life year (DALY) compared to $26 per DALY for HIV/AIDS (WHO, 1996). One of the possible reasons for the historical lack of attention is the view of accidents as random uncontrollable events that are an inevitable part of life (Johal, Schemitsch, Bhandar, 2014, Loimer, Guarnieri, 1996). Traditionally, the traffic collisions were perceived as the sole responsibility of the road users. It has been argued that although human error can trigger a crash, it might not be the underlying causative factor and indirect influences such as infrastructure, vehicle safety features, traffic laws and their enforcement contribute significantly (Rumar, 1999). Therefore, road crashes are not entirely random, but they are in fact comparable to any disease with an agent (road user), host (vehicle), and vector (transfer of acute energy that causes the disruption in the normal human physiology) (Hyder, 2004). A systematic approach needs to be adopted addressing all risk factors and areas for intervention. The idea of injury prevention control framework was first described by Haddon that identified three phases of an accident– pre-collision, collision, and post-collision (Figure 3, WHO, 2004).Medical Accidents Leading To Death And Disability Essay
Pre-collision – crash prevention
Road design and road layout
Collision – injury prevention
Other safety devices
Crash-protective roadside objects
Access to medics Medical Accidents Leading To Death And Disability Essay
Ease of access
Access and response
Figure 3: Haddon matrix, areas for intervention in road traffic injuries (adapted from WHO, 2004).
The global impact
Globally it is estimated that 3% of GDP is lost as a result of road fatalities and injuries. The effect is even bigger in low- and middle-income countries where it can be as high as 5% (Dahdah, McMahon, 2008). The estimated impact corresponds to $518 billion per annum out of which $100 billion occurred in developing countries. The economic loss in these countries is twice as high as the annual amount of financial assistance they receive demonstrating the magnitude of the impact (United Nations, 2003).Medical Accidents Leading To Death And Disability Essay
Road collisions place significant a strain on the healthcare systems, especially in developing countries. An epidemiolocal review in developing countries showed that between 30% and 86% of all trauma admissions are accounted to road traffic accidents. In some countries, traffic collision casualties represented 48% of bed occupancy within surgical wards, in addition to these patients also being the most frequent users of operating theatres and intensive care units (Odero, Garner, Zwi, 1997). Therefore, prevention of road accidents would not only save money and resources but would also relieve pressure on hospitals and healthcare professionals (WHO, 2004).Medical Accidents Leading To Death And Disability Essay
Individual and family level
Many families are pushed into poverty as a result of the costs associated with medical care, disabilities, funeral or simply the loss of income. A study conducted in Bangladesh showed that 70% of households reported decrees in their income and food consumption in addition to ¾ reported lower standards of living (Babtie Ross Silcock, Transport Research Laboratory, 2003). Furthermore, in some instances, it might lead to families selling its property or taking loans (Mock et al., (2003). Death or disability has an impact not only on the family financial situation but also on health and social status of the children left behind. For example, road accidents fatalities are the second commonest cause of children being orphaned in Mexico (Hijar, Vazquez-Vela, Arreola-Risa, 2003). Adding to this picture is the effect on the individuals involved in road traffic collision. This ranges from by physical disability, loss of employment to psychological effects (WHO, 2004).Medical Accidents Leading To Death And Disability Essay
Causes and preventions
Poor infrastructure, one of the most important causative factors, plays a major role in developing countries where a wide range of road users from trucks, buses, cars, motorcycles, bicycles and pedestrians occupy the same road without separation and therefore exposing the vulnerable group (WHO, 2004). A recent study on road safety in 60 countries showed that more than 50% of roads had poor infrastructure. Improvement in the 10% of roads with the lowest standards has the potential to prevent around 2.3 million deaths and 40 million serious injuries over 20 years (World Road Association, 2015). Safety designs, such as widening roads, raised pedestrian crossings, separate paths for bicycles and motorcycles, roundabouts, traffic calming devices, warning signs, have a profound effect in reducing the likelihood of accidents when planning as well as updating existing roads. Safety assessment and identification of the most dangerous roads is an example of affordable measures that can have a significant impact (WHO, 2015).Medical Accidents Leading To Death And Disability Essay
Speed limitations decrease the likelihood of accidents along with the reduction in severity should they happen. It attributes between 30-50% of accidents worldwide (Chisholm et al., 2012). However, according to WHO (2017), only 47 countries, that equates to 13% of the world population, have laws that comply with the best practice in urban areas (Figure 4).
Figure 4: Urban speed laws by county (WHO, 2015)
Alcohol has the opposite effect, increasing the risks of accidents. Yet again only 34% of countries have laws enforcing best practice. In addition, injury severity and the risk of death can be further reduced by the use of seatbelts, helmets, appropriate child restrains as well as use of vehicles with basic safety standards. However, a similar pattern in legislation concerning these protecting features is found worldwide (WHO, 2017). It has been shown that most effective intervention is joint enforcement on speeding, alcohol limits and helmet use laws due to their synergistic action and relative marginal cost of adding safety checks. One DALY saved costs $ 1000-3000 in the developing world, which is less than yearly income per capita, suggesting the intervention is cost-effective (Chisholm, Naci, 2008).Medical Accidents Leading To Death And Disability Essay
Access to healthcare
Most developing countries do not have basic emergency services. First aid at the scenes and transport, if any received, are delivered mostly by bystanders, relatives or police. Once reaching the hospital, the care in these countries is mostly delivered by general practitioners without any trauma training. Furthermore, there is a lack of surgeons, equipment, protocols and organisation within hospitals which result in delays and poorer outcomes (Mock, nii-Amon-Kotei, Maier, 1997). Studies have shown that over one-third of deaths could be prevented if developing countries had similar trauma outcomes as in high-income countries. However, these implementations are a lot harder to achieve and require significant global investment (Mock et al.,2012).Medical Accidents Leading To Death And Disability Essay
Despite the numbers being strikingly high, road traffic accidents attract less media attention compared to others less frequent and out of the ordinary diseases. Road traffic systems are complex and vary between country. A systematic approach that takes into account the needs of a specific country is required in order to achieve cost-effective and long-lasting changes to road safety.
In the NHS, as in health systems worldwide, patients are exposed to risks of avoidable harm 1 and unwarranted variations in quality.234 But too often, problems in the quality and safety of healthcare are merely described, even “admired,”5 rather than fixed; the effort invested in collecting information (which is essential) is not matched by effort in making improvement. The National Confidential Enquiry into Patient Outcome and Death, for example, has raised many of the same concerns in report after report.6 Catastrophic degradations of organisations and units have recurred throughout the history of the NHS, with depressingly similar features each time.789 Medical Accidents Leading To Death And Disability Essay
More resources are clearly necessary to tackle many of these problems. There is no dispute about the preconditions for high quality, safe care: funding, staff, training, buildings, equipment, and other infrastructure. But quality health services depend not just on structures but on processes.10 Optimising the use of available resources requires continuous improvement of healthcare processes and systems.5
The NHS has seen many attempts to stimulate organisations to improve using incentive schemes, ranging from pay for performance (the Quality and Outcomes Framework in primary care, for example) to public reporting (such as annual quality accounts). They have had mixed results, and many have had unintended consequences.1112 Wanting to improve is not the same as knowing how to do it.Medical Accidents Leading To Death And Disability Essay
In response, attention has increasingly turned to a set of approaches known as quality improvement (QI). Though a definition of exactly what counts as a QI approach has escaped consensus, QI is often identified with a set of techniques adapted from industrial settings. They include the US Institute for Healthcare Improvement’s Model for Improvement, which, among other things, combines measurement with tests of small change (plan-do-study-act cycles).8 Other popular approaches include Lean and Six Sigma. QI can also involve specific interventions intended to improve processes and systems, ranging from checklists and “care bundles” of interventions (a set of evidence based practices intended to be done consistently) through to medicines reconciliation and clinical pathways.Medical Accidents Leading To Death And Disability Essay
QI has been advocated in healthcare for over 30 years13; policies emphasise the need for QI and QI practice is mandated for many healthcare professionals (including junior doctors). Yet the question, “Does quality improvement actually improve quality?” remains surprisingly difficult to answer.14 The evidence for the benefits of QI is mixed14 and generally of poor quality. It is important to resolve this unsatisfactory situation. That will require doing more to bring together the practice and the study of improvement, using research to improve improvement, and thinking beyond effectiveness when considering the study and practice of improvement.Medical Accidents Leading To Death And Disability Essay
Uniting practice and study
The practice and study of improvement need closer integration. Though QI programmes and interventions may be just as consequential for patient wellbeing as drugs, devices, and other biomedical interventions, research about improvement has often been seen as unnecessary or discretionary,1516 particularly by some of its more ardent advocates. This is partly because the challenges faced are urgent, and the solutions seem obvious, so just getting on with it seems the right thing to do.
But, as in many other areas of human activity, QI is pervaded by optimism bias. It is particularly affected by the “lovely baby” syndrome, which happens when formal evaluation is eschewed because something looks so good that it is assumed it must work. Five systematic reviews (published 2010-16) reporting on evaluations of Lean and Six Sigma did not identify a single randomised controlled trial.1718192021 A systematic review of redesigning care processes identified no randomised trials.22 A systematic review of the application of plan-do-study-act in healthcare identified no randomised trials.23 A systematic review of several QI methods in surgery identified just one randomised trial.Medical Accidents Leading To Death And Disability Essay
The sobering reality is that some well intentioned, initially plausible improvement efforts fail when subjected to more rigorous evaluation.24 For instance, a controlled study of a large, well resourced programme that supported a group of NHS hospitals to implement the IHI’s Model for Improvement found no differences in the rate of improvement between participating and control organisations.2526 Specific interventions may, similarly, not survive the rigours of systematic testing. An example is a programme to reduce hospital admissions from nursing homes that showed promise in a small study in the US,27 but a later randomised implementation trial found no effect on admissions or emergency department attendances.Medical Accidents Leading To Death And Disability Essay
Some interventions are probably just not worth the effort and opportunity cost: having nurses wear “do not disturb” tabards during drug rounds, is one example.29 And some QI efforts, perversely, may cause harm—as happened when a multicomponent intervention was found to be associated with an increase rather than a decrease in surgical site infections.30
Producing sound evidence for the effectiveness of improvement interventions and programmes is likely to require a multipronged approach. More large scale trials and other rigorous studies, with embedded qualitative inquiry, should be a priority for research funders.Medical Accidents Leading To Death And Disability Essay
Not every study of improvement needs to be a randomised trial. One valuable but underused strategy involves wrapping evaluation around initiatives that are happening anyway, especially when it is possible to take advantage of natural experiments or design roll-outs.31 Evaluation of the reorganisation of stroke care in London and Manchester32 and the study of the Matching Michigan programme to reduce central line infections are good examples.3334
It would be impossible to externally evaluate every QI project. Critically important therefore will be increasing the rigour with which QI efforts evaluate themselves, as shown by a recent study of an attempt to improve care of frail older people using a “hospital at home” approach in southwest England.35 This ingeniously designed study found no effect on outcomes and also showed that context matters.Medical Accidents Leading To Death And Disability Essay
Despite the potential value of high quality evaluation, QI reports are often weak,18 with, for example, interventions so poorly reported that reproducibility is frustrated.36 Recent reporting guidelines may help,37 but some problems are not straightforward to resolve. In particular, current structures for governance and publishing research are not always well suited to QI, including situations where researchers study programmes they have not themselves initiated. Systematic learning from QI needs to improve, which may require fresh thinking about how best to align the goals of practice and study, and to reconcile the needs of different stakeholders.38
Using research to improve improvement
Research can help to support the practice of improvement in many ways other than evaluation of its effectiveness. One important role lies in creating assets that can be used to improve practice, such as ways to visualise data, analytical methods, and validated measures that assess the aspects of care that most matter to patients and staff. This kind of work could, for example, help to reduce the current vast number of quality measures—there are more than 1200 indicators of structure and process in perioperative care alone.Medical Accidents Leading To Death And Disability Essay
The study of improvement can also identify how improvement practice can get better. For instance, it has become clear that fidelity to the basic principles of improvement methods is a major problem: plan-do-study-act cycles are crucial to many improvement approaches, yet only 20% of the projects that report using the technique have done so properly.23 Research has also identified problems in measurement—teams trying to do improvement may struggle with definitions, data collection, and interpretation40—indicating that this too requires more investment.
Improvement research is particularly important to help cumulate, synthesise, and scale learning so that practice can move forward without reinventing solutions that already exist or reintroducing things that do not work. Such theorising can be highly practical,41 helping to clarify the mechanisms through which interventions are likely to work, supporting the optimisation of those interventions, and identifying their most appropriate targets.Medical Accidents Leading To Death And Disability Essay
Research can systematise learning from “positive deviance,” approaches that examine individuals, teams, or organisations that show exceptionally good performance.43 Positive deviance can be used to identify successful designs for clinical processes that other organisations can apply.Medical Accidents Leading To Death And Disability Essay
Crucially, positive deviance can also help to characterise the features of high performing contexts and ensure that the right lessons are learnt. For example, a distinguishing feature of many high performing organisations, including many currently rated as outstanding by the Care Quality Commission, is that they use structured methods of continuous quality improvement. But studies of high performing settings, such as the Southmead maternity unit in Bristol, indicate that although continuous improvement is key to their success, a specific branded improvement method is not necessary.45 This and other work shows that not all improvement needs to involve a well defined QI intervention, and not everything requires a discrete project with formal plan-do-study-act cycles.Medical Accidents Leading To Death And Disability Essay
More broadly, research has shown that QI is just one contributor to improving quality and safety. Organisations in many industries display similar variations to healthcare organisations, including large and persistent differences in performance and productivity between seemingly similar enterprises.46 Important work, some of it experimental, is beginning to show that it is the quality of their management practices that distinguishes them.47 These practices include continuous quality improvement as well as skills training, human resources, and operational management, for example. QI without the right contextual support is likely to have limited impact.Medical Accidents Leading To Death And Disability Essay
Important as they are, evaluations of the approaches and interventions in individual improvement programmes cannot answer every pertinent question about improvement.48 Other key questions concern the values and assumptions intrinsic to QI.
Consider the “product dominant” logic in many healthcare improvement efforts, which assumes that one party makes a product and conveys it to a consumer.49 Paul Batalden, one of the early pioneers of QI in healthcare, proposes that we need instead a “service dominant” logic, which assumes that health is co-produced with patients.Medical Accidents Leading To Death And Disability Essay
More broadly, we must interrogate how problems of quality and safety are identified, defined, and selected for attention by whom, through which power structures, and with what consequences. Why, for instance, is so much attention given to individual professional behaviour when systems are likely to be a more productive focus?50 Why have quality and safety in mental illness and learning disability received less attention in practice, policy, and research51 despite high morbidity and mortality and evidence of both serious harm and failures of organisational learning? The concern extends to why the topic of social inequities in healthcare improvement has remained so muted52 and to the choice of subjects for study. Why is it, for example, that interventions like education and training, which have important roles in quality and safety and are undertaken at vast scale, are often treated as undeserving of evaluation or research?Medical Accidents Leading To Death And Disability Essay
How QI is organised institutionally also demands attention. It is often conducted as a highly local, almost artisan activity, with each organisation painstakingly working out its own solution for each problem. Much improvement work is conducted by professionals in training, often in the form of small, time limited projects conducted for accreditation. But working in this isolated way means a lack of critical mass to support the right kinds of expertise, such as the technical skill in human factors or ergonomics necessary to engineer a process or devise a safety solution. Having hundreds of organisations all trying to do their own thing also means much waste, and the absence of harmonisation across basic processes introduces inefficiencies and risks.Medical Accidents Leading To Death And Disability Essay
A better approach to the interorganisational nature of health service provision requires solving the “problem of many hands.”53 We need ways to agree which kinds of sector-wide challenges need standardisation and interoperability; which solutions can be left to local customisation at implementation; and which should be developed entirely locally.14 Better development of solutions and interventions is likely to require more use of prototyping, modelling and simulation, and testing in different scenarios and under different conditions,14 ideally through coordinated, large scale efforts that incorporate high quality evaluation.Medical Accidents Leading To Death And Disability Essay
Finally, an approach that goes beyond effectiveness can also help in recognising the essential role of the professions in healthcare improvement. The past half century has seen a dramatic redefining of the role and status of the healthcare professions in health systems54: unprecedented external accountability, oversight, and surveillance are now the norm. But policy makers would do well to recognise how much more can be achieved through professional coalitions of the willing than through too many imposed, compliance focused diktats. Research is now showing how the professions can be hugely important institutional forces for good.5455 In particular, the professions have a unique and invaluable role in working as advocates for improvement, creating alliances with patients, providing training and education, contributing expertise and wisdom, coordinating improvement efforts, and giving political voice for problems that need to be solved at system level (such as, for example, equipment design).Medical Accidents Leading To Death And Disability Essay
Improvement efforts are critical to securing the future of the NHS. But they need an evidence base. Without sound evaluation, patients may be deprived of benefit, resources and energy may be wasted on ineffective QI interventions or on interventions that distribute risks unfairly, and organisations are left unable to make good decisions about trade-offs given their many competing priorities. The study of improvement has an important role in developing an evidence-base and in exploring questions beyond effectiveness alone, and in particular showing the need to establish improvement as a collective endeavour that can benefit from professional leadership.Medical Accidents Leading To Death And Disability Essay